Understanding and Naturally Relieving Rosacea

Rosacea is a chronic, progressive skin condition which manifests itself mainly as diffuse redness on the face, often centred on the cheeks, nose, forehead, and chin. It may be accompanied by a sensation of heat, visible small blood vessels (telangiectasia) or spots resembling those seen in acne. Unlike common acne, which frequently affects teenagers, rosacea most often appears in adulthood, particularly between the ages of 30 and 50. Although it mainly affects fair, reactive skin, it can affect all skin types.

Its causes are multifactorial: genetic predisposition, vascular reactivity, environmental factors, and imbalances in the skin’s microbiome can all contribute to its development. Rosacea can be highly debilitating, both physically (with sensations of burning, heat or skin hypersensitivity) and psychologically. Highly visible on the face, it is still associated with certain misconceptions, particularly those linked to alcohol consumption.

Rosacea generally progresses in stages, characterised by increasingly severe skin symptoms. However, this progression is neither systematic nor linear: some people may remain at the same stage for a long time or experience several symptoms simultaneously.

• Stage 1: Transient Redness or Flushing - which refers to sudden, temporary episodes of facial redness, usually lasting a few minutes, mainly on the cheeks and nose, often accompanied by a sensation of heat or burning

• Stage 2: Erythematous-Couperose Rosacea (couperose) - characterised by the development of persistent redness associated with dilated blood vessels visible on the skin’s surface, known as telangiectasias, most commonly affecting the cheeks but which may also affect the nose, chin and forehead

• Stage 3: Papulopustular Rosacea - characterised by the appearance of papules (red spots) and pustules (lesions with white heads) against a background of diffuse redness, without the presence of occlusive lesions such as comedones or microcysts, unlike acne

• Stage 4: Hypertrophic or Phymatous Rosacea - characterised by a progressive thickening of the skin, which becomes red, swollen and irregular in texture, most commonly affecting the nose but which may also involve the cheeks, forehead or chin; in the most severe forms, rhinophyma develops

The mechanisms underlying rosacea are not yet fully understood. However, several physiological and functional factors appear to play a role. These often act in combination, which helps explain why rosacea can manifest differently from person to person.

Excessive Reactivity of the Blood Vessels in the Face

Rosacea is largely linked to a dysfunction of the skin’s microcirculation. The small blood vessels on the skin’s surface dilate more easily than normal, which contributes to persistent redness and a sensation of heat. This vascular fragility also explains the more visible capillaries, particularly on the cheeks and nose.

Persistent Skin Inflammation

Inflammation plays a central role in rosacea symptoms. It can cause redness, a sensation of heat, papules, or small pustules. In some people, the skin reacts excessively to even minor stimuli, perpetuating a long-lasting inflammatory state and increasing skin sensitivity.

A Genetic Predisposition

Rosacea often runs in families. Some people may have a genetic predisposition to increased vascular reactivity or skin inflammation, which can contribute to rosacea.

An amplified cutaneous immune response

In some people, the skin’s immune system overreacts to internal or external stimuli. This response contributes to the inflammation, redness and skin hypersensitivity characteristic of rosacea.

An Imbalance in the Skin Microbiome

The role of the skin microbiota is increasingly being studied. Imbalances in this flora may promote inflammation.

The involvement of the mite Demodex folliculorum, which is naturally present on the skin but is sometimes found in greater numbers in affected individuals, has also been suggested.

Increased Sensitivity to Certain Triggers

In those affected, the skin may react excessively to various internal or external stimuli, particularly when vascular reactivity is already high.

Sudden changes in weather, exposure to wind, cold or sunlight, as well as intense heat – particularly in saunas or steam rooms – can accentuate the dilation of blood vessels and contribute to sensations of flushing.

Certain foods or drinks, such as hot drinks, spicy dishes, or alcohol, can also cause redness by stimulating blood circulation in the face. Stress and intense emotions can trigger visible vascular reactions. Finally, inappropriate use of corticosteroids on the face can weaken the skin and aggravate rosacea symptoms.

Rosacea manifests itself through various symptoms, the severity and frequency of which can vary depending on the individual and the clinical form.

• Persistent Facial Redness and a Sensation of Heat: The presence of long-lasting erythema (redness) in the centre of the face (cheeks, nose, forehead, chin), often associated with visible dilated blood vessels. The skin may feel warm, tight or as if it is burning

• Pimples and Inflammatory Lesions: The appearance of red papules or pustules, sometimes containing pus, against a background of diffuse redness. Unlike acne, these lesions are not usually accompanied by blackheads

• Localised Thickening of the Skin (rhinophyma): In more advanced forms, mainly in men, the skin may gradually thicken, particularly on the nose, which then takes on a bumpy appearance. This progression is uncommon and develops slowly

• Ocular Involvement (ocular rosacea): In some people, the eyes may also be affected. This manifests as redness, a sensation of dryness, burning, irritation or itching of the eyelids

• Hot Flash Episodes or Flare-Ups: Sudden redness, accompanied by a sensation of heat or tingling, may occur in response to certain triggers such as changes in temperature, spicy foods or the use of unsuitable cosmetic products

10% Azelaic Acid Concentrated Serum: This 100% naturally derived serum is specifically formulated to support combination to oily skin or skin prone to blemishes. It helps to unclog pores, visibly reduce blackheads, and soothe localised redness. Thanks to its high content of hyaluronic acid and silica, it helps maintain good hydration while mattifying the complexion, without drying out the skin. Its lightweight texture absorbs quickly and integrates easily into a targeted skincare routine. Formulated with a high concentration, this product should be introduced gradually into your beauty routine. Start by applying it 2 to 3 times a week, alongside gentle cleansing and moisturising products. Avoid applying it to the eye area. If you experience a skin reaction, space out applications; if symptoms persist, discontinue use.

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Concentrated Vitamin B12 & Prebiotics Serum: Formulated to meet the needs of sensitive skin, this serum combines active ingredients recognised for their soothing, restorative and protective properties. Vitamin B12 and liquorice extract work in synergy to reduce feelings of discomfort, soothe redness and restore the skin’s comfort. Prebiotics help to balance the skin’s microbiome, strengthen the skin’s natural defences and support a more resilient skin barrier. In addition, plant-derived NP ceramides promote cohesion within the stratum corneum, while oat oil softens, nourishes and protects. Finally, hyaluronic acid rounds off this formula by providing long-lasting hydration, which is essential for supple, soothed skin day after day. This serum should be stored at room temperature, away from heat, and tightly closed after each use to preserve the quality of its active ingredients. As with any facial care product, avoid contact with the eyes. In the event of contact, rinse thoroughly with clean water.

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Organic Italian Helichrysum Hydrosol from Corsica: This hydrosol is traditionally used to reduce minor redness and even out the complexion when used in combination with plant-based oils. With its astringent properties, it is also used in firming and soothing skincare products for both the face and body. Hydrolats, which contain no preservatives, are susceptible to contamination. To keep them fresh, store them in the fridge and use them within 6 months of opening. Handle the bottle with clean hands and use clean equipment. If the smell or appearance changes, stop using the product.

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Organic German Chamomile Hydrosol: Traditionally recognised for its soothing properties, this hydrosol is valued for relieving skin discomfort, such as irritation or itching, thanks to its high bisabolol oxide content. Use it in your homemade soothing creams and lotions, combined with vegetable oils. Hydrolats are delicate products that contain no preservatives. To preserve their quality, it is recommended that you store them in the fridge and use them within 6 months of opening. Always ensure you use clean hands and sanitised equipment. If the appearance or smell changes, it is best to stop using it.

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Calophyllum Inophyllum Plant Oil: Naturally rich in active ingredients with soothing properties, Calophyllum inophyllum vegetable oil is ideal for relieving feelings of tightness and soothing skin prone to redness. Its rich texture also makes it an excellent ingredient for invigorating massage treatments, particularly in ‘light legs’ rituals. This highly active oil should be used diluted, preferably in a lighter plant oil (such as calendula macerate or jojoba oil), before any application to the skin. Avoid contact with the eyes and mucous membranes. As with any cosmetic ingredient, a patch test on the inside of the elbow is recommended 48 hours before use. Keep the bottle tightly closed, away from heat and light.

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Mastic Tree Plant Oil from Kabylie: Powerful and aromatic, mastic oil is traditionally used to soothe sensitive skin, relieve redness, and calm minor skin irritations. Naturally rich in active ingredients that promote circulation, it is also valued as a complement to skincare routines designed to promote a feeling of lightness in the legs. When applied to the scalp, it is renowned for stimulating and strengthening the hair. Produced using traditional methods in Kabylie, this rare oil is a testament to local, environmentally responsible expertise. Due to its naturally high concentration of aromatic compounds, this oil should be used diluted, particularly on sensitive areas such as the eye contour (maximum 50%, in a suitable roll-on bottle). Avoid contact with the eyes and mucous membranes. Keep out of reach of children. Store away from heat, light and moisture, in a tightly sealed bottle. Before use, carry out a patch test on the inside of your elbow 48 hours in advance.

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As rosacea is linked to highly reactive skin, certain preventative measures can help to minimise triggers and maintain the skin’s balance.

• Maintaining Good Hydration of the Skin and the Body: Well-hydrated skin is generally more resistant to external aggressors. Using moisturisers suitable for sensitive skin and drinking enough water helps maintain the skin’s comfort and suppleness.

• Avoid Irritating or Handling the Skin on Your Face: Rubbing, scratching, or handling the skin can exacerbate inflammation and weaken the small blood vessels. Gentle movements, without excessive friction, help to minimise skin reactions.

• Choose Gentle, Skin-Friendly Cleansers: Skin prone to rosacea does not tolerate harsh or stripping products well. Gentle cleansing with formulas suitable for sensitive skin helps preserve the skin barrier without triggering inflammation.

• Protect Your Face From Extreme Temperatures: Both intense cold and excessive heat cause blood vessels to dilate and can trigger redness. Protecting your skin from the cold, avoiding prolonged heat exposure, and minimising sudden temperature changes can help reduce skin reactivity.

• Avoid Very Hot Drinks: Very hot liquids can cause rapid vasodilation in the face and trigger hot flushes. Let drinks cool to lukewarm before drinking to help limit this.

• Protect Your Skin From the Sun All Year Round: UV rays are a well-known aggravating factor in rosacea. Applying a sun cream suitable for sensitive skin every day, in both summer and winter, helps to protect the skin and reduce the severity of redness.

Dermatological management of rosacea depends mainly on the type of symptoms and their severity. It may involve a combination of different approaches, tailored to each individual case.

1. Reducing Persistent Redness: Where rosacea manifests mainly as diffuse redness and dilation of small blood vessels, vascular laser treatments may be recommended. These procedures target the visible blood vessels and help to reduce the intensity of the redness. In addition, corrective cosmetic solutions may be used, such as tinted skincare products containing green pigments that visually neutralise redness and help even out the complexion

2. Treating Inflammatory Lesions: Where papules or pustules are present, medication may be prescribed. Antibiotics from the cycline family are sometimes used for their anti-inflammatory action, although taking them may be associated with side effects, particularly affecting the gut or vaginal flora. In certain more severe forms, oral isotretinoin may be considered under strict medical supervision. Its use requires careful monitoring and specific precautions due to its side effects and contraindications

3. Use Appropriate Topical Treatments: Topical treatments, in the form of creams or gels applied directly to the skin, are frequently recommended to treat inflammation and lesions. Among these, formulations containing azelaic acid are often used for their effect on redness, inflammatory lesions and the overall appearance of the skin.

If your skin is prone to redness, choose gentle, fragrance-free skincare products formulated to respect the skin’s natural balance and minimise the risk of irritation. Before using any new product, whether natural or synthetic, carry out a patch test on the inside of your elbow 48 hours before applying it to your face. Certain essential oils and concentrated plant oils need to be diluted and may not be suitable for sensitive areas of the face. Finally, if redness worsens or discomfort persists, seek medical advice so that you can adapt your skincare routine to your skin’s needs.

Rosacea can significantly affect quality of life, especially when accompanied by a burning sensation, tightness, or persistent redness. To manage this skin sensitivity, opt for a minimalist routine with fragrance-free, alcohol-free skincare products that reactive skin tolerates well. Light textures, soothing and moisturising active ingredients, and daily sun protection form the basis of an appropriate skincare regime. It is also recommended to avoid irritating formulations, significant temperature fluctuations, or prolonged sun exposure. With consistency, patience and a good understanding of your skin, it is entirely possible to regain greater comfort in your daily life.

Dr Agathe Aoun-Coussieu is a dermatologist in Martinique, where she practises general, surgical and cosmetic dermatology on black and mixed-race skin. Her expertise comes from many years of practice in the West Indies and French Guiana. Sensitive to skin wellbeing, she also offers natural advice and products for sensitive or special skin types. She has also set up an Instagram account where you can find her favourite products, explanations of skin conditions and skin advice (@dragatheaoun).