Powell, F. C. (2005)
Am I the patient or the doctor?
I go to the dermatologist once a year for a skin cancer screening, and it is the only thing I go to a dermatologist for.
I had just come from the gym so naturally my cheeks were a little pink. The dermatologist was just about done, all seemed fine and then I was asked “do you have rosacea?”
So I said to him, you're the doctor, what are you doing asking me for a diagnosis? It was a good example of the demise of professional medical knowledge and doctor responsibility and how the patient is now expected to diagnose themselves.
But what was worse is that a doctor trained specifically in diseases of the skin couldn’t delineate between healthy skin with a pink hue from blood flow due to a working cardiovascular system, and a severe skin disease caused (primarily) by widened blood vessels near skin’s surface.
The severity of rosacea goes beyond a little bit of redness. It can even affect the eyes. Powell, F. C. (2005)
Lack of doctor knowledge is why so many people are under the false impression that they have a disease when they are perfectly healthy. Your doctor does not have time to give a thorough diagnosis, they spend an average of 7 minutes on each patient. And they do not have the time to verse themselves in the latest research, which takes hours every day. They are not experts on skin care and therefore are the last ones you should be getting skin care advice from.
And this is a big problem that no one is aware of.
Think about it this way: Lets say I did not know about skin at all. I have not been studying it for years and I am completely dependent upon my doctor’s knowledge to guide decisions about my health. I go to the skin cancer screening after going to the gym and I get asked if I have rosacea. I would say, “Oh, I don’t know. I guess if you think thats what it looks like…maybe I do.” The doctor then says that my face is red, and I say, “what should I do?” Then I am prescribed medication.
See the problem here? I am prescribed medication I don’t need for an illness I do not have.
What is even worse is that I was given a haphazard, hasty and informal diagnosis and now I am under the impression I have an illness, which will guide my medical and skin care behaviors for the rest of my life.
The Problem of Diagnosis
There is no such thing as a test for rosacea, so the best you will receive is a diagnosis from a simple and quick visual inspection from a doctor. The lack of objective testing (and preponderance of subjective testing) means that thousands of people are being told that they have a skin disease that they do not have, and are medicating themselves for no reason.
More than likely if your doctor says you have rosacea, you really have sensitive skin, pale skin or damaged skin and nothing more. Sensitive skin, pale skin or damaged skin is not a disease, but treating your skin like you have a disease is going to give you trouble. If you have sensitive or damaged skin, applying medicated creams and gels is just going to make it redder and more sensitive. It may even give you rosacea.
Furthermore, going to a doctor will mild skin issues worse because they cannot deviate from the standards of care, otherwise they risk putting their career in jeopardy. That means that you will only receive medication.
Medication is a treatment, not a cure. And it often worsens or creates skin disease.
Rosacea is more than just skin redness, so if you just have some redness, that in and of itself does not necessarily mean that you have a disease. And it is important to not self-diagnose. Go and get a second or third opinion. Some people just have a natural redness to their skin and it is important to know with certainty if it is rosacea or just redness.
Rosacea is more than skin redness
Those with rosacea experience symptoms beyond just facial redness, and the disease is a lot more severe than most would think . Those with rosacea will also experience at least one the following external symptoms:
- Dilated blood vessels on the face
- Presence of papules, pustules and lesions on skin
- Swelling of the nose
- Burning, itching sensation
- Intense skin dryness
- Skin thickening in affected areas
Blount, B. W., & Pelletier, A. L. (2002).
Those with rosacea may also experience issues with maintaining a proper gut microbiome. However this may be due to the improper prescribing of antibiotics (such as doxycycline) in an effort to treat rosacea.
The treating of rosacea with antibiotics is ludicrous and irresponsible because rosacea is not an issue of bacteria on the skin. It is an issue with the skin structure itself. When antibiotics are used to treat rosacea, it will just make the problem worse because it will invite a colonization of bad bacteria on the skin, which will cause the skin to break down and the redness to worsen.
The treating of rosacea with creams is also absurd because creams trap heat and bacteria, and that will make redness worse.
And if you do not actually have rosacea, using medication to treat it will weaken your skin and possibly give you acne, dermatitis and other skin illnesses.
No Cure, Only Avoidance
There is no cure for rosacea so the best thing to do, if you have it, is to avoid what makes it worse.
Things that will make rosacea worse include
- Skin care containing fragrance and essential oils- Irritants that will break skin down
- Essential oil diffusers- Airborne irritant that will inflame the skin
- Denatured alcohol in skin care- Will dehydrate the skin
- Physical scrubs - Tears the skin down, causes cell death and can release inflammatory skin sebum
- A high concentration of inflammatory oils in your skin care
- Creams and gels- Trap heat and makes redness worse
- Antibiotics (only use when prescribed for legitimate medical reasons)
- Makeup and makeup brushes- Trap heat and bacteria in the skin, brushes also scrape the skin and will cause irritation
- Steam, hot or warm water- irritate and dry the skin
- Chemical sunscreens (opt for mineral sunscreen)
- Alcohol consumption
- Sun exposure
- High winds
- Spicy foods
- Emotional stress
Skin Care and Rosacea
I only agree with using medication for rosacea treatment in severe cases, and if it doesn't show improvement of symptoms within 4-6, then it shouldn't be used.
For mild rosacea, I believe proper, non-medicated skin care is best.
I have noticed from customer feedback, that a high concentration of those who use the No. 9 and UV-Rtogether have reported an improvement in their skin redness. No. 9 is a gentle exfoliant that does not affect live skin, and UV-R has a high concentration of anti-inflammatory extracts.
For those with rosacea or natural skin redness or damaged/sensitive skin, I recommend diluting both with distilled water at a 1:1 ratio for one month and over several months working your way up to full strength.
If you have natural skin redness, your best way to keep your skin calm is to avoid trapping heat on the skin with creams, avoiding the irritants mentioned above.
References:
Abram, K., Silm, H., Maaroos, H. I., & Oona, M. (2010). Risk factors associated with rosacea. Journal of the European Academy of Dermatology and Venereology, 24(5), 565-571.
Blount, B. W., & Pelletier, A. L. (2002). Rosacea: a common, yet commonly overlooked, condition. American family physician, 66(3), 435-444.
Gravina, A. G., Federico, A., Ruocco, E., Lo Schiavo, A., Masarone, M., Tuccillo, C., ... & de Sio, I. (2015). Helicobacter pylori infection but not small intestinal bacterial overgrowth may play a pathogenic role in rosacea. United European gastroenterology journal, 3(1), 17-24.
Parodi, A., Paolino, S., Greco, A., Drago, F., Mansi, C., Rebora, A., ... & Savarino, V. (2008). Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clinical Gastroenterology and Hepatology, 6(7), 759-764.
Powell, F. C. (2005). Rosacea. New England Journal of Medicine, 352(8), 793-803.