If you have a flushed face and are over 50 - It could be Rosacea

Rosacea & The Baby Boom Generation: Potential Causes and Solutions

Rosacea is quite common in those aged 50-65 years and older - a particularly vulnerable² time of life.

Dealing with aging skin is stressful enough. The added burden of rosacea makes matters even worse!

Many analyses of this condition draw attention to the issues faced by younger³ rosacea patients. Elderly patients are too often over looked!

That’s why we’re breaking down the potential causes and current solutions to this skin condition with a particularly emphasis on the older demographic.

What is Rosacea

Rosacea¹ is a (non-contagious) chronic skin disease characterized by a flushed face, redness, blushing, red bumps, and cysts on the face and chest. While most of the symptoms are visible, some rosacea patients feel burning or stinging sensations on their skin, too.

Demographic Profile

Common For Both Men & Women Of European Ancestry

Rosacea is most common for those with European (particularly Celtic) ancestry⁴. However, it can also develop for people of other backgrounds. While it can occur for both sexes, it’s somewhat more prevalent amongst women⁵.

Women typically develop rosacea around the cheek and chin area. Men, on the other hand, experience rosacea around the nose far more frequently than women. Rhinophyma (a form of stage three rosacea skin disorder - the most severe) is almost exclusively an elderly male phenomenon¹.

Rosacea skin disorder - frequency among baby boomers

It’s possible for rosacea to manifest at any age but it usually begins mid-adulthood. The age profile of rosacea¹ is different for women than it is for men.

Rosacea becomes more common after the age of 35 for women, while the increase in prevalence happens later for men (after 50). The frequency of rosacea in the population also peaks later for men (around 76-80 years) than it does for women (approximately 61-65).

Rosacea is especially troubling for the elderly generation. It typically doesn’t go away by itself - and rosacea can get worse and worse without medical intervention⁶. Ignoring the problem for years results in a more severe form of rosacea as you get older (with increasingly intense symptoms).

Causes and aggravators

Scientists are uncertain about the exact cause(s) of rosacea. However, a number of potential causes, contributory factors, and aggravators have been identified.

Potential Causes

- Family History

One 2015 study⁷ concluded that rosacea is driven by approximately 50% genetic and 50% environmental factors. A 2010 study⁸ revealed rosacea sufferers are more likely to have photosensitive skin, have a family history of rosacea, and to have smoked cigarettes in the past.

Despite common misconceptions, rosacea sufferers were no more likely than non-sufferers to drink more caffeine or alcohol. Further research reaffirms this finding - rosacea is not causally connected to caffeine or alcohol consumption^1,9.

- Hormones

This condition is sometimes linked to hormonal changes as a woman enters the menopause phase of her life. When you’re going through menopause the added stress of rosacea is the last thing you need!

- Immune System

Evidence from a 2011 analysis¹⁰ suggests rosacea is caused by an excessive innate immune system response. An overactive innate immune system results in the production of abnormal peptides. Lab tests reveal that these abnormal peptides produce rosacea-like skin inflammation. The authors of this study suggest that this overactive innate immune system response may have a genetic basis.

- Mites

It’s possible that Demodex mites (oil mites) cause rosacea¹¹. These mites live on all humans - especially in the hair follicles and the sebaceous glands on the face. Sufferers of rosacea have higher amounts of oil mites on their skin than the general population.

However, it’s not clear whether the over proliferation of these mites cause or are caused by rosacea. It could be the case that rosacea spawns from an overabundance of mites emerging on damaged skin due to weather¹¹, aging, or overproduction of sebum.

- Drugs

Some drugs can potentially induce rosacea or make an existing rosacea case worse - particularly topical or systemic corticosteroids¹².

Known aggregators

While the exact causes of rosacea are still disputed and somewhat unclear, it’s understood certain triggers can exasperate this condition such as food and nutrients. As our population continues to age, we need to do more to address these skin issues for the 65+ age cohort.

Flushed Face and Skincare Products

Some skincare products can trigger rosacea flare ups¹, particularly for the over 65s. Clinical testing for skincare regularly excludes this age group. This isn’t surprising - elderly customers are not the typical target demographic for new skincare products¹³. However, testing on aging skin is arguably most needed of all!

With age the skin thins and becomes more fragile¹⁴ - meaning older patients are more susceptible to the pain and irritation¹⁵ that can come along with skin conditions. Rosacea is commonly coupled with dryness for elderly patients - resulting in highly sensitive (and often painful) skin!

Other Common Aggravators Include:

harsh weather conditions (strong wind or heavy rain)
prolonged exposure to the sun
emotional stress
anxiety

Solutions

Rosacea is not easy to completely cure. Not too surprising, given that it’s potentially the result of an abnormality¹⁶ in our innate defense system!

Thankfully, there are multiple treatment options available to reduce the symptoms of rosacea. Treatments are increasing and becoming more safe over time.

So if you suffer from just the occasional flushed face or all the rosacea symptoms listed here, it’s important to consult your doctor to find the best treatment for your particular situation. Treatment will vary from case to case depending on the severity and longevity of the rosacea, while also taking any potential comorbidities into account (rosacea is commonly comorbid with depression¹⁷).

Current treatments include:

Topical creams (azelaic acid or metronidazole gel) help repair the barrier of rosacea-induced broken skin. A recent 2018 study revealed oxymetazoline cream (Rhofade) helps reduce facial flushing and redness for rosacea patients¹⁸. However, because rosacea damages the barrier of the skin, these creams can often cause a burning or stinging sensation.

Surgery (including laser surgery) is useful to treat rhinophyma¹ and the prominent erythema common in older rosacea patients.

Hormone replacement therapy can help treat rosacea-like menopausal flushing¹⁹.

Beta blockers (like propranolol) work to reduce the severity of anxiety-related rosacea²⁰.

Acupuncture is a potential rosacea treatment. A 2018 case study²¹ revealed acupuncture was more effective at improving the rosacea of one 52 year old woman than conventional treatments. However, more research with much larger sample sizes is needed to determine its efficacy.

In addition to the treatments above, try to avoid aggravating the rosacea by taking these steps:

Use UVB and UVA sunscreen protection daily.

Protect your skin from harsh weather conditions by wrapping up warm and keeping your skin moisturized in cold or windy weather.

Keep your stress levels low by taking time out of your day to relax.

Steer clear of skincare with irritating ingredients like alcohol and fragrance.

Consult your doctor for a diagnosis

Rosacea can negatively impact an individual’s quality of life and there’s a certain stigma attached because it’s often misunderstood as a symptom of alcoholism.

Rosacea typically develops gradually over time. Symptoms like a flushed face may come and go but this skin condition usually doesn’t disappear by itself. It’s important to treat the condition, otherwise it’s possible rosacea can accelerate into disfigurement²² or loss of vision (in the case of ocular rosacea).

It’s often (understandably) confused with acne as the symptoms can be similar. Yes, you're never too old to suffer from acne or clogged pores and blackheads. Elderly rosacea patients sometimes mistake the symptoms as just a normal part of the aging process²². That’s why it’s always important to consult your doctor for a proper diagnosis.