Treating rosacea: here's everything you need to know

The tips and tricks to managing rosacea, the skin condition that caused Princess Diana's flushed cheeks

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Princess Diana (L) and Emma Corrin who plays the late Princess on-screen in Netflix's The Crown 

It seems, since it first aired over a week ago, all anyone can talk about right now is season four of The Crown. And why not? There is much to discuss. Like, why Gillian Anderson's performance as the late Margaret Thatcher is a stark reminder of one of her most powerful political weapons, her helmet hair, or whether any of us would ever stand a chance if faced by the Balmoral Test.  

But above all, it's the show's arrival of Princess Diana which has undeniably grasped our full attention thanks to the intricacies that have gone into preserving all the hallmarks of her character, from the iconic fashion moments right down to those flushed cheeks, which were thought to have been the result of rosacea. 

According to Bupa, around one in 10 people in the UK suffer from rosacea, and with heavy, crisp winds and dry central heating being the new norm, those with the condition are likely to see it worsen as symptoms exacerbate over winter.

What causes it?

A common condition - both Prince Charles and Prince Harry are said to have it too given ruddy complexions - rosacea "is a chronic skin disease which manifests itself as sensitive, flushed skin," says consultant dermatologist Dr Hiba Injibar. "These skin types have very sensitive facial vessels beneath the surface which dilate, causing a hot sensation and can eventually become permanent, like in Prince Charles's case."

While it may have contributed to Princess Di's overall look of endearment, consultant dermatologist and dermato-surgeon at EF Medispa Dr Aikaterini Charakida, points to the seriousness of the condition which, as well as redness, presents itself in a range of symptoms including: burning or stinging sensations; dry skin; red bumps; the appearance of tiny broken blood vessels on the skin surface; soreness and swollen skin around the eyes; yellow patches on the skin, and thickened skin around the nose.  

"This unique chronic inflammatory disease results from skin barrier dysfunction, an overactive local immune response and hypersensitive nerves around the blood vessels causing them to widen persistently. Over time it can become more severe if left untreated," she adds. 

Princess Diana is famously thought to have suffered with rosacea Credit: getty

The treatments 

Though an incurable condition, there are many treatments available to help keep things under control. Dr Hiba approaches this in three folds. First by putting patients on an anti-rosacea skincare protocol which is specifically geared towards extremely sensitive skin. Then, by prescribing topical or oral antibiotic treatments, containing medical substances such as metronidazole, ivermectin or brimonidine, which target the problem directly by controlling redness, shrinking blood vessels and reducing inflammation. And finally by offering clinical treatments. 

There are a host of in-clinic treatments available. "At EF MEdispa we offer an extensive range of rosacea treatments, from rosacea peels, which are bespoke facial peels to soothe the skin, reduce redness and even out skin tone, to LED Luminous lift, which utilises light technology to help encourage the production of fresh new collagen, and IPL therapy, a skin resurfacing light treatment that targets inflamed blood vessels to improve skin’s texture and reduce redness," says Dr Aikaterini. 

Your rosacea-fighting kit

Dos and don'ts

While the direct causes of rosacea remain unknown, we do know what can aggravate it. This can stem from a number of lifestyle choices including alcohol intake, stress and lack of sleep, to certain foods such as caffeine, spicy foods or cheese. Even wearing a face mask can aggravate the condition by altering the skin's microbiome. 

What helps is sticking to a great cleansing routine. Aikaterini points out that those with rosacea-prone skin should use a gentle cleanser, like the Bioderma Sensibio DS+ Cleansing Gel, £14.80, twice a day and keep the skin hydrated by using a rosacea friendly moisturiser or barrier cream, such as La Roche Posay's  Rosaliac UV Riche Anti-Redness Moisturiser, £17.50. You should always ensure that you wear SPF to protect against the sun’s harmful UVA and UVB rays, and try to avoid products with fragrance or alcohol in, along with certain acids like glycolic and lactic, as well as sodium lauryl sulphate as these can aggravate the condition.

You can, however, rely on certain biologically active ingredients like green tea, niacinamide and feverfew, which can help to soothe, treat and manage rosacea. Both niacinimde and azelaic acid are naturally occurring acids which can calm the skin and reduce redness. Try Dr Sam's Flawless Brightly Serum, £44, which combines azelaic acid, niacinamide, ascorbyl glucoside and bakuchiol to even out and calm the skin.

And, if like Diana, you are not one to shy away from make-up despite skincare concerns, first opt for a yellow or green-tinted primer to help correct the redness and even out the skin tone, then apply a powder or non-clogging foundation on top, like the It Cosmetics Your Skin But Better CC+ Cream with SPF 50+, £32, which will create a hydrated, colour corrected canvas while being kind to skin.