# Rosacea/Basic Skin Care

Prior to beginning any new rosacea treatment, one needs to prepare the skin, and allow the skin to heal from the effects of previous treatments, which may have left the skin damaged or overly sensitive. We often hear people tell us that the rosacea treatments they had been using left their skin so sensitive that “even water hurts their skin” which can be very true. If one then uses a harsh acidic or invading rosacea treatment such as laser, skin rejuvenation or anti-wrinkle treatment, or retinoids, then obviously the rosacea sufferer is going further down the wrong rosacea treatment pathway.
So many times rosacea or the worsening of rosacea from a mild stage to a more severe stage is the result of treatments that we have used in the past or are currently using. Use of acne treatments containing ingredients such as salicylic acid or benzoyl peroxide cause increased redness to the facial skin; often we overuse these products because we feel they are not working. For instance you have more pimples so you use more of the acne treatment. When you do this, the skin reacts by trying to form a barrier of more oil to protect itself from the harmful effects of the offending treatment. So you tend to use more to counteract this effect and in doing so the pores tighten and close resulting in clogged pores, pimples and papules.
While coping with Rosacea, a way to successful skin care is to avoid doing anything to irritate your skin which may cause a flare up and worsen the condition. Anything that makes your skin (more)red is just worsening the problem. When selecting a skin care regimen, it is important to avoid ingredients that may irritate the skin. Alcohol, alpha-hydroxys, glycolic acid, should generally be avoided. Additionally, exfoliation should be avoided, particularly in affected areas. The key to managing skin with Rosacea is recognizing that the skin is suffering an inflammatory response.
Rosacea is very often associated with sun exposure, so protection of the skin with sunscreens is important.

## Cleansing

Experts agree that a gentle cleansing regime is very important. Avoiding chemicals that aggravate the rosacea, but will clean and moisturise the skin is a step in the right direction. Routine everyday care of skin is an essential part of optimal patient management. Common problems such as xerosis, dermatitis, eczema, psoriasis, acne, rosacea, and photodamage leave the skin vulnerable to external insults, partly as a result of varying levels of barrier dysfunction. Cosmetic surgery procedures also typically damage the stratum corneum (SC) and leave skin with a very weak barrier during recovery phase. Cleansing is an important aspect of any skin care, since it not only removes unwanted dirt, soil, and bacteria from skin, but also removes dead surface cells, preparing skin to better absorb topically applied drugs/medication. Care must be taken to minimize any further weakening of the SC barrier during cleansing. Cleansers based on mild synthetic surfactants and/or emollients that cause minimal barrier perturbation are ideal for these patients.
Absolutely no way should harsh cleansers and toners be used. The natural oils on the skin must be regulated to allow the skin to form it’s own defenses against any harmful bacteria or environmental distress. Stick with mild cleansers targeted at sensitive skin. Cetaphil is one of the mildest cleansers out there and an ideal choice for delicate, irritable skin. Avoid cleansers that are heavily perfumed or contain detergents, alcohol, or other known irritants. Just because a cleanser says it provides "mild cleansing" doesn't mean it will be kind to rosacea skin. When looking for a cleanser, look for "Sensitive Skin Tested" on the label. The bottom line: If it stings, don't use it. It's as simple as that. Return it, throw it out, or give it away and start again.
After using the cleaner, the face will be rinsed with plentifulness of water and smudge with a soft towel in order not to irritate your skin. Because the skin touched of rosacea is very dry, you should avoid using coppices or rough towels to rub your face skin. When washing your face you should utilise lukewarm water instead of hot water.

## Basic Skin Care

Never rub the skin. This can be difficult rule to follow, particularly when applying makeup, shave, or dry the skin after cleansing, but it is important. All these activities should be done in a way that does not move the skin. Use a very light touch at all times. An alternative to using a cleanser is to use a warm water rinse. Let your skin air dry as much as possible, and if needed blot very lightly with a soft towel.
Use a moisturizer free of fragrance, dyes, and other known irritants. As with washing and drying, do not rub the product into your skin. Rub the product between your hands before applying very gently and use more product than may seem needed, as this will prevent friction, If you find it easier, simply blot the moisturizer onto your skin after you have rubbed it onto your hands. Any extra product can be removed by placing a tissue over your face and neck and blotting it off. Lay it flat and lightly press and peel off. This method should be used by those who wear a foundation to cover redness. Also of course, pay attention to ingredients in your makeup as well.

## Sunscreen

An unexpected day out at the beach or a sport game in the back yard in the searing heat will leave a rosacea sufferer red all over. The heat from the sunlight can cause flushing and the sunburn cause extra redness. Even when not out in the sun wearing a sunscreen is recommended.
UV light is of a shorter wavelength than visible light and is subdivided into three bands UVA, UVB and UVC. UVA light penetrates deeply and contributes to ageing, UVB causes burning and redness. Very little UVC light makes it past the atmosphere.
The SPF (sun protection factor) of a sunscreen is a laboratory measure of its effectiveness against UVB light that causes sunburn. SPF 15 means that a user can nominally remain in the sun 15 times longer than would otherwise cause them to have sunburn, but this varies with a number of factors. The SPF is not a linear measure of the amount of Ultraviolet blocked. A sunscreen rated 15 blocks 93.3% of UV, and an SPF 30 sunscreen blocks 96.7%. The SPF does not measure a sunscreens effectiveness against UVA light.
Sunlight was identified as the most common trigger by a survey by the national rosacea society. In many studies it has been found beneficial for rosacea patients to use sunscreen everyday to reduce their symptoms. Sunscreen is also highly recommended for patients taking treatments that cause photo sensitivity such as various antibiotics and isotretoin.
Find a broad sprectrum sunscreen preferably with zinc oxide or titanium dioxide as the main active ingredient that is also noncomedogenic and nonirritating skin. zinc oxide and titanium dioxide both block UV light instead of absorb then like most sunscreens. They also work immediately after application while other sunscreens need to be applied 30 minutes beforehand.
It is important to have sun protection while in the sun, but it is also important to use a sunscreen that will not cause irritation. Select a sunscreen target toward those for rosacea or sunscreens that have good reviews by rosaceans.

## Shaving

Shaving will always cause some irritation but it can be minimised.
Get a good rotary head electric razor, a wet/dry one if possible so you can use it in the shower. You can use a shaving lotion to allow the shaver to glide easily over your face. Recommended lotions are jojoba oil, an aloe-based shaving cream or Edge Gel for Sensitive skin. Don't use anything with alcohol in it. You can shave before bed time, in the shower or after having a shower. Shave with light, short strokes in the direction of hair growth. Shaving with the grain helps prevent ingrown hairs, razor burn, and cuts. Instead of shaving against the grain to get a close shave, shave twice. If you use a blade, make sure that your face is coated with a thin stream of hot water before applying shaving cream. Give the cream a few minutes to settle in. Use a sharp razor that has a double blade attached to it. Take your time and rinse with cold water, not hot. Allowing the steam of a shower or hot towel to soften the follicles of a tough beard can be a better preparation.
Do not forget to shave gently and shaving too frequent shaving will irritate skin.

## Concealers and makeup

Both men and women can benefit from the vast range of rosacea friendly makeup products. Give yourself the edge by testing the impact that correctly applied makeup can have. We hope that in reading this, you're armed with the information you need to make this a success.
Make yourself familiar with ingredients which may aggravate or irritate rosacea skin. Some find that they are only able to use mineral makeup. Ingredients to various brands of mineral makeup can be found at the Mineral Powder Foundation Ingredients List website (http://people.delphiforums.com/tracikenyon/IngredList22405.html).
Many of the main stream commercial brands may include ingredients that may irritate. Sometimes the only way to know is to try so it's a good idea to do a bit of research in regards to ingredients. Lots of great brand name foundations out there though. No one product will work for everyone! If you wanted a more sheer look, find a liquid foundation that matches your skin tone and doesn't irritate and mix a few drops into your daily moisturiser. It will give sheer coverage, natural and it may be all you need. Lighter, oil free foundations are better for those with oily skin, and more emollient products are better for dry skin.
Always go for a foundation with a yellow base. Some opt for a green makeup base or primer. Some use concealers with a green tint. For the most part, this is just an added step, with more products now on your skin. Most people find that once they find the appropriate foundation, using green based products isn't necessary.

### Application

Open your mouth when applying foundation to expose the neck area and eliminate an obvious line at the jaw line. When testing, apply a sample to the jawline and then go outside with a small mirror. If you can't see where the foundation is, then you've got the right colour.
Buy 2 different shades of the same foundation, one lighter and one darker, so that as the seasons change you can mix the colours to accommodate any changes in your natural skin colour. Some find that this is not necessary.
As far as application, always apply your makeup in natural daylight. And for novices, spend time at how perfecting application. Always start with less as it is easier to add more as you go along if needed. Put a little foundation on the hand (add a complimentary tone if necessary). Dot it over the face-on the nose, the cheeks, the chin and the temples and in between the brows. Using the tips of two fingers or a small clean, dampened sponge(from which excess water has been removed) blend the foundation. Always work from the face outwards, to avoid an accumulation of the foundation around the hairline-move from the cheeks to the ears, from between the brows down over the nose, from the chin out towards the jaw, then onto the neck. Work quickly, carefully and lightly. Blend well around the hairline, on the neck, below the eyes and behind the ears. Also take the foundation over the eyelids. Finally blot the face with a clean dry tissue, pressing it lightly over the skin. Apply a little powder to set the foundation if necessary. Go lightly the first time and go back to focus on certain areas the second time. Try to make everything look better, not look perfect. Whatever isn't covered by your first application/subsequent spot treating (very light spot treating) you might want to just leave alone. It has to match exactly. Even if you get "Wow, this is nearly invisible", try to see if you can get to the point where you say "Wow, this is invisible." It's absolutely critical it matches. If you try something and for whatever reason this brand doesn't offer you a good enough match, don't buy it just because. Try a different brand, first. When testing, apply a sample to the jawline and then go outside with a small mirror. If you can't see where the foundation is, then you've got the right colour. But, don't judge your match in blinding sunlight, this light will "blend" almost anything seamlessly and will not be accurate.

### Extra bit For Men

Although the above information applies to everyone, I figured I'd touch on this subject further. Don't gravitate to products that say "For Men" on them. The color selections are almost always horrible and they are either too expensive or lacking in formulation. Or both. In short: The men who want to buy this stuff have already bought it and don't care if something is designated "For Men." The difference is in the packaging. "For Men" is for the men with fragile egos. Stick with bigger brands, they have more color selection, better formulations, you name it. MAC, Clinique, Estée Lauder, Armani, Becca, etc. You can do some browsing online for products you might want to try but just jot down the names of the products, don't bother remembering the name of the color. They're usually far off base in person. If going to a counter makes you uncomfortable, you might want to go in the morning when there are less people. Remember: You're not the only guy they've done this for! Sometimes sales associates will try to sell you things you don't need, so in case you didn't already know: you don't need primer, you don't need separate cleansers, etc. While you're learning, sponges and brushes are not necessary. Tell them you'll stick to using your fingers for now. (Unless of course you want to buy them.) Ask them for samples! Even if they have to put them in a little jar or something. Most if not all counters/stores do this. Keep in mind you will need a cleanser that is able to remove makeup. Lastly, if you're going to worry all the time that you have makeup on, always running to the mirror, being self conscious, etc, it defeats the purpose of wearing it. Don't feel forced into this. This should be something to help you feel better about yourself. Not worse.

### Introduction links

* About-Rosacea.com "A Daily Skin Care Program" (http://www.about-rosacea.com/lifestyle2.htm#Further%20Reading)
* Rosacea-Ltd International News "Rosacea Treatment And Skin Care" (http://www.bassandboney.com/news/rosacea-ltd/?p=7)
* Cosmetic Connection "Rosacea 101: Basic guide" (http://www.cosmeticconnection.com/rosacea101.html)

### Cleansing links

* Frequently Asked Rosacea Questions v.1.15 (http://www.faqs.org/faqs/medicine/rosacea/)
* Rosacea Support "Mild cleanser is important" (http://rosacea-support.org/mild-cleanser-is-important.html)
* Cosmetic Connection "Rosacea 101: Basic guide" (http://www.cosmeticconnection.com/rosacea101.html)
* Journal a day "How to Take Care of a Rosacea Skin?" (http://www.journal-a-day.com/Health_And_Fitness/394969-how-to-take-care-of-a-rosacea-skin.html)

### Makeup links

* Rosacea Support archives msg:11538 - Article on foundations (http://health.groups.yahoo.com/group/rosacea-support/message/11538)