The disease course of rosacea is waxing and waning in nature, with episodes of symptom aggravation known of as "flare-ups" interspersed between periods of relatively few and less bothersome symptoms. Flare-ups are triggered by various environmental or lifestyle factors that rosacea sufferers should try to avoid. Trigger avoidance is an important part of the treatment approach for rosacea.

Triggers of flare-ups

Examples of lifestyle and environmental factors that may trigger a flare-up include:

• Sun exposure, hot or cold weather and wind
• Emotional stress
• Heavy exercise
• Consumption of alcohol, spicy foods or hot drinks
• Hot baths, certain cosmetics
• Certain medications
• Certain medical conditions
• The menopause

Each person with rosacea has their own unique set of triggers. In order to help identify and avoid these, patients may be asked to maintain a diary recording any known exposure to triggers before a flare-up occurs. This may take some time, but usually a pattern emerges from this information that can help physicians identify specific inducers of flare-ups. Surveys have shown that trigger avoidance has previously improved symptoms by up to 90%.

Some of the lifestyle measures taken include:

• Avoiding sun exposure
• Avoiding spicy food, foods suspected to cause flare-ups, hot beverages and alcohol
• Avoiding heavy exercise
• Practising meditation and other relaxation techniques to ease stress
• Choosing cosmetics and skincare products carefully.

Skincare

As rosacea patients have especially sensitive skin, they need to choose skincare products that are designed to maintain the integrity of the skin barrier and avoid products that irritate the skin. Cleansers, moisturizers and sun blocks are important, protective products and a sun protection factor of 15 or higher is recommended. If the patient is allergic to sunscreen or develops irritation, they may use sun block that contains zinc or titanium dioxide instead. The ingredients in cosmetics should not cause sensitivity or irritation, nor should they contain volatile substances, irritants or allergens. After washing the face, skin should be blotted rather than rubbed dry to reduce any stimulation of the skin that may cause flushing.

Moderate-to severe symptoms

In mild cases of rosacea, symptoms are seldom severe enough to cause concern. However, in moderate-to-severe cases, the condition can eventually cause facial deformity and adversely affect an individual's social life, occupation and emotional well-being. Depression and anxiety commonly manifest which may, in turn, raise the emotional stress levels that can give rise to flare-ups. Counselling may prove useful in these cases, providing advice about how to cope with symptoms and maintain a positive outlook so that the impact the condition has on quality of life is minimized.

Further Reading

• All Rosacea Content
• Rosacea – Facial Redness
• Rosacea Symptoms
• Rosacea Epidemiology
• Rosacea Subtypes

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.