Rosacea Reality!


by Danne Montague King

Rosacea has probably been one of the most misdiagnosed and misunderstood skin disorders in the history of the human race. The symptoms of Rosacea are so variable that many people have been treated for it when they were in fact, suffering from so other skin disorder and many people who had rosacea were treated for common acne. The term Acne Rosacea was a common medical diagnosis a few years ago. Now it is no longer considered a valid disorder under that name.

Most severe skin disorders put fear into Beauty Therapists, who have been taught to refer the client to a Dermatologist immediately, the feeling being that the Doctor will magically sort the problem out with treatments that are beyond the therapist skills.  Rosacea, however, does not fall into this category. I can boldly say that there has been as much success in treating various symptoms of rosacea by advanced beauty therapists as there has been by physicians. This is due, in part, to the variety of symptoms of rosacea and the fact that the scientific world has no set rules on the origins or causes of rosacea.

Several researchers have theorised that rosacea is brought on by a species of mite, the Demodex Follicuorum,  (a microscopic mite) or Helicobacter Pylori (a type of bacteria). Other skin experts claim facial erythema due to edema and leading to papules and pustules are really rosacea by other names and still other opinions say rosacea is pharmalogic (such as in response to topical steroid use). There is evidence that harsh wind, sun exposure and dietary factors exacerbate rosacea and there is promising research into the immunologic arena.
The therapist must be aware that certain prescription drugs for problems not related to rosacea may cause flushing and redness more readily. In these cases the above type of treatment may be the ONLY type of treatment possible until the client is off the drug.  Vasodilator drugs to watch out for can include: Griseofulvin, Chlorpropamide and Antabuse

Medical doctors are uncomfortable with the term couperose but therapist internationally is familiar with the term and there are many approaches to treating it. The correct, medical term for couperose is Telangiectasia, which in actual fact is also becoming popular with therapists lately. The Beauty Therapy profession for many years has used diathermy, Schlerotherapy and other methods. Now, there is a nicotinic acid cream that will flush out capillaries in the skin that have become pinched or congested at their branch connections, thus swelling them up to where they can be viewed through the translucent layers of the epidermis. I know the word flush seems contradictory for a rosacea category like telangiectasia, but this is a localised action applied directly to the problem area and seems to work extremely well. This type of creame contains niacin derivatives, which are known for their robarant (strengthening) effect on weak capillaries.

There is one symptom called Rhinophyma that requires medical attention. I have seen this disorder on many male clients, especially in Ireland for some reason (maybe the Guinness?)The nose is grossly swollen, deep red and sometimes has actual fissures in the skin and swollen veins.  Another symptom called B-conjunctivitis should be avoided as it deals with the eye tissue, thus making any topical beauty therapy treatment a risky option. If these symptoms are present, immediately recommend a medical specialist. I have personally taken on clients with these disorders over the years, but in general, it is risky business.


  • Flushing (treatable by therapists)
  • Erythema (treatable by therapists)
  • Papules  (treatable by therapists)
  • Pustules (treatable by therapists)
  • Oedema  (treatable by therapists unless chronic)
  • Rhinophyma (medical treatment only)
  • B/Conjunctivitis (medical treatment only)
  • Kerstitis (treatable by therapists unless drug related)
  • Comedones  (treatable by therapists)
  • Scarring (treatable by therapists trained in scar revision techniques).

Controlled Remission would be a better term rather than say, “cure.”  Using the “cure” word to a client suggests that all problems will be sorted out forever. This is totally unrealistic in almost all skin disorders, including aging skin.
Only once in my 37 plus years career did I actually take part in what could remotely be called a cure. A middle aged, attractive woman in Northern California came to one of our skin specialists with inflamed rosacea.

She was to preside over a 20-year high school reunion, which involved seeing people she had not seen for years. She gave us three months to remove her problem. Taking up the challenge, we did every treatment we knew on her skin. We went through skin blow-ups to skin peeling off like a snake. She bravely bore it all and suddenly, six days before the reunion date she started to clear up. By the evening of the reunion, she possessed porcelain skin and our team all sighed with relief!  I have seen a lot of uncanny remissions in my time but this was the fastest response I have ever witnessed. The fairy tale ending was; there was a man at the reunion that had been madly in love with her in high school. To him, she had not changed a bit when he saw her at the function.

He later proposed and they married. And so it is that even in skin therapy we not only may change people’s skins, but also their lives. Unfortunately these cases are rare. Clients viewing before and after photos of extreme makeover successes almost always assume that they too will become nearly flawless in a few weeks. It is vital to remember that counselling a rosacea client about the many irregular factors that go into treatments determines the outcome. These may include genetic, lifestyle, age and any mental attitude that they have regarding their condition. In the last analysis, I believe that the root cause of rosacea isthe Demodex mite, a tiny parasite living in the sebaceous glands. Chronic conditions either are viral or parasitic, not bacterial, bacteria being easy to eliminate.  The fact that we can clear up rosacea with alkaline washes and aggressive, rather then ”calming” treatments has convinced me of this reality.

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