There are four identified rosacea subtypes. Many patients experience characteristics of more than one subtype at the same time, and those often may develop in succession. While rosacea may or may not develop from one subtype to another, each individual sign or symptom may progress from mild to moderate to severe. Early diagnosis and treatment are, therefore, recommended.
Treatments for Rosacea subtype 1
People with Subtype 1 rosacea have very easily irritated skin. It often feels tight and is sensitive. Sub type 1 also tends to have very dry skin. (Dermatology times jan 2014).
The finca type 1 serums is precisely what type 1 rosacea skin needs. It adds oils and water/moisture to the skin which is naturally lacking, and does so in a way that is non irritating..ie. no harsh ingredients or harsh preservatives. When the skin barrier is repaired in a gentle way then it begins to act like a proper barrier to external irritants and redness is subsequently reduced.
The ingredients in the finca type 1 serum are plant based - for example .. The vitamins and essential fatty acids that occur naturally in organic cold-pressed rosehip oil (main ingredient in finca type 1 serum) possess anti-inflammatory properties, known to heal and soothe damaged or dilated capillaries, which cause the redness of rosacea. Click here to find out more.
Hyaluronic acid in the finca type 1 serum helps to bind water to the skin increasing the moisturisation of sensitive skin in a natural and non abrasive way. For more information the American Academy of Dermatology website offers some insights into caring for rosacea skin including the use of hyaluronic acid in skincare formulations - click here for more information.
Heavier waxier plant oils in the finca type 1 rosacea serum, including argan, jojoba and macadamia help improve the lipid content of the skin and stop TEWL (transepidermal water loss) which leads to skin barrier disruption and facial redness.
Use finca type 1 rosacea serum to help repair the skin barrier in a natural and ultra gentle way.
The balms are formulated using only plant oils, and an eco cert approved preservative.
Ingredients include red raspberry seed oil. It has been found in clinical studies to provide UVA and UVB protection as well as anti-inflammatory properties.. Below is an excerpt from a clinical study.
Red raspberry seed oil possesses an exceptionally high proportion of alpha and gamma tocopherols (Vitamin E), vitamin A and omega-3 and omega-6 fatty acids. Red raspberry seed oil offers the skin broad spectrum protection from damaging UV-A and UV-B rays. The SPF of red rapsberry seed oil has been found to be equal to that of titanium dioxide and has been rated to have an SPF as high as 28-50’’ (Oomah et al 2000).
Red raspberry seed oil has more pronounced anti-inflammatory properties than avocado, grapeseed, hazelnut and wheatgerm oils and may prove to be most effective oil to use in the treatment of eczema, psoriasis and other skin conditions’’ (Oomah et al 2000).
Other ingredients include olive oil, green tea oil, cucumber oil and again hyaluronic acid as well as a very small amount of organic beeswax -all helping to prevent TEWL and hence skin irritation and facial redness. Type 1 rosacea skin is also super sensitive to UV. Hence type 1 sufferers should use sunblock (factor 30+) every day with zinc oxide or titanium dioxide as the active sunblock – not chemical sunscreens The finca skin organics sunscreen is ideal - contains only 7 ingredients including zinc oxide and is lightly tinted to lightly cover redness.
Redness and flushing result in lack of confidence and self esteem but the appearance of flushing, redness and visible blood vessels may also be reduced with cosmetics. Products with a green or yellow tint can counteract visible redness, and cover makeup may be used to conceal visible blood vessels and other signs of rosacea.
Finca has developed a green tinted anti redness primer which will reduce the visible appearance of redness, whilst the sufferer begins to look at their own particular rosacea triggers.
What else can be done to treat facial redness?
Visible red veins on the face often add to overall redness . These can be treated very easily with diathemy needle therapy. For more information Click Here.
Unlike any other treatment, Diathermy is 98% guaranteed to work. Diathermy is the most effective method for the removal of broken capillaries, red veins, thread veins and spider veins on the face. All of these can add to the overall facial redness. Look at your skin under a good magnifying mirror -you may well have small red veins which can easily be erased using diathemy needle therapy.
During treatment the blemish is cauterised or “zapped. There is no guesswork. The treatment is not very expensive and above all it is not painful. There is no waiting. Results are instant. In cases where there is extensive broken capillaries on the nose and cheeks, a course of two or three treatments is sometimes required.
It is best to do perhaps five minutes of treatment at a time. Experienced beauty therapists can offer this treatment. Ensure that they have before and after photos of previous patients they have worked on.
After Diathermy needle therapy, the treated area will develop a small white scab. This is normal. The most important thing to remember is that this scab should be left alone to fall off by itself. It should not be picked or disturbed by any means. It resembles dry skin and is nothing more noticeable than that.
No make up for 24 hours. No microdermabrasion or skin needling for at least 2 weeks after diathermy treatment. No harsh toners or alcohol based products to be used on the skin for up to 1 week after treatment.
Use sun protection factor 50 on your skin if you are outdoor. Never underestimate the winter sun.
Laser therapy is also a treatment used for overall facial redness associated with type 1 rosacea. Below shows results which may be obtained if using an experienced therapist with the proper equipment for super sensitive rosacea skintypes.
Only use a therapist who is qualified and can give patient references or before and after photos of previous patients. If not you could end up with a patchy effect and risk of actual damage to the skin.
Laser therapy and those that treat rosacea using laser therapy can promise much. Whilst it is difficult to very accurately predict results, experienced therapists should be able to look at your skin and predict improvement rates based on previous clients. For a therapist to say they can improve your skin 100% and actually improve it 40% or even less is disingenuous.
Better to say 40 -50% improvements and realistic expectations than disappointed customers. Especially when paying up 800 dollars for treatments. As a customer you should insist on realistic improvement predictions or take your hard earned dollars elsewhere!!
And remember - Not all lasers are equal. Laser is different from IPL (intense pulsed light).
Candela lasers only operate over specific wavelengths as do Cutura lasers and these have had good results. IPL. on the other hand, uses lots of different wavelengths taking away good and bad pigment and leaves the outcome much more difficult to predict.
So do ask what equipment is used at the clinic you are talking to, and make sure they at least know the difference between IPL and lasers with specific operating wavelengths.
Your outcome will depend very much on the equipment used and the skill of the operator. In any case more than one treatment will be necessary and the cost will be in the hundreds of dollars...and dont forget to apply a high spf afterwards.
Erythema (redness) of the face in Subtype 1 rosacea can also be successfully treated with brimonidine tartrate gel better known as Mirvaso.
In a 1-year clinical trial, subjects who used MIRVASO Gel daily for at least 12 months had consistent results—from day 1 through day 365.‡ The most common side effects were:
- flushing (10%),
- erythema (8%),
- worsening of rosacea (5%),
- nasopharyngitis (5%),
- skin burning sensation (4%),
- increased intraocular pressure (4%),
- and headache (4%).
However US Rosacea forums have seen some mixed reaction with this mirvaso gel. It is still relatively new. It works by constricting the blood vessels near the skin surface bringing about a reduction in redness – which makes logical sense. The effect however is temporary – approx. 12 hours and in some cases brings about what is called a rebound flush…but this does not happen in all cases.
Next the type 1 rosacea sufferer should look at external and internal stimulants which are making the skin flush.
Identifying and avoiding lifestyle and environmental factors that trigger rosacea symptoms in individual cases can be especially effective in controlling the flushing and redness of subtype 1, Look at the diet and lifestyle suggestions here to know your triggers and use appropriate skincare products.
Rosacea subtype 2 (papulopustular)
The symptoms of type 2 rosacea is persistent redness around the centre of the face, with bumps and pimples resembling acne. Burning and stinging may also occur. This type is often seen after or in combination with subtype1.
Sub type 2 skin is mainly oily or greasy. (dermatology times jan 2014) They can look like pimples and be solid bumps, or filled with pus. But remember Subtype 2 is the type of rosacea that responds most easily to treatment.
Recent studies of the demodex mite in humans and in particular rosacea type 2 sufferers have found that that there may be a link between the numbers of mites on rosacea type 2 skin and the condition itself.
These findings raise the possibility that rosacea is fundamentally a bacterial disease resulting from the over-proliferation of Demodex mites living in skin damaged as a result of adverse weathering, age or the production of sebum with an altered fatty acid content.
Potential role of Demodex mites and bacteria in the induction of rosacea Stanisław Jarmuda,1 Niamh O’Reilly,2 Ryszard Z ˙aba,1 Oliwia Jakubowicz,1 Andrzej Szkaradkiewicz3 and Kevin Kavanagh2
Hence the control of the numbers of demodex mites may lead to control of the symptoms of type 2 rosacea. It is believed that the demodex mites eat the sebum (oil) on the skin and for most people – most of the time – they are harmless but not for type 2 rosacea sufferers.
The demodex mite like a wet and warm environment and become most active in the dark when they come out of the hair follicles on the face to mate. (Hence, treatments that control the mite population, are applied at night just before bed.)
Some of the therapies which help reduce the population of demodex mites to normal levels and will therefore reduce your type 2 rosacea are Ivermectin - it is based on an insecticide commonly employed for mite infestations and scabies in animals. This is a new cream brought onto the market in 2016, called Soolantra.
It has been having good success – in trials, over 70% of rosacea type 2 sufferers rated their improvement in their skin as excellent or good – and there are positive reviews on rosacea forums as well, from actual users of the product. The US rosacea forums also have potential customers talking about the cost of Soolantra. At over 200 dollars for roughly one months supply it is not cheap. A natural alternative to the demodex mite problem in type 2 rosacea is finca type 2 serum.
It includes a combination of natural actives to reduce the numbers of mites and hence reduce the symptoms of type 2 rosacea. The plant actives are contained in a gentle formulation including zinc oxide and grapeseed extract to heal and strengthen the skin barrier. Tea tree oil is one of the active ingredients in the finca type 2 serum.
A study published in the British Journal of Opthalmology investigated the use of tea tree oil in vitro and in vivo to kill ocular Demodex. It showed how a weekly lid scrub with 50% and daily lid scrub with TT shampoo could eradicate ocular Demodex in 1 month in seven of nine patients. The finca type 2 serum works in the same way - to reduce the numbers of demodex mites over the course of a number of weeks and hence reduce the sypmtoms of type 2 rosacea.
Other treatments for type 2 rosacea
Topical antibiotics (creams); eg metronidazole Systemic antibiotics (oral tablets); - it may take a couple of trials with different anti biotics to find one that works for you. Always take a pro biotic when on a course of anti biotics to help keep your levels of good bacteria in your gut healthy. In cases that prove difficult to treat, isotretinoin (Roacutane) is sometimes useful, but people do usually relapse within a year of using it.
Some rosacea patients have very severe outbreaks and do not respond to topical treatments or oral antibiotics. Isotretinoin is a strong antibiotic so is considered at low doses and monitored closely by their dermatologist. It is also has known side effects and is not recommended for use during pregnancy.
Sub type 3 - phymatous rosacea.
May include thickening skin, irregular surface nodularities, and enlargement. May occur after or in combination with subtypes 1 and 2. A: mild; B: moderate; C: severe This is a complication of rosacea that occurs rarely, and mostly in male sufferers. Early stages are characterised by ‘peau d’orange’ where the skin has the texture of orange peel. It is caused by an overgrowth of the oil glands of the nose giving it an enlarged and distorted appearance called rhinophyma.
For types A and B, sufferers could try our type 2 serum. The natural ingredients, including sulphur, in the serum help to reduce the production of sebum and hence the swelling of the glands. Sulphur has long been known to have a slightly drying effect on the skin (ie reducing sebum). See article from a study from the Journal of Dermatological Treatment 1997.
Other options for type 3 rosacea include:
- Surgical excision
- – or –
- Laser treatment.
Rhinophyma, in which the enlargement of tissue results in a bulbous and bumpy appearance of the nose in some rosacea sufferers, may usually be effectively addressed with laser surgery, according to Dr. Jeffrey Dover, associate clinical professor of dermatology at Yale University.
"Although rhinophyma may be generally unresponsive to oral or topical therapy, it is usually very amenable to surgical approaches," he said. "Besides manual surgery, electrosurgery and lasers are often very effective in reducing the excess tissue and returning the nose to a more normal appearance."
Sub type 4 Rosacea
Eye irritation – ocular rosacea. About 50% of people with rosacea are affected by ocular (eye) rosacea.
They get itchy eyes and inflammation around the lashes. They may also get conjunctivitis. Treatment for mild ocular rosacea may include: use of omega 3 capsules daily ...research in 2016 concluded that Rosacea patients with dry eye symptoms have significant improvement in symptoms, MGS, TBUT, and Schirmer score, following dietary intervention with Omega 3’s for 6 month.
In other words using omega 3 capsules for 6 months significantly reduced symptoms of dry eyes !Using artificial tears that contain lipids; - dry eye spray and drops are available on the product section of this website. good ones - with hyaluronic acid.
Gentle cleaning of the lids with water and a warm compress. Tears, your eyes’ own lubrication, are made up of water and an oily substance produced by glands along the eyelids. If cells in the glands harden and plug the opening, it can keep the oil from getting into the tear film.
Without that oil, the water in tears evaporates too quickly, leaving eyes feeling dry. A warm compress helps liquefy plugs so the oil can flow into tears. How to use them: Place a warm, wet washcloth over your eyelids for up to 10 minutes once a day as needed.
Your doctor also might recommend antibiotics to help with your symptoms or prescribe eye drops or ointments with steroids for the irritation and redness. Artificial tears can help keep your eyes moist. In cases of severe ocular rosacea, inflammation of the cornea may lead to a corneal ulcer with infection.
If left untreated, the corneal ulcer may even perforate the eye. This is a serious and potentially blinding complication. Always consult a medical physician.