Rosacea and Exfoliation

  • Should rosacea sufferers exfoliate? 

  • If so, how and how much? 

  • Will exfoliation aid in the healing of rosacea? 

  • Will it harm rosacea-prone skin?

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SBT Seabuckthorn Cleansing Regime

Seabuckthorn And Rosacea

At Seabuckthorn International, our rosacea treatment products and advice are anchored in the premise that rosacea is an auto-immune, inflammatory, whole-body syndrome best treated by a multi-pronged, inside out approach incorporating nutritional therapies, lifestyle changes and skincare. This approach is supported by a body of evidence, and is in contrast to other rosacea theories that assert simple rosacea causes such as sebaceous over-activity or the Demodex mite. Additionally, there are many threads of misinformation about rosacea, which can result in misapprehensions about the most appropriate treatment. The place of exfoliation in a rosacea treatment plan is the aspect we will address here.

Defining Exfoliation
First of all, what is exfoliation? Exfoliation is simply the removal of skin, but in most conventional applications, the word is intended to mean the removal of dead skin cells from the skinís surface. Our bodies naturally shed dead skin cells, but sometimes dead skin cells get trapped in pores causing acne symptoms, or remains on the skinís surface giving the appearance of dry, flaky skin.

Manual exfoliation takes two main forms, chemical and mechanical. Chemical exfoliation methods include acids, hydrogen peroxide preparations, Retin-A, and other substances. Mechanical exfoliation ranges from gentle friction using clean fingers (our method, see our SBT Seabuckthorn cleansing programme for details), to abrasives like cloths, mitts or scrubs, to clinical dermabrasion using sanding and sandblasting tehnologies.

Appropriate exfoliation will leave your skin smooth, soft and shiny without being greasy, and will minimise the appearance of wrinkles. Over-exfoliation will leave your skin feeling and looking chapped, may cause uncomfortable tightness, redness, or red bumps, and may actually make your skin flakier.

How Much Is Too Much?
If you read our related cleansing programme material, youíll discover that weíre not big fans of assisted non-clinical mechanical exfoliation treatments (exfoliating with scrubs or cloths). There are many good reasons to avoid using such harsh methods on your skin, but even gentle exfoliation with your fingers can be overdone, resulting in over-exfoliation symptoms. We recommend starting with 15 seconds twice a day and working up from there after two weeks. Many people use our method for up to 120 seconds a day, but some rosacea sufferers may find even 30 seconds a day too much.

Why Rosacea And Exfoliation Don't Always Get Along
The two misconceptions about rosacea that result in unnecessarily-vigorous cleansing treatments are:

  • that rosacea is a form of acne and therefore the treatment should  mimic acne treatments; and 

  • that rosacea is caused by the Demodex mite, which is gorging itself on sebaceous secretions and oil, and must Ė along with its food source Ė be forcibly removed.

Acne
Notwithstanding the fact that too-vigorous exfoliation isnít good for acne either, addressing the acne comparison: rosacea is sometimes called acne rosacea, but it differs from acne in several respects: 

  • if bacteria is present in rosacea sufferers, it is of a different strain than that associated with acne vulgaris; 

  • rosacea sufferers seldom experience the over-production of sebaceous secretions associated with acne

  •  rosacea-prone skin is much more sensitive.

Rosacea- and acne-prone skin have two things in common, however; inflammation, defined as irritation and vulnerability of skin cells coupled with interstitial fluid that causes swelling - and over-zealous shedding of skin cells that gets trapped in pores, causing or contributing to whiteheads. However, while rosacea skin is often thicker (like acne-prone skin), the thin skin surface is more fragile (despite its sometimes scaly appearance), which means any exfoliation needs to be more careful and delicate.

Addressing inflammation specifically, consider this: when the delicate, easily-damaged skin surface of the rosacea sufferer is exposed to harsh chemicals or abrasives, or even to cleansers for too long a time, the fragile surface develops cracks and tears, and the inflammation that causes swelling (and therefore whiteheads and cysts due to the skin debris getting trapped in pores) is stimulated, thereby exacerbating the rosacea rather than helping.

Demodex
Itís a horrible idea, that mites are infesting your skin, eating your skinís debris and secretions, and causing the devastating inflammation and cysts that mar your face. Itís no wonder that many rosacea sufferers take to their skin with Brillo pads and Comet, trying to remove as much of this scourge as they can.

While the notion of Demodex as the cause of rosacea has been promoted, it has not yet been proven. It has been proven that a small proportion of rosacea sufferers do have an overgrowth of Demodex (and donít forget that the average human has over 300 microbes growing on and in her body), but it has not been yet shown that Demodex is the cause, rather than one symptom of rosacea.

However, even if you do have an overgrowth of the Demodex mite, if you choose to battle the bug by trying to energetically scrub it away, you are doing it a favour rather than striking it a mortal blow.

Yes, your thickened skin, swollen-shut pores and excessive shedding of skin cells are encouraging the mite, but it is due primarily to a failure of your immune system that the mite is allowed to proliferate. 

Irritating your skin and fostering further ruptures are only taxing your immune system, and the healing from these abuses causes more over-shedding of skin cells.

Finding The Exfoliation Balance
As a rosacea sufferer, your skin does Ďturn overí skin cells more quickly than average, sometimes resulting in dry, flaky skin. The lack of skin oils to moisten and soften your skin can further contribute to this. But your skin is so fragile and delicate that you must be very careful and gentle in any attempts at exfoliation, for rosacea is so unforgiving.

First, avoid touching your face as much as possible, and avoid extractions (squeezing plugged pores and cysts) at all costs. Follow the cleansing programme from the above link, starting with 15 seconds twice a day and working up after 2 weeks of success. You should be able to gently exfoliate for 30 seconds a day without irritation.

If you find your skin showing symptoms of over-exfoliation, try gently cleansing for only 5-10 seconds and using the exfoliating massage with seabuckthorn oil instead; if the symptoms persist, try a different cleanser. 

Avoid all chemical and mechanical exfoliation, except under the supervision of a licensed skincare practitioner (aesthetician experienced in treating rosacea, dermatologist, etc). You may also find success rinsing your face with purified or distilled water, if extreme chemical sensitivity is part of your rosacea profile.

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