You’re in your thirties and confident that those former anxieties about teenage acne are ancient history. Then you begin to notice something. Hmm… your cheeks…your chin…and the bridge of your nose seem to redden easily, especially when you eat some spicy food or drink alcohol. At first you think nothing of it, and don’t mind when friends comment about your “healthy glow.” But then, this odd redness just doesn’t seem to go away. When you examine your skin carefully, you see lots of tiny blood vessels. Your face appears a little swollen, and it definitely feels tender. Since the resemblance to Santa Claus is getting a bit unnerving, you decide it’s time for some help.
During the ensuing visit to the dermatologist, you learn that you’ve joined the 5% of adults who live with rosacea. Although the cause of this skin condition is unknown, and conventional treatments for it don’t seem to work all that well, some of our WholeHealth Chicago suggestions may really help.
Rosacea is a chronic skin condition in which areas of the cheeks, nose, forehead, and chin repeatedly become florid, and numerous small, spidery blood vessels appear just below the skin. The reddish patches grow progressively more inflamed, and in many cases, the inflammation becomes permanent. Clusters of tiny bumps or pimples may erupt in these areas, sometimes resembling the acne typical among adolescents. (It was this resemblance that at one time gave rise to the misleading description of rosacea as “adult acne.”) In more severe cases, mainly among men, a thick, reddish layer of bumps may form around the lower part of the nose. Rosacea affects some 13 million Americans, or about 5% of the overall population. Among fair-skinned individuals, though–particularly those of Irish and British ancestry–the incidence is much higher. Women between the ages of 30 and 60 are most likely to be affected, and women in general are three times more likely to develop it than men are. However, men tend to have worse symptoms and are usually the ones who develop the “W.C. Field’s nose,” called rhinophyma.
At present there is no cure for rosacea, which often becomes progressively more severe when left untreated. Current medical therapy typically includes an open-ended use of antibiotics or the topical antiprotozoal cream metronidazole.
- Excessive flushing; frequent and prolonged redness on the cheeks, nose, forehead, and chin.
- Clusters of tiny red spots and bumps in the affected area.
- A rough, reddish swelling around the nose.
- A sensation that your skin is stretched too tightly across your face
- Itching or burning around the eyes; a bloodshot appearance.
What Causes Rosacea?
The underlying causes of rosacea are assumed to be genetic, or a combination of genetic and environmental factors. Some researchers believe that a circulatory disorder is involved; others that the inflammation is caused by mites living in facial hair follicles. The precise mechanisms are still unknown, but blood vessels in the skin clearly lose their normal elasticity, dilating too easily and sometimes permanently.
Cigarette smoking increases a person’s vulnerability to rosacea because nicotine interferes with vascular function.
Other stimuli that can trigger flare-ups are common in everyday life, and include virtually anything that might cause flushing:
Dietary habits such as drinking coffee or alcohol, or eating hot or spicy foods.
Changes in weather; extremes of heat, cold, humidity, wind, or sunlight.
Psychological factors that tend to produce flushing, such as stress, anger, or embarrassment.
Use of niacin, certain blood-pressure drugs, and other medications.
Hormonal changes, especially those experienced by women during menopause.
Treatment and Prevention
Rosacea is a chronic condition, and its treatment needs to be approached as a long-term program. One aspect of this is patience: A month of supplement therapy may go by before any results are visible, and it is important not to give up the effort prematurely. At the same time, the rosacea should also be examined by a physician and the use of supplements discussed with him or her to avoid interference with any prescription medication.
Most dermatologists prescribe a lengthy course of the antibiotic drug tetracycline, which seems to suppress but not cure the condition. The microscopic skin mite Demodex folliculorum, that normally lives on the surface of the skin in cast-off cells, is found in unusually high amounts among rosacea patients. Whether this triggers the inflammation or perpetuates it, is uncertain. However, most dermatologists prescribe the local application of metronidazole, an anti-protozoal cream, onto the affected areas. For some patients, but not all, the rosacea does improve. The unsightly rhinophyma, which appears predominantly on the nose, is now currently treated using dermabrasion, a surgical procedure that rubs or sands away the blemishes.
The supplement program, though certainly not a specific cure for rosacea, is designed to bring the maximum level of health to your skin. A good balance of the right vitamins, antioxidants, and essential fatty acids will maximize your own immunologic and healing capabilities.
Just a reminder: If you have a serious medical condition or are taking medication, it’s always a good idea to check with your doctor before starting a supplement program.
How Supplements Can Help
Vitamin A in doses higher than normally required by the body, has been used by dermatologists for almost 60 years for conditions involving hyperkeratosis (excessive formation of keratin, the outer layer of skin).
Taking a vitamin B complex will correct or prevent the deficiency in B vitamins occasionally noted in people with rosacea. In addition to B complex, an extra amount of vitamin B2, riboflavin, encourages the secretion of protective mucus by skin cells (thus reinforcing vitamin A), and helps eliminate cellular waste. Likewise, extra vitamin B12 is essential to the growth, repair, and replication of healthy skin cells (and other cells of the body).
Zinc helps heal the epidermis (the top layer of skin) and maintain proper levels of vitamin A in the blood. (Note that zinc should be combined with a copper supplement whenever it is used for more than a month.)
Inflamed skin can be soothed internally by increasing your intake of the essential fatty acids found in flaxseed oil and evening primrose or borage oil. They also regulate nutrition in skin cells and produce prostaglandins, hormonelike substances that cause blood vessels to contract.
Finally, in addition to its many other benefits, taking vitamin C with flavonoids strengthens the lining of blood cells and the tissue connecting skin cells. Grape seed extract may also be useful because it contains proanthocyanodins, which enhance the stability of the blood vessels.
Use only grease-free, unscented facial cleansers and makeup; avoid astringents. After washing your face, gently blot it dry; never rub or chafe it.
Soaking a cloth in cold water and pressing it gently against the flushed areas on your face for 10 minutes will reduce inflammation by causing blood vessels to constrict.
When you go outdoors, even on overcast days, wear sunscreen with an SPF rating of at least 15.
Avoid over-the-counter creams or ointments used to treat common acne; they are not meant for rosacea and actually make it worse.
Shaving with an electric razor instead of a blade helps some men reduce the severity of flare-ups.
Keeping a trigger diary is the best way to pinpoint activities and other stimuli that lead to flushing. Common culprits include alcohol, hot beverages, spicy foods (chilis, curries), saunas and steam baths, as well as very high doses of the B vitamin niacin.
Avoid garments that cause friction, like turtleneck shirts and tight collars.
Avoid topical steroid creams as these may worsen the condition.
When to Call a Doctor
- If you develop excessive flushing or any of the other symptoms of rosacea.
- If your skin remains reddish after blushing instead of returning promptly to its normal color.
From Mike Cronin, N.D. at WholeHealth Chicago: Rosacea is a chronic condition–one you may not ever completely cure. You can help keep your symptoms under control, however, by taking the supplements listed below on a maintenance basis. All of them can be used with any conventional medications your doctor may prescribe for treating rosacea.
It’s also important to avoid foods or other substances that can aggravate rosacea symptoms. Alcohol, coffee, and spicy foods are common culprits (they dilate the small blood vessels of the skin). Sun exposure, cold or windy weather, certain cosmetics, and various medications can also be rosacea triggers.
Remember, too, that with any chronic and supposedly incurable condition such as rosacea, you should always keep abreast of research advances. For example, some dermatologists have found that many rosacea patients tested positive for the same bacteria (Helicobacter pylori) that causes stomach ulcers. When this bacteria was treated and stomach function restored (often requiring supplemental enzymes and hydrochloric acid), these patients experienced an improvement in their skin status. Ask your dermatologist or a gastroenterologist about these findings.
As far as supplements are concerned, just be sure to give them a chance to work. Their full effect may not be obvious for several weeks.
How to Take the Supplements
The vitamins on our list are meant to be taken in addition to your daily multivitamin and your antioxidant complex. Vitamin A keeps skin cells from excessive thickening and hardening, while the B complex (especially the riboflavin) compensates for a deficiency in B vitamins commonly found in people with rosacea. One preliminary study also indicates that riboflavin improves the skin’s resistance to the mite Dermodex follicularum, which is considered another possible cause of rosacea. The added dose of vitamin B12 is beneficial for cell growth and repair.
Many researchers believe that people with rosacea have a disorder in the small blood vessels beneath the skin. Regular use of vitamin C and flavonoids can be beneficial because they are well-known nutritional necessities for optimal performance of blood vessels, capillaries and connective tissue.
Analysis of the digestive function in some patients with rosacea has shown both low amounts of stomach acid and of the pancreatic enzyme lipase. Some rosacea patients who take digestive enzymes with each meal have reported improvement, confirming small clinical studies.
Adding the zinc should aid in healing irritation of the epidermis, the top layer of skin; for long-term use, take zinc with copper.
Flaxseed oil also speeds the healing of skin, and along with evening primrose oil, can have an anti-inflammatory effect. This in turn can help relieve itching and irritation as well as stimulate the contraction of blood vessels.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
David Edelberg, MD