Rosacea – Beauty and the Beast
Are you a fair skinned, easily blushing maiden who seems to descend straight from medieval minstrels’ songs? Is your skin extremely sensitive to cosmetics and responds to cold temperatures, sharp winds, alcohol and spicy foods with a delicate pink flush spreading over your nose and cheeks? Have you ever noticed small reddish bumps on your forehead and nose? Have you ever noticed that your skin can be oily in one area, yet dry and flaky in another? If you've answered “yes” to most of these questions, you may have rosacea.
Rosacea is a very common skin disorder that, according to official estimates, affects over 10 million Americans. The actual numbers may be even higher since many people with mild cases of rosacea never visit the doctor. Rosacea predominantly affects fair skinned individuals of Northern European origin (Scandinavian etc.); however, other skin types may be affected as well.
In the beginning the only symptoms of rosacea may be a poetic tendency to blush easily, an extreme sensitivity to cosmetics and a rosy glow that appears on the nose and cheeks after exposure to cold air, eating spicy foods or drinking alcohol. At this stage, many people regard those symptoms as one of the characteristics of their skin and see no reason to consult a dermatologist.
Yet as rosacea progresses the symptoms become more worrisome – some areas of the skin become dry and covered with silvery scales, while in other areas you may notice enlarged oil glands (as is the case with acne). The presence of pink or red bumps that look like pimples may add confusion and indeed, at this stage, many people think that they just have a mild case of acne. Until recently, many dermatologists called rosacea “adult acne” or “rosacea acne”. However, rosacea is completely unrelated to acne. In fact, many anti-acne cosmetic products and over-the-counter medications may make rosacea even worse.
In some cases, untreated rosacea may lead to fibrous deposits under the skin of the nose and cheeks – causing a red bulbous nose and puffy cheeks. Many individuals who let their rosacea progress that far may suffer from an adverse social image. Unfortunately, such facial features (a swollen red nose and puffy, inflamed cheeks) are commonly associated with excessive imbibing of hard liquor. Even though you may be a teetotaler, a prospective employer may turn down an individual due to a tale-telling appearance.
In youth, your easily blushing face might be considered charming and poetic. But as you become older, a tendency to turn red when agitated may be interpreted as evidence of a violent temper, even if you are as docile as a lamb. Yes, even though rosacea starts small and can even make your appearance rosy and poetic, with time it becomes ugly. Beauty turns into the beast.
What Causes Rosacea?
It wasn't very long ago that scientists had no idea what caused rosacea. Today, we understand some key mechanisms that are responsible.
1) Abnormal production of antimicrobial peptides. Individuals with rosacea have abnormally high production of an enzyme (kallikrein 5) which is involved in the processing of cathelicidin – an antimicrobial peptide that causes vascular reactions and inflammation. Normally the skin produces antimicrobial peptides in response to microbes, excessive UV-radiation, cold temperatures, irritants etc. as part of its defense reaction. With rosacea, this normal defense reaction causes trouble, leading to skin reddening and inflammation.
2) Reactive Oxygen Species (ROS). ROS are free radicals of oxygen that are constantly produced in our skin as part of normal metabolism, after UV-radiation, and in the course of inflammation. Normally, a robust antioxidant system in skin detoxifies ROS, keeping them under control. Today we know that for people who have rosacea, different adverse factors such as microbes, irritants, excessive UV-radiation and others activate a special signal pathway that leads to a sharp increase in ROS production. If the antioxidant system is unable to detoxify them, ROS may aggravate inflammation and vascular reactions, as well as damage skin cells and proteins, all of which will accelerate aging.
3) Imbalance between metalloproteinases and their inhibitors. Your skin uses a class of enzymes called matrix metalloproteinases (MMP) to break down damaged fibrous proteins – collagen, elastin and others. This action is balanced by a class of molecules called metalloproteinase inhibitors. A fine balance between MMP and their inhibitors is maintained in skin remodeling and wound healing, allowing prompt degradation of damaged and worn out collagen, while avoiding excessive damage. UV-radiation, ROS and other factors may over-activate MMP, but usually the balance is quickly restored. In people with rosacea the skin cannot restore the balance that easily, which leads to excessive degradation of collagen as well as fibrous deposit formation.
If you have rosacea your golden rule is “Avoid irritants”. The unpleasant tingling sensation and reddening of the skin that you experience after applying certain cosmetic products is a sign that your skin’s defense mechanisms are activated. Those with normal skin can ignore it. But if you have rosacea, this means that your skin starts abnormal production of antimicrobial peptides, generation of ROS and activation of metalloproteinases.
This is not fun, because every time it happens, the condition progresses a tiny step further. Often you may hear at the cosmetic counter that if your skin gets red and start tingling, this means that the product is “working”. Do not believe such statements. For you, the best products are the ones your skin doesn’t notice.
Wash your face with only neutral and very mild cleansers (pH around 7). Avoid harsh alkaline soaps, alcohol based cleansers, hot or very cold water. After washing your face, gently pat it with a soft towel – DO NOT RUB. Apply a thin coat of a protective moisturizer. Since many cosmetic moisturizers contain irritants, explore natural moisturizers such as squalane and emu oil.
Avoid harsh solvents such as alcohol and acetone. Stay away from artificial dyes and perfumes. Be sure to check if a cosmetic product you use contains harsh detergents. Components such as sodium lauryl sulfate must be avoided.
What About Sunlight?
So if UV radiation is one of the factors that aggravate rosacea, does that mean that you should avoid sunlight? Not necessarily.
In fact, doing that may be a grave mistake. Your skin needs the healing power of the sun and it needs vitamin D. Of course that doesn’t mean you should go to a tanning booth or spend the whole day on the beach baking under the blazing sun. Sensibility is the key.
Expose your skin to the healing sun in the morning hours and no more than 15-30 minutes. Full body exposure is the best, since it allows maximum vitamin D synthesis stimulation with minimum exposure time.
On other occasions, use a physical sunblock with titanium dioxide and wear a hat with a wide brim to protect your face.
The Power of Copper Peptides
Rosacea is a medical condition and it must be treated by a medical professional. As with any other condition, you will get better results if you assist your skin by creating a favorable environment for its healing mechanisms.
The truth is that copper peptides have been proven to alleviate many factors that cause rosacea. In addition, they are very safe and have many other beneficial actions on the skin such as wrinkle reduction and stem cell activation.
1) The human copper binding peptide GHK-Cu discovered by Dr. Loren Pickart in 1973 demonstrates remarkable anti-inflammatory and antioxidant power. It can reduce inflammation by lowering the level of inflammatory cytokines, such as TNF-alpha and TGH-beta, as well as inhibit iron release from ferritin. It stimulates production of antioxidant enzymes, supplies copper required for the major skin antioxidant superoxide dismutase (SOD), and quenches many toxic products of fatty acid peroxidation.
2) Copper peptide GHK-Cu regulates skin remodeling by up- and down-regulating MMP and their inhibitors, preventing excessive collagen degradation and fibrosis.
3) GHK-Cu increases decorin – an antioxidant, anti-inflammatory and anti-scarring protein, preventing skin fibrosis.
4) In addition copper-peptides improve the skin barrier, lessening the risk of skin irritation and protecting it from the adverse effects of UV-radiation. Copper-peptides reduce excessive skin oil production and help skin to manage microbial infection.
You may also want to explore natural skin protectors such as squalane – a natural component of skin oil, Emu Oil – a healing oil used by native Australian people, Aloe Vera gel – which has anti-inflammatory and moisturizing effects, and plant antioxidants such as lutein and lycopene.
Vitamin compounds known as tocotrienols – a form of vitamin E – have been shown to accumulate in the skin thereby protecting it from harmful effects of UV-radiation. In addition, select essential oils such as lavender and pumpkin oil have a pleasant scent and also reduce irritation. However it is important to always thoroughly research your options before you purchase, since many cheap essential oils today are adulterated with synthetic compounds which can cause further irritation.
With proper care your delicate skin can remain beautiful despite rosacea and its rosy glow can continue to inspire dreams for many years to come.
Any suggestions mentioned are not for the treatment or prevention of any skin disease or condition.
If you have a special skin concern, please consult a physician or dermatologist first.
Questions or Advice?
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