Is rosacea an autoimmune disease? Top derm says maybe

Internet beauty groups are calling rosacea an autoimmune disease, but is that accurate?

Rosacea is a chronic skin disease that affects the face and can come and go over time and affects as many as 16 million Americans according to recent statistics. Some of the tell-tale symptoms like red, splotchy marks on the forehead, nose, cheeks and chin can be there forever. Facebook beauty groups, Instagram influencers and TikTokers all seem to be suggesting one thing lately—that rosacea is an autoimmune disease. In fact, some sources suggest that the rate of celiac disease doubles with women suffering from rosacea, a strong indicator that something is going on.

Purvisha Patel, a board-certified dermatologist in Memphis, Tennessee and founder of Visha Skincare, strongly believes that the only way to properly assess rosacea and treatment options are by seeing a qualified doctor. It’s a trend that dermatologists around the country are latching onto out of the concern of misinformation and potentially dangerous home-grown treatment options being perpetuated in catchy social media videos and posts.

A link between rosacea and autoimmune disorders?

"Seeing a board certified dermatologist is important if you think you have rosacea, as there is prescription medication that can help the process," she says, adding that "The chronic inflammation from rosacea can cause increased size of the oil glands and can change the shape of facial features such as noses- a condition called rhinophyma. Prescription medications commonly used are metronidazole, a topical antibiotic, Azelaic acid and ivermectin topically. People with eye involvement may also be given a low dose oral antibiotic. People with rosacea, because of the flushing, over time get an increased number of blood vessels to the surface of the skin. These red lines or telengectasias on the face can be treated with lasers."

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Patel, who is also a Mohs skin cancer surgeon, has been practicing 15 years in her Memphis office and has seen the full range of patients seeking everything from rosacea and associated symptomatic diseases to those looking for a bit of aesthetic Botox.  

"Rosacea is a genetic skin condition that entails inflammation of the sebaceous, or oil glands of the skin and flushing of the skin," she explains. "It presents in many ways, with some people just getting flushing and redness of their faces. Some people get pimples and an acne like eruption, eye dryness, and some people get a burning sensation of the skin of the face. If rosacea goes untreated it can result in a permanent bubbly appearance of the skin and nose, which is called rhinophyma."

Is rosacea an autoimmune disease though?

"Rosacea is an inflammatory process, which means there are immune cells involved. There is much debate if this is the body’s response to mites in the skin," says Patel, who doesn't feel comfortable pinning rosacea down as entirely autoimmune-related, "And some treatments that work are targeted towards the demodex mite, whereas autoimmune means the body is attacking itself. In rosacea the inflammation is targeted to the sebaceous oil glands, so that is why it is likely described as an autoimmune disease."

Even worse, seasonally hot and humid climates like those in the Memphis area and much of the East Coast can aggravate the condition. " Adry cold climate or hot sweaty climate," can trigger rosacea flare-ups, says Patel. "Both extremes can disrupt your skin barrier and in turn result in more inflammatory response in normal skin. For those with rosacea, the response can be exacerbated."

The Dermatology Times didn't hold back in their article on the subject, outlining other clear links to associate health issues.

"Female rosacea patients have higher rates of autoimmune disorders including type 1 diabetes, celiac disease, multiple sclerosis and rheumatoid arthritis. Men, with rosacea, however, were only more likely to suffer from rheumatoid arthritis, according to a recent study."

What does this mean for rosacea treatments?

Rosacea treatments are all about keeping that inflammation to a minimum, it seems. "Antibiotics such as doxycycline are used to calm the inflammation down," she says of prescription treatment options, adding that one of the biggest helpers is a far more over-the-counter approach. "Diet is also stressed as the skin is the largest immune organ of the body and the gut is the second largest immune organ. Decreasing your intake of inflammatory foods such as sugar and dairy may help decrease the symptoms of rosacea."

The next most-helpful thing rosacea sufferers can do to help keep their symptoms at bay is a little more expected, and definitely easy to access for most. "Your skincare regimen is the icing on the cake to rosacea treatment, as it can hurt as well as augment the inflammatory process depending on what products you use."

Dr. Patel suggests always wearing a sunscreen during the day as sunburns can trigger additional inflammatory response, and only using mild cleansers to prevent the harsh inflammation caused by exfoliants of all kinds.

Visha Skincare Mommy Brightener, $65 here

"Use serums with azelaic acid such as Visha Skincare Mommy Brightener," she says, which can, "Augment rosacea treatment as it is an active ingredient in even some prescription treatments." For women in their 40s and beyond, supplementing with added moisture can be a major help as well, suggests Patel, "Rejuvenating Moisturizer is a calming moisturizer that helps with moisture loss from loss of estrogen. A dry, impaired, vulnerable skin barrier is more prone to be inflamed from the environment."

Calming your rosacea doesn't have to cost anything though

While you should definitely seek medical care from a board certified dermatologist to treat your rosacea, the idea that keeping it under control has to be prohibitively expensive just isn't true even if your insurance doesn't cover skin-related care.

"Lifestyle changes like the ones below are an important step in getting your rosacea under control," she says. Those include:

• Drinking at least six glasses of water each day

• Getting a solid eight hours of sleep

• Taking MVI treatment

• Taking probiotics or eating fermented foods with natural probiotics 

• Use SPF 30 or greater

• Reduce or eliminate sugar and dairy from the diet

• Don't eat late at night. The inflammatory response is also linked to reflux, so don’t go to sleep two hours after eating.

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