'Tis the season to suffer red itchy skin: How cold walks and mulled wine mean misery for the one in ten with rosacea
23:22 GMT, 17 December 2012
Roaring fires, mulled wine, and stress — Christmas is enough to make anyone red in the face.
But as one of the one in ten people who suffer with the skin condition rosacea, I really dread this time of year.
I fit the typical profile of a rosacea sufferer — a fair-skinned woman in my 30s.
'At work, in a meeting people would often misread my flushing, thinking I was flustered,' said Rosie Green
I first noticed it in my 20s, when a few drinks or work stress would leave me rosy-cheeked.
But it really took hold a decade ago, when I was 30, when the combination of motherhood and a full-on career as a magazine beauty editor caused my stress levels to soar.
The juggling act left my skin red, irritated and dry — when I was organising a particularly stressful shoot I would get a butterfly of redness across my nose and cheeks.
Gradually it would worsen and I’d see burst blood vessels on my cheeks and occasionally angry bumps in the mirror. Instead of fading in a few hours, a flush would last all evening.
It was distressing, not least because in my job, good skin is practically a prerequisite.
At first, I tried to combat the redness by loading on more skincare products, but if anything this made it worse, until I was pretty much in a permanent state of itchy redness.
After six months of suffering, I saw a dermatologist, who immediately diagnosed rosacea.
Rosacea is thought to have a strong genetic link; medics agree that sufferers are born with inefficient veins, which gives them a propensity to flush.
Flushing exhausts the blood vessels, so they struggle to dilate and constrict properly.
Normally, when we flush the blood vessels open and then constrict, but in those with rosacea they remain dilated, leaving the skin permanently red.
Fifteen years on, Rosie still has redness on her cheeks and nose, and her rosacea flares up at least twice a year
‘Genetics are clearly important,’ says Harley Street dermatologist Dr Sam Bunting.
‘Hence the preponderance of rosacea amongst fair skinned, light-eyed people of Celtic origin.’
But doctors are baffled about what causes this to happen and why it tends to strike when people are in their 30s.
Some theories blame a microscopic mite (Demodex folliculorum) found on the skin of sufferers, or a bacterium called H. pylori that is thought to stimulate the blood vessels into over use.
My symptoms were typical — experts talk of a scale that starts with flushing, progressing to persistent redness, then developing spots and papules, then visible blood vessels.
More extreme cases can result in thickened skin, a red swollen nose and eye irritation, but according to Dr Bunting ‘this is rare and much more likely to be in men that women’.
Again, doctors don’t know the reason for this.
The condition is not dangerous to health, but it can be damaging to self-esteem — as Jenny Dyson discovered.
The 40-year-old company director from London has suffered with rosacea for more than a decade and she can pinpoint the exact day it kicked off.
‘I was one month into a new job, my boyfriend had some personal problems and I couldn’t leave the office to support him.’
The next day she woke to find, in her words, ‘pizza face’ and so began a 15-year battle with red, inflamed skin — and its effect on her confidence.
‘At work, in a meeting people would often misread my flushing, thinking I was flustered,’ she says
Her social life suffered, too, when rosacea-induced redness led to ‘men thinking you fancied them’. Her self-esteem was also affected.
The standard treatment is a cream containing the antibiotic metronidazole (brand name Rozex), which works by killing bacteria.
Another option is azeliac acid (such as Finacea gel), a compound found in wheat, rye and barley, which kills bacteria as well as reducing the growth of certain surface skin cells that can block pores and cause spots.
‘Those with more severe or persistent disease may need supplementation with oral antibiotics,’ says Dr Bunting.
These are usually tetracycline, metronidazole or erythromycin.
For those who do not like the thought of long-term use (complaints of thrush abound) doctors may prescribe the drugs as and when needed.
Many people with rosacea try to overload it with skin treatment products, but in fact this is the worst thing you can do, says Dr Bunting.
‘Women are desperate for their skin to look good so they throw everything at it, but deep cleansing, exfoliating products and masks are all stripping processes that can worsen the condition,’ she explains.
Many people with rosacea try to overload it with skin treatment products, but in fact this is the worst thing you can do
‘Rosacea sufferers’ skin is flaky and dry as their skin barrier is weaker, and not so effective at keeping moisture locked in.
'The key is to pull back on exfoliators and moisturise instead.’
Jenny tried everything from antibiotics (which reduced the inflammation but the redness raged on), a no-sugar diet (‘impossible to stick to’) and endless beauty products (‘generally disappointing’) — but nothing worked.
Fifteen years on, she still has redness on her cheeks and nose, and her rosacea flares up at least twice a year.
She uses a multi-pronged approach of occasional courses of metronidazole antibiotic cream and a moisturiser with a high SPF.
The difference now is she has grown to accept the condition (‘it’s part of who I am’) — and perhaps, as a result of this, her flare-ups are less frequent.
In my own case, antibiotic pills worked, and within days suddenly I had clear skin again. I rejoiced, but once I stopped taking them the redness crept back.
So instead I worked out my triggers. These can include alcohol, sun exposure, wind, spicy food, heating, hot baths, saunas, hot or cold weather, heavy exercise and fragrance, says Dr Bunting.
‘Going from cold to heat will invoke a vascular response — the little capillaries are flooded with blood,’ she says.
‘Most people experience these blood vessel changes in the skin – this is how we regulate our body temperature — but in rosacea sufferers these are exaggerated.’
Having cut out red wine and spicy food and reduced my stress levels by swapping my office job for a home-based one, I now have my rosacea pretty under control.
I also have annual intense pulsed light therapy, which shrinks the capillary network, reducing visible red veins.
At upwards of 300 a go, it’s not cheap but it seems to work.
I stick to a puritanical skin care regimen with no exfoliators, and wear sunscreen every day, too, even in winter — sunlight is a big rosacea trigger.
But still I dread this season of goodwill — just when I want to look my best the condition always flares up.
Dr Bunting says this is very common.
‘Christmas time brings temperature fluctuations,’ she says.
‘We also know alcohol will make those blood vessels open up and that stress will exacerbate any condition like rosacea.’
‘It’s hugely emotive,’ she adds, ‘people can get very self-conscious.’
My advice to anyone dreading a red-faced Christmas: steer clear of stress and log fires and try to remember, when it comes to booze and beauty products, less is most definitely more.