There are two major causes of rosacea, in my opinion. The first is a genetic predisposition to develop veins and redness from the sun. The second is the SUN, which I believe is the biggest factor. Why do I believe this? People with rosacea acquire facial veins very easily from sun exposure. These veins occur from sun-exposure, but not the sun-exposure you think of when you think of the sun. I’m not talking about the sun we get on a beach or an amusement park. It’s the sun exposure we get every single day when we aren’t paying attention. We are exposed to the sun while driving in our car, while walking around, and going to and from our homes and the car.
If you look at patients with rosacea who drive a lot their symptoms are usually much worse on the left side of their face (in the US, on the right in England). This tells us that UVA, the non-burning rays of the sun, are probably a big contributor to rosacea, since car window glass blocks UVB, but not UVA.
So, we acquire these veins from the sun, and people with rosacea have a predisposition to developing them, but once we acquire these veins they tend to be much more reactive than other veins in our body, and are very good at making more veins when exposed to more sun. That’s why people seem to get worse at a rapid rate, once their rosacea gets more noticeable.
Facial Veins Become Highly Reactive
Facial capillaries have arterioles that regulate blood flow and can cause flushing. Those arterioles are much more reactive in the facial capillaries we acquire from the sun than in other areas of our body, so when we drink coffee, drink hot liquids or alcohol, and exercise we’re much more likely to flush and blush in those facial vessels acquired from the sun.
In addition to flushing and blushing, once we acquire all these veins in our face, it changes the characteristics of our facial skin. So, we are much more likely to get pimples in skin affected by rosacea. So now not only do we get spider veins in our face and diffused generalized redness, but we can also get acne-like pimples.
Rosacea can even affect our eyes, a condition known as ocular rosacea, which has symptoms like itching and burning of the eyes. An eye doctor can tell you if you have eye rosacea or ocular rosacea.
Failure to treat rosacea will result in an increase in symptoms and flare-ups over time.
What Factors Can Cause a Flare-up?
There are several factors that cause rosacea flare-ups. Drinking alcohol, drinking coffee, drinking other hot beverages, eating hot soup, spicy foods, certain topical products, exercising, or even going out in the cold or heat can cause the arterioles, which regulates how much blood goes into these extra blood vessels, to dilate and temporarily make rosacea look worse. Although, in my opinion, none of these triggers permanently affect rosacea, in the short term they can make people look much redder and cause a flare-up of symptoms including the acne-type bumps that come with rosacea. So, they are temporary triggers.
Prevention: Sun Avoidance is Imperative
Because people with rosacea acquire facial veins very easily from the sun, preventing sun-exposure is crucial. Also, 71% of UVA light comes through car windows, so clear UVA & UVB blocking film can be installed on car windows to prevent exposure while driving. Most people only ‘count’ the sun-exposure they get while at the beach, when they are purposely going in the sun. Sadly, this is only a small fraction of the time we are ‘outside’ driving our cars, walking around, or doing small repetitive tasks like going to the mailbox.