Rosacea: Expert Advice on Symptoms, Triggers & How to Calm Your Skin

If I were granted three wishes, one of them would definitely be for there to be a cure for rosacea. It is a skin condition that we still know very little about the “why” and one that frustrates me the most because it is, at the moment, incurable. What we can do though is treat the symptoms, and for many doing that successfully really changes how they feel about their skin.

Rosacea is classified in four ways:

1. Vascular Rosacea is the more common form which presents itself with erythema and telangiectasia. Erythema skin is skin that has an all over redness or flushing in the cheeks, nose, forehead or chin. It can present in all or just some of those areas. You may also find that there is some telangiectasia involved as well. This is where you can actually see more pronounced capillaries in the areas of flushing.

2. Papular and Pustular Rosacea will often have the flushing we see with Vascular Rosacea, but will also include pustules and papules on top of the flushed areas. This is often called Acne Rosacea.

3. Ocular Rosacea presents itself in the eyes, often creating watery and bloodshot eyes with increasing irritation and swelling around the eye lids.

4. Phymatous Rosacea happens when there’s a thickening of the skin, this often occurs on the nose making it more bulbous.

Rosacea is more common in women, which is believed to be down to hormones – but men can have it more severely.

In my years of treating skin and having hundreds of rosacea clients, I have learned that every rosacea client's experience is different, with different triggers and different ‘fixes’. It’s important to note that the mental impact can be huge, too, so I try to remind clients all the time that it is not their fault. If you are reading this, you did not do anything to give yourself rosacea, so please don’t beat yourself up about it. 

These are all tips that have worked really well on my clients with rosacea to calm the symptoms down.

1. Clinisoothe. I cannot stress this enough. Post cleansing, before serums and moisturisers. Clinisoothe is excellent at calming irritated and inflamed skin. If you are not using it, get it STAT.

2. Stay away from gel and foaming cleansers. These can strip your acid mantle, and we need that acid mantle to protect us from our day to day environmental stressors, as well as to keep our lipid balance, well, balanced. A gentle cream or milk based cleanser (preferably without a lot of fragrance) is what I recommend. Always remember to gently remove your cleanser with a warm (ish) flannel. Please do not splash your cleanser off. It can lead to other problems like acne and blackheads. I have found LaRoche Posay's Toleriane Dermo Cleanser to be very gentle and it will also remove make-up.

3. Wash your sheets weekly. Skin with rosacea doesn’t need/want any extra bacteria, so clean sheets are very important. I recommend washing weekly in hot water.

4. Keep your gut in check. A good probiotic somewhere between 30-50 billion cultures for 90 days helps to reduce inflammation in the body, which will in turn help to reduce inflammation in the skin. I always recommend Wild Nutrition’s probiotics which are food-grown for better absorption. A healthy, well-functioning gut really does help to improve your skin's health.

5. A good quality PHA product (preferably one that isn’t formulated with an AHA) will help to reduce inflammation and hydrate the skin. Mortar & Milk’s PHA Barrier Repair Serum is obviously my favourite.

6. If you have rosacea, please do not use products with AHA’s in them. I would also steer clear of dedicated retinol products.

7. Minimise really hot showers and baths, steam rooms and hot tubs. I would also try to reduce or remove spicy foods and keep high histamine foods to a minimum.

8. It is also a good idea to keep a food diary. Not necessarily a day-to-day diary, but when you have a flare up write down everything that you ate and drank over the last 48 hours. Ultimately you should see a pattern.

9. There are a number of medications that your doctor can prescribe, but it’s important to note that while one may work for one person, it may not work for another, so it's important to not give up and to keep working with your dermatologist.

10. If you have papular/pustular rosacea, getting a little bit of mandelic acid in your routine can help with the spots. Exuviance’s Night Corrector is a great formula for anyone with congested skin. It uses mandelic acid along with PHA’s to clear out the congested pores and reduce inflammation.

It is reminded that anyone that is reading this that I know it is frustrating, and I know if you’re reading this, you’ve probably been given loads of different advice to no avail. The above bits of advice are simple yet effective ways to reduce inflammation. There’s no miracle answer sadly but in concert these changes can make a meaningful impact on reducing your symptoms.

Try Clinisoothe+ Skin Purifier, a gentle product to add to your skincare routine. Simply spritz your skin after cleansing and allow the product to soothe irritation and reduce the appearance of redness.

Pamela Marshall, our Resident Skin Health Expert, Clinical Aesthetician and Co-Founder of Mortar & Milk London.