With the age of Dr Google or GP Facebook group, I find that many people take their ailments into their own hands or into those of their peers. Community is a great source of knowledge, don’t get me wrong but sometimes our problems require the help of the experts in the field. There are particularly two common skincare problems that need expert help. They both are chronic conditions and there is no magic cure or one size fits all solution. These are Rosacea and Acne.

Rosacea

This is a term that some have heard of and others not. Rosacea is a chronic skin condition with symptoms like facial flushing, redness, visible vessels (telangiectasias) and bumps and pimples. The first sign can often be redness and flushing that comes and goes.

It typically affects women with fair-skin aged between 30-50. When it does affect men, it’s often more aggressive. Cheeks, nose, forehead and chin are the typical areas that are affected. I know that sounds like the whole face anyway right?

Cause and Effect

The cause is not completely known and understood yet. Theories involve small intestine overgrowth, an immune reaction to a natural mite that lives in our skin, unstable vessels, genetics and sun exposure. What we do know is that something irritates the skin leading to chronic inflammation with flare-ups.

The skin barrier is damaged causing water loss through the skin (this is called trans epidermal water loss, TEWL). This leads to sensitive skin and dehydration. When the skin is sensitive or damaged, it will not cope with daily aggressors. These are sun, wind, pollution and even food.

These simple aggressors cause a reaction in the skin from free radical formation. The body sends blood to the areas as a defence mechanism, bringing with it all the cells and immunity. But this also brings heat, redness and inflammation. If this happens regularly the blood vessels become dilated and the redness more permanent. This in turn leaves the skin more vulnerable and the reactions and symptoms of rosacea will get worse.

So what is the solution if you don’t know what the cause is? Well first I would say try and pin point the things that aggravate your rosacea (everyone will be different) and try avoid them. But the overriding principle is restore the skins barrier function.

1. Strengthen the skin cell and capillary wall. To prevent damage from these aggressors. L-ascorbic acid, commonly known as Vitamin C is an antioxidant which mops up free radicals.
2. Repair the skin barrier (hydrolipid barrier). With an intact barrier water can’t escape and aggressors cannot easily cause damage. There are certain peptides that help as well as Niacinamide (vitamin B3).
3. Manage Bacteria. If those mites and bacteria can aggravate it, then keep control of the environment with antibacterial ingredients like Hinokitiol.
4. And just as importantly Protect the skin from further damage against UV rays with zinc oxide based SPF.

Acne

The bane of a lot of ladies’ lives. We thought we would outgrow teenage acne or felt blessed to be clear of it when adult acne hit us. Acne consists of comedones, papillae, pustules and cysts and there are varying degrees as well as causes. It is found on areas of the body that contain a lot of sebaceous glands that produce sebum or oil.

When we look broadly, acne is caused by 3 major factors:

1. Blockage of hair follicles (pores) by dead skin cells.
2. Overproduction of sebum (oil) by the sebaceous glands, which are found in the hair follicles.
3. Proliferation (growth) of the bacteria linked to acne called P. Acnes (quite aptly named). Bacteria leads to inflammation.

However it’s not that simple. Hormones, weather and genes all contribute to each of these. There are also two types of acne; non-inflammatory and inflammatory. Basically non-inflammatory means blocked pores (whiteheads and blackheads) but it does not get red and angry. With inflammatory acne, the follicle wall is under pressure and can break, spreading the contents into the surrounding skin. The immune system then responds causing inflammation. Papules, pustules and cysts are all varying degrees of inflammatory acne. Cysts and nodules are larger, painful and extend deeper into the skin layers. They last longer and destroy the follicle, causing scarring. It’s important to see a dermatologist if you have cysts and nodules.

Did you know that a blackhead is blockage of dead skin cells and oil causing a plug? It’s not dirt! It’s only black because of the melanin (colour that our body produces) and oxidised oil. Whiteheads are exactly the same thing but a thin layer of skin covers the plug and the oil cannot oxidise.

Treatment

1. Manage bacteria. Like with rosacea, antibacterial ingredients are key. Hinokitiol and salicylic acid are what you are looking for in various products.
2. Stimulate cell turnover. Essentially you want to get the skin to go through its cycle faster so that the skin sloughs off the cells more regularly. Retinol is the key ingredient. This is also known as Vitamin A and related to the oral acne treatment you may have heard of; Roaccutaine.
3. Antioxidant protection for cells. Like with rosacea, you want to prevent further unnecessary damage to the skin by free radicals. Reservatrol is the one you want here as L-ascorbic acid can worsen acne rather than help it.
4. Protect against UV rays with zinc oxide based SPF.

Often people with acne try and strip their skins of the oil and exfoliate the hell out of it to unblock the pores, but others have a more sensitive version. And it’s that sensitivity and dryness that worsen their acne. As you can see it’s not a simple fix of throwing the above ingredients at them.

Other Skincare Problems

Rather than overload you with too much information about ALL other skin conditions that may need help, these are two that are always problematic. Others are a matter of perspective like with pigmentation/melasma and ageing skin, but to note that psoriasis and eczema are not simple conditions and need the help of a dermatologist.

Seek Expert Help for Skincare Problems

If you feel confused or frustrated with your rosacea or acne, then book a consultation with me. We will deep-dive into your specific aggravating factors, skin type, explore the science and causes, and come up with solutions that can help you manage it better.