Rosacea: Causes, Triggers, and How Estheticians Can Help Clients

The National Rosacea Society has deemed April as Rosacea Awareness Month. Learn about rosacea, and what you, as an esthetician, can do to help clients whom are affected by this skin condition.

What is rosacea?

According the National Rosacea Society, rosacea affects an estimated 16 million people in the United States and 45 million people around the world. Often mistaken for acne (and mistreated as such), rosacea can cause tiny red pimples, dry skin and fine red lines. It has periodic flare-ups with symptoms that come and go. It is more frequent among women, yet more severe among men.

What causes rosacea?

The causes of rosacea are not fully understood. Although nothing has been conclusively proven through research, theories surrounding rosacea causes have ranged from autoimmune responses to bacteria, to a mite (demodex) that lives in high numbers on rosacea sufferers, to cathelicidin, a protein that usually protects the skin from infection.

What triggers rosacea? 

While causes aren’t clearly known, triggers of breakouts are well documented.

Dietary triggers: There is a long list of dietary no-nos, starting with alcohol. Remember though, while liquor is a trigger, it is not a cause of rosacea. And among alcoholic drinks, red wine, beer, bourbon, gin, vodka or champagne appear to be the biggest culprits. Dairy products, especially sour cream, yogurt and cheese, should be avoided. Chocolate, citrus fruits, spicy dishes and soy sauce are also known triggers. Even thermally hot food can provoke a reaction. So can spicy cuisine. And just say no to chopped liver!

Other triggers: There are other factors that also affect sufferers, including extreme temperatures, intense exercise, sunlight, stress, anger or embarrassment. Some drugs, such as corticosteroids like prednisone, or compounds that dilate blood vessels such as blood pressure medications, can prompt an outbreak.

In all cases, people afflicted with rosacea should be counseled to take care of themselves. In addition to avoiding proscribed foods, sufferers should wear broad-spectrum sunscreen, and during the winter protect their faces with scarves or masks. They should try to remain well-hydrated and examine their lifestyles for triggers. Ultimately, they should try, as much as possible, to reduce the stress in their lives. The National Rosacea Society surveyed more than 1,200 people afflicted with the condition and 96 percent said they had identified personal triggers, and by reducing those factors they were able to minimize their flare ups.

Is there a cure for rosacea?

While there is no cure for rosacea, modern medicine has developed effective treatments once a proper diagnosis has been given. With changes to diet, lifestyle, and appropriate skincare, outbreaks can be reduced and kept to a minimum.

What should estheticians look out for as the telltale signs?

For an esthetician, nurse practitioner or other non-specialist healthcare provider, it’s imperative to be sensitive to the symptoms of rosacea, as well as a client’s family history, lifestyle, and medical conditions that may contribute to the skin condition.

Photo courtesy of the National Rosacea Society

The signs of rosacea are red facial skin, marked by easy blushing, which sufferers may not at first think is a skin disorder.  While estheticians cannot provide a medical diagnosis, they have the skills to recognize this condition during Stage 1 and perform a soothing facial.

There are three stages of rosacea –

  • STAGE 1: The first stage is a breakout of red skin, in which the sufferer complains of burning, itching skin that is particularly sensitive after application of the wrong cosmetics, sunscreens or scents. Small red veins appear. Bumps and pimples may accompany the outbreak. Such breakouts last from hours to days.
  • STAGE 2: This stage features inflamed papules and pustules. The breakouts last for weeks. Pores become enlarged and damage from the sun can cause distinct scarring. If the sufferer is bald, the pustules can extend into the scalp area. They often cover the neck, throat and behind the ears, even over the back.
  • STAGE 3: This is far more serious – large, inflamed nodules on the cheek and nose, skin that is swollen, rough skin with enlarged pores that might be compared to the skin of an orange. The nose is often one of the first and most prominent areas affected – the rhinophyma associated with W.C. Fields.

Rosacea often also involves the eyes. Indeed, the problem can begin with the eyes and is another often-misdiagnosed problem. Symptoms include dry, irritated, swollen and red eyelids, conjunctivitis and inflammation of the cornea and iris.

What should estheticians do in the spa for clients with rosacea?

Although estheticians cannot diagnose or treat rosacea, as it is a medical condition, I have found in over 47 years of my experience as an esthetician that we can certainly help those clients who are suffering from rosacea. In fact, in 2015 the Repêchage Hydra 4 Red-Out® Facial was launched, designed to help improve the appearance of clients with hypersensitive skin. This facial, made with hydrating and cooling seaweed, can help soothe and calm the appearance of sensitive skin.

When providing facials, I also recommend for estheticians avoid hot steamers, brushing, scrubs, microdermabrasion, harsh peels, aromatherapy and perfumes. Do not massage the skin with your hands as this can create flushing. Instead, you may want to use a Silver Ball Massager that is cool to the touch and can help provide the correct pressure.  (Watch our Facial Massage for Sensitive Skin video)

What is the recommended at-home regimen for dealing with rosacea?

While an esthetician can’t prescribe or claim that they can cure rosacea, they can help the client and provide recommendations to calm and sooth the appearance of their skin. In my experience, with clients, even if they are under a dermatologist’s care and are taking topical drugs, a gentle face wash, such as Hydra 4® Red-Out® Calming Cleanser and serum, such as Hydra 4® Red-Out® Serum, seem to improve the appearance of sensitive skin as reported by our clients. Other skin care products include Hydra 4® Tonic, Hydra 4® Daytime Protection Cream and Hydra 4® Mask. Remind your clients to avoid using scrubs, wash clothes and hot water in their cleansing regimen. This will help calm the appearance of their skin.


*This blog is for informational purposes only and is not intended as medical advice, treatment or diagnosis. Always seek the advice of your doctor or health provider with any questions or concerns you may have about a medical condition.

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