Rosacea is a common, chronic skin condition that impacts about 15 million people in the U.S. alone and nearly 50 million people worldwide. If you suffer from rosacea, you know that one of the keys to controlling this skin condition is identifying and avoiding your triggers. According to Dr. Jennifer Holman of U. S. Dermatology Partners in Tyler, Texas, “While everyone has a unique experience with rosacea, there are some common factors that seem to negatively impact most people with this skin condition. Stress is one of the most frequently reported triggers for rosacea flareups, and the past few months have been very stressful for many people. It’s no surprise that many rosacea patients are reporting an increase in their symptoms right now.” In this blog, Dr. Holman will walk through the connection between stress and rosacea and provide tips for reducing stress and keeping your skin healthy during even the most stressful times.
What is Rosacea?
Rosacea is a chronic skin condition that typically presents as reddening (flushing, blushing) of the face and neck. In some cases, rosacea sufferers also have visible blood vessels, skin thickening, excessive skin dryness, bumps in the reddened area, and eye irritation. These visible symptoms of rosacea are often accompanied by sensory symptoms like burning, stinging, and itching skin. Most rosacea patients are fair-skinned people who typically notice symptoms for the first time around the age of 30. Additionally, women are more likely than men to develop rosacea. While these are the most commonly affected groups, men, people of color, and kids or the elderly can also develop rosacea. Studies are still being conducted to determine the specific cause of rosacea, but the majority of those who are diagnosed with this condition share specific genetic traits. For this reason, those who have very fair skin or who have family members with rosacea are much more likely to develop this condition.
According to Dr. Holman, “Most people with rosacea first visit a dermatologist for this condition after a referral from their general physician. There are other skin and health conditions that can present with similar symptoms, so we’ll need to affirm the physician’s diagnosis of rosacea. This will include a physical examination, review of symptoms, discussion of family and personal health history, and in some cases, we may run tests to rule out other conditions before we recommend a treatment plan.”
While rosacea typically begins as a tendency to blush more easily or for longer periods of time, this condition can become much more serious without treatment and preventive care. In order to create the right treatment plan, your dermatologist will also want to determine what specific subtype of rosacea you are likely struggling with. There are four subtypes of rosacea:
- Erthematotelangiectatic rosacea – causes skin redness and increased visibility of blood vessels.
- Papulopustular rosacea – causes skin redness, inflammation, and often co-occurring acne breakouts.
- Phymatous rosacea – causes skin redness accompanied by rough, bumpy, or thickened skin texture.
- Ocular rosacea – causes skin redness, inflammation, and irritation typically focused around the eyes and the upper parts of the cheeks.
What are the Common Rosacea Triggers?
Each person will have different triggering factors that will lead to rosacea flareups. During the initial diagnosis process, your dermatologist will ask you to monitor your skin for several weeks or months, noting when you experience flareups, how long they last, how often they occur, and what changes or external factors seemed to contribute to the flareup. Some of the most common triggers for rosacea include:
- Sun exposure
- Heat, humidity, wind, cold, and other weather-related changes
- Specific foods and beverages (alcohol and spicy foods are some of the most common)
- Makeup, skincare, and hygiene products
- Cleaning products (dish soap, laundry detergent, etc.)
- Exercise
- Medications
How is Stress Related to Rosacea?
In addition to the common triggers listed in the previous section, stress may be the most reported contributor to rosacea flareups. Stress negatively impacts rosacea sufferers because their skin is already prone to breakouts and flareups. The elevated cortisol and adrenaline production associated with increased stress can lead to new rosacea flareups or prolong a flareup by making it more difficult for the skin to effectively repair itself. According to Dr. Holman, “Many people are experiencing unprecedented levels of stress right now. The COVID-19 pandemic has impacted many of our patients, causing fear, uncertainty, and high levels of stress. Change is always stressful, but that transitional stress is compounded by a very real fear for your health and the safety of your loved ones. For many patients with rosacea, we’re seeing increased flareups, and it’s likely linked to prolonged elevation of stress levels.”
During times of stress, our bodies trigger a series of biological responses centered around keeping us safe from potential dangers. You may have heard of this response referred to as fight or flight. When our body enters these stress response processes, the endocrine and immune systems are triggered to work at high capacity. When stress is constant or chronic (occurs repeatedly), these elevated levels of endocrine and immune response will take their toll on our health. Dr. Holman went on to explain that, “Stress is very taxing for the body. Unfortunately, when our other systems are working overtime to respond to stress, the brain sees the skin, hair, and nails as less important. To keep the other body systems going, essential nutrients are redirected away from the skin and into other areas. However, our skin helps to keep our body at homeostasis, a state of balance and optimal function, so when the skin doesn’t get the nutrients it needs, you’re at risk for other health concerns. That’s why treating our skin health concerns and reducing stress are both essential to ensure we maintain optimal overall wellness.”
How Can I Prevent Rosacea Flareups?
Knowing your rosacea triggers and taking steps to avoid them is one of the best ways to limit the number and severity of flareups you’ll experience. You can work with a dermatologist to identify your unique triggers.
If you’re suffering from rosacea flareups related to stress, you may want to take the following steps to reduce stress and improve skin health:
- Create a stress management plan, so when you feel stressed, you don’t have to worry about what to do.
- Give yourself 90 seconds to reset. The initial process that occurs when stress levels spike only lasts this long. Holding onto or ignoring stress can actually prolong this experience. When you first notice you feel stressed, take 90 seconds to recognize the elevated stress levels and consider what you can do to address the situation. Then, give yourself permission to do something else.
- Take time for self-care and maybe a little extra pampering. Make sure you’re showering, sleeping, and caring for your skin every day. Use rosacea-friendly products for an at-home facial or other treatment to relax you and improve overall skin health.
- You know what relaxes you. Whether it’s reading a book, listening to music, or meditating, take a few minutes to do something you know will help you relieve stress and feel a little better.
- Get plenty of sleep. During sleep, the body repairs, renews, and replaces cells, so lack of sleep can make it even more difficult for the skin to heal and produce new, healthy cells.
- Consider talking to a professional. If chronic stress is impacting your health and wellbeing in a way that is making it difficult for you to cope, working with a therapist to develop better stress management techniques can be very beneficial.
Additionally, the following preventive steps may be helpful to avoid rosacea flareups:
- Limit sun exposure and always wear sunscreen.
- Avoid extreme weather conditions (high temperatures, dryness, humidity) and limit time exposed to the elements. When you are outdoors for longer periods, take steps to protect your skin by wearing a hat or scarf and other protective clothing.
- Pay attention to what you eat and how it impacts your skin. Hot foods and beverages (both spicy-hot and heat-hot), as well as alcohol, are commonly associated with flareups.
- Discuss changing medications, especially if you’re on prescriptions to treat high blood pressure, glaucoma, and migraines. In many cases, changing to a different prescription is effective in reducing rosacea symptoms.
How Can Dermatologists Help?
In addition to recognizing and addressing your rosacea triggers, this chronic skin condition may require professional dermatologic treatment to address symptoms. According to Dr. Holman, “We always want to start our treatment plan by improving the negative effects of immediate symptoms like itching, inflammation, and skin redness. In addition to tackling these severe symptoms, we’ll also work together to control the long-term impact of rosacea by using anti-inflammatory medications and other treatments to keep your skin healthy.”
When Should I Visit U.S. Dermatology Partners for Rosacea?
Many people with rosacea can address the symptoms of this condition using over the counter medications and skin care products. However, if your rosacea symptoms are severe, don’t improve after a few days, or are impacting your daily routine, you should work with a dermatologist to get flareups under control and improve your skin’s health.
In response to the COVID-19 pandemic, U.S. Dermatology Partners has taken steps to ensure our patients receive seamless care that is also safe. For this reason, we are offering both in-office and teledermatology appointments at this time. A teledermatology appointment is a great option for patients who are experiencing rosacea flareups but are unable to visit us in-office because of increased COVID-19 health risks, distance, or other limitations. We can easily examine your skin health, make care recommendations, and call in prescriptions as needed. You can request a virtual appointment using our simple online form.
For your convenience, our office locations have also resumed scheduling in-office appointments for non-emergency conditions. You can learn more or get started with an in-office appointment using our in-office appointment request form. We are pleased to be able to offer you both in-office and telehealth scheduling options so that you have convenient access to quality care for your skin. We look forward to hearing from you soon.
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