Bill Clinton’s ruddy face may not be due to illicit meetings involving cigars and interns alone, he is one of the many men and women to live with a skin condition once known as the “curse of the Celts” aka acne rosacea (AR).
While the papular form of AR is often misdiagnosed as true acne (acne vulgaris) and in fact is sometimes referred to as “adult acne” the presentation is not always as straight forward as that. AR predominantly appears around the cheeks and nose, not always with the classic acne-like pimples but as a generalised redness, exposed capillaries or an inflamed, bulbous nose. Some forms of chronic blepharitis (inflammation and crusting around the margin of the eyelids) are caused by AR.
As AR is a chronic condition, with an unclear cause, people understandably can feel a little disheartened with the diagnosis. They may find the appearance of their skin can fluctuate quite widely from a mild blush to a bright redness. Orthodox medicine tends to consider AR as a triviality, offering treatment for mainly cosmetic reasons. The most popular prescriptions are for broad-spectrum antibiotics (as in true acne) which need to be taken for many months, sometimes years, and do not always “cure”. Evidence based medicine (EBM) for AR thus far has found topical treatments – antibiotic and azelaic creams to be the most effective of the pharmaceutical options. However the later sometimes causes hair growth on the face and neck of women
Even conventional medicine acknowledges that that certain foods and beverages inflame AR and worsen the appearance. From years of clinical practice I can attest when someone follows the guidelines faithfully, it really does improve the condition.
Dietary change focuses on removing triggers that cause dilatation and inflammation of the blood vessels. The number one cause is alcohol. It appears all alcoholic beverages aggravate the vessels in this way and a single drink can provoke a flair for a number of days.
Also on the hit list are – chilli, coffee and caffeine generally.
Conversely an anti-inflammatory diet, though unproven, is a logical plan to follow. Choose foods that are unprocessed and avoid fried foods and saturated fats (animal products) as much as possible. Fish and raw vegetable oils (eg flaxseed or pumpkins seed oil in salad dressings), along with lots of fresh fruit, vegetables and raw nuts form the basis of the eating plan. Anecdotally, some people with AR have found great relief when following a vegan diet.
Like with all skin problems, drink at least 2 litres of water a day.
Echinacea can provide a viable anti-infective alternative to antibiotics in AR, however it is important you find a good quality product that includes the root of the plant. Echinacea is generally well tolerated and side effects or drug interactions are relatively rare.
There are many “skin teas” on the market following the age-old herbalist tradition of using ‘alterative’ herbs (ones that aid the organs of elimination). Common ingredients include: calendula, red clover, nettles, dandelion root and/or leaf. A good organic source of these herbs, drinking 3 cups a day, is often one of the most effective herbal treatments for this and other skin conditions.
When stress is an obvious trigger consider including chamomile to your blend. When chamomile flowers are steeped (eg in an enclosed teapot covered in boiling water) the anti-inflammatory properties of chamomile are activated, making it even more appropriate for AR.
Topical herbal creams, washes and lotions may help. Calendula is the number one ingredient to look for. The essential oil of chamomile, though pricey, is well indicated in a topical wash.
Zinc: is a long time favourite nutrient to help skin, hair and nails. Currently no EBM exists for the treatment, due to lack of research in the area. A standard adult dose is 20 mg (elemental zinc) per day.
B Vitamins: can both help and aggravate AR. Stress, a known trigger for the condition, depletes the body of a wide range of B’s, however B3 (nicotinamide) in high doses can cause vasodilation ie: flushing. At times of stress, I’d still advise a moderate B-complex, using 50 mg of B6 as a guide in a balanced B.
Stress is a recognised factor in many skin conditions including AR. Physiologically, any situation (emotional or physical) when we feel unsafe will activate the autonomic nervous system’s flight or fight response, which interferes with blood flow to the skin. It may also cause increased inflammatory factors in the circulation. If you feel chronically stressed, unhappy or tense stress management must become a major part of your treatment for AR. Consider – learning relaxation and breathing techniques, cognitive behavioural therapy with a registered psychologist, a daily walk and regular exercise such as tai chi or yoga, meditation, herbs such as chamomile, skullcap or passionflower and taking steps towards a simpler life.
The environment is also a known trigger for AR. Direct sunlight is best avoided; wear a large brimmed hat or cap that adequately deflects sun from the affected part of the face. Changes in heat can also be also aggravate the condition. In winter be aware that moving between over heated buildings to the chilly outdoors and vice versa may make your skin react. Where you have control over your internal environment, turn the heating down or even better get used to wearing more layers before thinking of putting the heater on.