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Finding a good herbalist

Much of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

What is Rosacea?

Rosacea is three times more common in women than it is in men and most commonly starts after 30 or 40 years of age. It is a common and chronic skin condition that usually begins as an increased redness in the central part of the face (nose, cheeks or forehead) but it can also show up on the chin, scalp, ears and neck. There is no special laboratory or blood test that determines this condition so the diagnosis of rosacea usually comes from a detailed physical examination and case-history. One of the quirks of rosacea is that most skin rashes at least temporarily improve when you put steroids on them whereas rosacea, if anything, tends to get worse from steroids.

What causes it?

I have now worked with quite a number of men and women with rosacea and, seeing the distress it causes and how people have often tried numerous treatments without effect, I have done a lot of personal research into it to better understand what it is and what may help.

What causes rosacea is obviously a vital question and, both from the scientific literature and from my own experience with real-life patients with rosacea, I see that there are two main causes 1) damaged facial capillaries from chronic infection and 2) damaged facial capillaries from excess flushing


Damaged facial capillaries from chronic infection

The evidence supporting an overgrowth of harmful bacteria in people with rosacea is compelling and, if you are interested in doing some research of your own into this online, you will quickly find a number of referenced studies showing these connections.

The reason that there has been research into the connection between chronic infection and rosacea is that it has long been known that some people’s rosacea will improve with antibiotic therapy.

It used to be thought that this was because there was a kind of surface infection, generally thought to be from the demodex mite, but this theory has now given way to a wider appreciation of an overall microbial overload, especially in the gut, where the common chronic stomach infection H.Pylori is implicated amongst other potential pathogens.

The improvement in rosacea that may be seen with antibiotics has led to them being widely used as a primary treatment but, frustratingly, antibiotics only work for some people and even more frustratingly the problem can still come back after initially getting better.

We know that chronic infection can be a pivotal cause to rosacea but we need to be prepared to think 'out of the box' to both determine if it is the key driver as well as look at the most important question -- 'what do you do about it?'

Is an overgrowth of bad bacteria causing the rosacea?

In my own practice I have a special piece of equipment that analyses the breath for the presence of hydrogen down to single parts per million. We don't make hydrogen but a number of bacterial organisms do -- including ones that can do us harm if they are too dominant in the gut flora.

Without being able to analyse your own breath for hydrogen there are several other classic signs of chronic infection in the gut. One of them is bloating, the other is excess wind. If you commonly get either or both of these symptoms this this area is likely to need extra attention.

My own experience has shown a clear trend of much higher than usual breath-hydrogen levels in patients with rosacea -- I suspect that an overgrowth of bad bugs is a key part of the condition for many people.


What can help rosacea caused by chronic infection?

A long-term treatment using antibiotics is an option but it is not for everyone -- some people suffering from rosacea will have already tried this without success, or have had a rapid rebound when they stop, others have found that the side-effects of taking antibiotics every day for several months are too upsetting to be worth the potential improvement to their rosacea.

Fortunately there are other methods to help rid the body of chronic infections in the gut and I go into this subject in detail in an article on 'dsybiosis' written up here.

In summary you need to start by weeding out the harmful organisms -- for most people the classic remedies of Garlic and/or Wormwood are the best tools for that job. The second step is to then seed in good bacteria.

For some people with rosacea it may also be essential to improve overall digestion and in this case the best help may come from the great digestive tonic Gentian.

For some it will also be vital to build up immune health in general or any short term gains in winning the infection battle may soon be lost. An overview of this subject is written up here. Amongst other effective methods I particularly rate two great herbs Echinacea -- which you can read more about here and Astragalus, more on it here.

Echinacea angustifolia


Damaged facial capillaries from excess flushing

The ‘flush reflex’ is at its most extreme and most familiar to us when we are acutely self-conscious (i.e. blushing) but it actually occurs all the time for much less dramatic reasons --simply getting too hot too quickly, causes the tiny blood vessels in the face to rapidly dilate with blood and so quickly release excess heat from the face. If those blood vessels are not sturdy enough then, in that process of repeated rapid swelling, they can get tiny tears and ruptures, leading to the broken blood vessels of rosacea.

Many things can cause the facial blood vessels to quickly enlarge -- caffeine containing drinks can do it for some, strong winds on the face can do it for others, vigorous exercise or excess sunlight can be the key triggers for some people and even just hot food or drink can start it off for others. As well as such physical causes there is certainly also emotional triggers to facial flushing -- embarrassment is the most obvious but for some people any strong emotion that provokes the release of vaso-dilating adrenal hormones which can immediately cause a rush of blood to the head.

It is important to be clear in discussing this that such things as strong feelings, sunlight, exercise, hot drinks etc. are all triggers -- they are not the root cause. Triggers are important to identify and diminish where possible but we have to look at the deeper cause here -- which is a heightened flush reflex along with fragile capillaries that combine to cause tissues in the face to become swollen, damaged and inflamed.

Is excess flushing causing the rosacea?

It can be hard to know when you are flushing unless it is a particularly sudden or intense rush of blood (such as in the classic 'blush') because we can't see our own faces without a mirror.

Nevertheless you know your skin and if you are like anyone I've met with rosacea you will certainly have been wondering about what makes your skin worse some days more than others. If you honestly don't know then stick with that but the more you feel that things such as weather changes, spicy foods, emotional stress etc. do set your rosacea off then the more this is likely to be a key issue.

Likewise however much you feel your skin is better when you avoid things that cause you to overheat is some measure of how much the flush reflex is a primary cause for you.

What can help heal damaged facial capillaries?

There are drugs that reduce the blushing/flushing reflex but the literature suggests that these have been used with somewhat limited success and they seem to come at a high price in terms of side effects.

I suggest that a much better first step in helping to heal capillaries damaged by excess flushing is to let Nature help and there are two medicines in particular that seem to do just that.


The first is the herb Horsechestnut which is actually remarkably good at gradually building up the strength of the blood vessel walls -- you can read more about it including practical suggestions re dosage etc. here

Aesculus hippocastanum (Horsechestnut)



The second is the herb Hawthorn which is one of the safest and most reliable of all medicines at regulating and strengthening the heart -- thus in turn helping to stabilise circulatory imbalances -- you can read more about it here.

I have personally seen these herbs work well for my own patients with rosacea but the catch is that you must not expect fast results with them! I suggest a minimum of three months before you assess whether they are making a significant difference and even then you may need to keep taking them for much longer still.

Crataegus monogyna (Hawthorn)


Does using make-up aggravate rosacea?

Yes, it may do, especially if your rosacea is primarily being triggered by the flush reflex because if it is thick enough it may impair your skin from 'breathing' and easily dispersing heat.

However what needs to be weighed up here is the simple fact that emotional stress, even if it is not a primary cause, can certainly make your condition worse

If you are feeling painfully self-conscious because of the degree of visible rosacea on your face then I would be the first person to advise you to use some concealing make-up when out and about to help reduce the adverse effects of stress. That said I suggest you use make-up as sparingly as possible and let your skin breathe naturally as much as you can.

What can you put on your skin to help?

I don't think there is any direct cure for rosacea in terms of skin products however you still need to take good care of your skin, especially when it has been damaged.

I have a lot of time for the use of clay masks for rosacea on the face, especially if someone tends towards an oilier skin complexion. There is a brief write up on the 'how-to' of clay in my article on acne here. Clay is cooling, cleansing and it can be very healing to damaged skin -- I suggest you look into it.

However if a person tends towards a dry skin or scalp I would probably not recommend clay but rather it may be helpful to use a pure emollient such as coconut oil, or perhaps rose-hip oil, to nourish and protect the skin.

If your skin is simply getting too hot then consider the wisdom of regularly putting a cool compress on your face. Done as simply as wetting a face-cloth in cool water (from the fridge or with ice if necessary) and placing over your face until it the cloth has absorbed the heat from your skin and your face is nice and cool again. Try and see, this simple practice has clearly been of significant benefit to some of my patients with rosacea.


Stress and rosacea

This is a big subject in itself. Having been in practice for quite a few years now I can state for a fact that stress makes any health problem worse and virtually all health problems cause stress! It's a vicious cycle that causes tremendous suffering to far too many of us.

I think it is a simple folly to try to make judgements on which came first -- the stress or the physical condition -- they are always interlinked. That said if it is true is that you are feeling stressed about your rosacea, or about life in general, then I trust you will understand that feeling better in yourself is every bit as important as curing your rosacea.

Of course there is no one 'answer' to all this but having worked with a great many people suffering extreme stress (especially after the devastating Christchurch earthquakes) I can say in all honesty that I have put some strategies to help anxiety and tension to the most stringent of tests and found them to be exceptionally effective. I have written about all this in more detail here. Another area of the website that may help if you just generally need to relax are some of the commentaries and/or music here.


Constitutional Health Note

Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general as well as what might potentially help your skin to heal. For example, if you have rosacea and you are one of the damp constitutions you are especially likely to benefit from treatments that target your immune system whilst if you are one of the dry constitutions then working with strengthening the capillaries may be of particular benefit. There is a brief introduction to this whole subject here and a more detailed section on working out which constitution you are here.

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!



© 2011 R.J.Whelan Ltd