If you’re a rosacea sufferer, then you’ve probably had many conversations with your skin asking it questions like, “why are you upset?” and, “can’t I just have one glass of wine without you getting mad!?” It can really feel like you’re having relationship problems with a part of your body at times. The key in understanding this relationship is not blaming your skin for all the trouble but understanding that rosacea is also an internal condition presenting in the skin. We’ll get into the nitty gritty behind that point throughout this blog, but I can’t stress enough that if you aren’t willing to look within, then you may continue to feel like your skin has a mind of its own.
What causes rosacea?
Rosacea is defined as over angiogenesis (overproduction) of capillaries with thinning of the epidermis. This presents as redness and sometimes swelling on the face, particularly on the cheeks, chin and forehead. This isn’t a cause so much as a branch symptom often combined with a compromised skin barrier and disordered skin cells. This is worth mentioning first because many rosacea sufferers seek only topical treatment as initially. Depending on the treatments they receive it may lessen the look of rosacea, but if the root cause isn’t addressed it can come back in full force down the track.
SIBO – Small Intestinal Bacterial Overgrowth
More recently an overgrowth of bacteria in the small intestine has been linked to rosacea. This gut imbalance can cause histamine intolerance which is often to blame for flushing after eating certain foods. 50% of rosacea sufferers are said to have SIBO which is a massive percentage! Normally bacteria in 1mL of small intestinal fluid is 10,000, but in SIBO sufferers it’s 1000,000,000,000. Some of the causes of SIBO are low stomach acid and slow peristalsis with ties to gluten sensitivity. Folks with SIBO often have a mild form a coeliac disease which causes pockets to form in the small intestine and house bacteria. With this in mind you can imagine how important diet and supplementary support is! You can work with a naturopath or nutritionist to test for SIBO and get to work treating it. Many people report feeling much less bloated and their skin much less reactive when the SIBO is irradicated.
Demodex Folliculorum are mites that live in our hair follicles! That’s right, everyone has them! For most people it’s not a problem, but the theory is that the excretion from the mites causes skin infection. More recently it’s thought that an overabundance of mites triggers an immune response. They’re plentiful in the typical rosacea areas of the nose, cheeks, chin and forehead and have been found in biopsies of papules and pustules. The balance of the skin is particularly important when it comes to this theory, as the skin’s PH balance is meant to help keep these mites in check. Western medicine typically prescribes antibiotics to deal with the skin infections caused by the mites, while skin therapists tend to repair the skin’s barrier to control the overproduction.
Cathelicidins are an important host defence peptide that plays crucial roles in innate and adaptive immunity. It can eliminate pathogenic microbes, modulate host immune responses, and promote wound healing. When activated they attract neutrophils (white blood cells) causing inflammation that can show up for rosacea sufferers as watery blisters. Cathelicidins are present in everyone’s skin, but those with rosacea tend to have higher concentrations of them, with the added issue of thin skin which can lead to the cathelicidins reacting more. The key is to build up the skin’s barrier so the immune cells underneath can relax and not kick up such an inflammatory fuss!
Chinese Medicine’s point of view
From a CM point of view, we tend to look for patterns that contribute to the heat and flushing of rosacea. Here’s a few CM patterns associated with rosacea (this is by no means an exhaustive list):
- Heat in the lungs/stomach – red popular rash of the cheeks
- Toxic heat – red pustular rash with swelling of the nose
- Blood-heat – Red papular rash aggravated before or during menstrual cycle
- Blood stasis – Dark red or purple papular or pustular rash of cheeks and nose
- Yin deficiency – malar flush
- Yang rising – flushing that occurs when emotional
The treatment of rosacea should take on a multifaceted approach that includes addressing the skin’s barrier and cells within, the gut and whatever other accompanying systems are involved (Eg. hormones). In my practice I’m able to work with all aspects, both internally and externally. If you’re working with a skin therapist find a good naturopath, nutritionist or CM practitioner to help you address the internal factors. You’ll end up with a better, long-lasting result.
Here’s a snapshot of what I do in my practice:
Rebuild and Restrengthen the skin:
- High dose Omega 3’s (EPA/DHA)
- Recommend skincare that supports and repairs the skins barrier
- Prescribe serums with active ingredients that calm the immune cells within the skin and encourage the stem cells producing healthy new skin cells
- After the skin is properly prepared use skin needling to break down overproduction of capillaries
Address internal imbalances:
- Test for SIBO
- Look at hormonal influences
- Diet changes – Eg. heaps of alkalizing greens
- Address CM patterns with acupuncture and herbal medicine
- Heal gut
If you suffer from rosacea and resonated with this blog post, don’t hesitate to reach out with any questions you might have. I also offer 15-minute free skin consultations where we can sit down and chat one-on-one.
Andrea Murphy works on a Wednesday, Thursday and Friday from 2pm to 8pm and a Saturday from 9am-2pm.
138 Tanti Avenue, Mornington, VIC
03 5973 6886