by kerry watsonthis is a question we get asked a lot at sS especially when we are working with a client that tends towards having a rosy complexion. unfortunately, this is not a question that we, as estheticians, can answer. rosacea is a condition that can only be diagnosed by a medical doctor like a dermatologist. what exactly is rosacea? this is a question that we can answer:rosacea is a disorder that mainly affects the skin of the face, causing flushing, redness and in some cases, inflamed papules and pustules. it is most commonly seen on the nose and cheeks but it can also show up on the forehead and chin or even on other parts of the body like the chest, neck or back and in some cases the eyes. the redness and flushing comes from the dilation of capillaries underneath the skin. there are four basic types of rosacea. you can have just one type, or you can have more than one.1st type: facial rednessthis is the most common type and the one that most people are familiar with. symptoms can include the following:- stinging, burning, sensitive skin- distended blood vessels that are visible underneath the skin- dry, rough or swollen skin- blushing or flushing with exposure to triggers2nd type: breakoutsthis type causes papules and pustules on the skin that can look like acne. it's the 2nd most common type of rosacea. other symptoms can include:- oily skin- patchy raised areas on the skin- small visible blood vessels- sensitive skintype 3: thick skinthis type of rosacea is rare. most people have another type first. left untreated, it can cause skin thickening on the nose, making it look enlarged. other symptoms can also include:- bumpy skin- large pores- oily skintype 4: ocular rosaceathis type affects the eyes. if not treated, ocular rosacea can cause vision problems. other symptoms include:- dry eyes- burning or stinging of the eyes- blurry vision- frequent styeswhy does this happen? there are several different factors that can cause/worsen the condition. this site is an excellent resource in understanding rosacea and its causes. i'll highlight a few here as well.genetics:generally, if you are diagnosed with rosacea someone else in your family has it too. it's one of those genetic conditions (like acne). there's not much we can do about our genetics but we can control and avoid the triggers that make the condition worse. triggers:the flushing can be triggered by a variety of causes. some of the most common triggers include stress, hot beverages, alcohol, spicy foods, some mediations, heat and caffeine. the more often someone with rosacea is exposed to their particular triggers the more often the flushing occurs. constant capillary distention over time often leads to the loss of elasticity in the capillary wall. think of a rubber band that has been stretched so many times that it doesn't bounce back to it's original size. loss of elasticity in the capillary wall causes permanent distention and inflammation which manifests on the skin as redness or a constantly flushed appearance. avoiding triggers is a major part of controlling the condition. also avoiding instances where the capillaries dilate and constrict is key. an example of this would be washing with super hot water and then rinsing with cold water. this would be remedied by washing and rinsing with tepid water only.something that i've come across and find interesting is that many clients with rosacea experience migraines (either themselves or someone else in their family), which is another condition involving dilation and constriction of the capillaries (of the brain instead of the skin). my dad has severe rosacea. i have mild rosacea and migraines. also, many of the triggers for migraine are the same as those of rosacea. the demodex mite:in recent years more scientific evidence has shown a strong correlation between rosacea and increased numbers of demodex mites in the skin. the demodex mite is a microbe found in at least 80% of human facial skin. normally, its presence doesn't produce any symptoms but higher than average numbers have been consistently found on the skin of rosacea patients. it is believed that a bacteria found on the demodex mite may trigger an inflammatory immune response in the skin that causes rosacea to develop. find out more about the fascinating link between the demodex mite and rosacea here.conventional medications:if you are diagnosed with rosacea your doctor may prescribe some of these medications. keep in mind that many of the ingredients prescription topical products contain are cloggy and can lead to acne breakouts. also, we cannot treat you with extractions, peels or an active home care regimen. if you are using any topical or internal medication that can make your skin more reactive, sensitive or unpredictable unless you provide a note from your doctor.finacea gel 15% is a topical prescription medication containing azelaic acid. this medication is most effective for treating the inflamed papules and pustules that can accompany the general redness of rosacea in some people. there are several common side effects of note including burning, stinging, tingling, dryness, tightness, flaking, itching, redness and irritation topically. dizziness, headache, diarrhea, nausea, stomach pain, loss of appetite constipation, changes in taste, furry tongue and dry mouth have also been reported with topical use.(source rxlist.com)metronidazole or metro-gel 1% is another topical medication that is commonly prescribed to treat rosacea. this product has anti-inflammatory and antimicrobial effects. side effects include stinging, burning, redness, irritation, dryness, scaling, itching, metallic taste, nausea, headache, numbness, tingling feeling in hands/feet, stuffy nose, sore throat, cold symptom, vaginal itching or discharge.antibiotics (topical, oral) are often used for their temporary anti-inflammatory effect. once the course of antibiotic treatment is over the symptoms of inflammation can return and even worsen. antibiotics can also wreak havoc on other parts of the body, the digestive tract and immune system in particular. antibiotic medications do not distinguish between good and bad bacteria in the body, they just kill bacteria period. this includes the beneficial bacteria that lives in the small and large intestines which helps us breakdown and absorb nutrients from our food and makes up an important part of our immune system that protects us from food borne illness and harmful microbes. commonly prescribed antibiotics include tetracycline, minocycline, erythromycin, clindamycin and doxycycline.steroid creams are sometimes prescribed to help reduce topical inflammation and redness temporarily. steroid creams can make rosacea worse if used for longer periods of time. in addition, they can thin the skin making it prone to bruising, tearing and premature aging.we can help:we have treated many rosacea clients for acne and general skin health with great success. the first step is getting the skin in a healthy place so that it can tolerate the active products that help reduce inflammation and properly exfoliate the skin. a gentle moisturizing regimen is the first step. when the skin is ready we'll add in a mild exfoliant like our mandelic blend toner at a low to moderate percentage. once this regimen is being well tolerated for at least 2 weeks we can add benzoyl peroxide in the form of a face wash or gel. and then after a few more weeks we introduce a salicylic serum. the combination of benzoyl peroxide and salicylic acid is extremely successful in calming the inflammation of rosacea and getting the skin to a less reactive place. just like with acne, a combination of the right diet, lifestyle (avoiding triggers) and skin care products can make all the difference in rosacea.* please remember that we are not doctors. we do not prescribe, treat or diagnose. we hope to be able to empower you with knowledge, different tools and alchemy to help you sustain the best version of yourself! if you think you may have rosacea please contact your dermatologist to get a proper diagnosis and keep him or her updated on the products that you are using on your skin as well as any supplements or dietary changes you decide to make.