Aromatherapy for Rosacea

“Rosaceae is an odd disorder which seems to defy understanding…”
(Dr. Ronald Marks, cited by DelRosso 2012)

Rosacea (pronounced “roh-ZAY-sha”) is a chronic inflammatory disorder primarily affecting the facial skin and is often characterized by flare-ups and remissions. Rosacea tends to affect adults (after 30 years of age) and individuals with fair skin.  Although women are more prone to the condition it can affect men and often with more severity.

Symptoms may include redness on the cheeks, nose, chin or forehead that may come and go. In some cases, rosacea may also occur on the neck, chest, scalp or ears.  According to Del Rosso (2012), the diagnostic term ‘rosacea’ reflects a spectrum of clinical features with the more common presentations characterized by increased blood flow and vasodilation during disease flares, which accentuate central facial erythema (facial redness which is a result of cutaneous blood vessel dilation and increased blood flow to the skin). Inflammatory lesions, usually papules and/or pustules are present in some cases.

Left untreated, bumps and pimples often develop, and in severe cases the nose may grow swollen and bumpy from excess tissue. This is the condition, called rhinophyma (pronounced “rhi-no-FY-muh”), that gave the late comedian W.C. Fields his trademark bulbous nose. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.

Primary Signs of Rosacea

• Flushing
: Many people with rosacea have a history of frequent blushing or flushing. This facial redness may come and go, and is often the earliest sign of the disorder.

• Persistent Redness: 
Persistent facial redness is the most common individual sign of rosacea, and may resemble a blush or sunburn that does not go away.

• Bumps and Pimples
: Small red solid bumps or pus-filled pimples often develop. While these may resemble acne, blackheads are absent and burning or stinging may occur.

• Visible Blood Vessels
: In many people with rosacea, small blood vessels become visible on the skin.

Other signs may include:

• Red nose (called a bulbous nose)
• Acne-like skin sores that may ooze or crust
• Burning or stinging feeling in the face
• Irritated, bloodshot, watery eyes

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Potential Triggers include:

Foods

• Liver
• Yogurt
• Sour cream
• Cheese (except cottage cheese)
• Chocolate
• Vanilla
• Soy sauce
• Yeast extract (bread is ok)
• Vinegar
• Eggplant
• Avocados
• Spinach
• Broad-leaf beans and pods, including lima, navy or pea
• Citrus fruits, including tomatoes, bananas, red plums, raisins or figs
• Spicy and thermally hot foods
• Foods high in histamine

Temperature-related

• Saunas
• Hot baths
• Simple overheating
• Excessively warm environments

Weather

• Sun
• Strong winds
• Cold
• Humidity

Drugs

• Vasodilators
• Topical steroids

Beverages

• Alcohol, especially red wine, beer, bourbon, gin, vodka or champagne
• Hot drinks, including hot cider, hot chocolate, coffee or tea

Medical conditions

• Frequent flushing
• Menopause (gotta love/laugh that this is considered a medical condition)
• Chronic cough
• Caffeine withdrawal syndrome

Emotional influences

• Stress
• Anxiety

Physical exertion

• Exercise
• “Lift and load” jobs

Skin care products

• Some cosmetics and hair sprays, especially those containing alcohol, witch hazel or fragrances (synthetic and some essential oils)
• Hydro-alcoholic or acetone substances

The information above regarding Rosacea, unless noted otherwise, was obtained from:  http://www.rosacea.org/patients/allaboutrosacea.php

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Aromatherapy Options

The exact cause of Rosacea is unknown and natural holistic treatments are aimed at working with symptoms, both physical manifestations as well as emotions that can accompany the condition.  The main focus for the physical manifestations is on keeping the skin cool, reducing inflammation, vasoconstriction of blood vessels, and preventing irritation.  Emotional conditions which can either be a trigger of or a reaction to include: anxiety, stress, and low self esteem.  Essential oils can be used via inhalation, full body massage (avoiding facial area), and cool/warm baths during remission phases.

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Gels

Aloe vera is a succulent perennial plant belonging to the lily family that grows wild in Madagascar and large portions of the African continent. Because of its many therapeutic uses, it is now commercially cultivated in the United States, Japan, and countries in the Caribbean and Mediterranean. Aloe vera is a common houseplant. The aloe plant is best known for its healing aloe vera gel, a thin, clear, jellylike substance that can be squeezed or scraped from the inner part of the fleshy leaf. A soothing juice is also made from this gel.

Concentrated aloe vera gel is increasingly being employed for aromatic applications for the skin and muscular system, due to its cooling and hydrating effects and for localized applications for muscular aches and pains, varicose veins, burns, and wound healing. Aloe vera gel is one of the best gels, since it adds its own healing attributes. Aloe vera is used for wound healing, burns, and other tissue damage. Aloe vera is also considered an immune-enhancer and exhibits antifungal activity (Pizzorno and Murray, 2000, p. 582). A concentrated aloe vera gel is available in most health food stores.

Aloe vera gel is key in providing a cooling base as well as the perfect medium to add both hydrosols and vegetable oils.

In researching in several discussion groups, a number of individuals commented on having success using a product called: Aloe99.  http://www.amazon.com/Aloe-99-Moisturizer-99-9%25-Processed/dp/B000SY38PM/ref=sr_1_3?ie=UTF8&qid=1335453640&sr=8-3

Another group of individuals found that utilizing aloe vera gel directly from a plant in their home provided the most relief.

Since the condition is a chronic inflammatory disease, this could be representative of too much heat in the body (In Ayurveda, this would be an excess of pitta), so appropriate dietary changes are called for and also the use of aloe vera gel internally may be of great benefit.  For articles on working with excess pitta see: (from Banyan Botanicals) 

rosacea-research-part-2
rosacea-research-part-i
Cleansing Excess Pitta from the Body  and http://www.banyanbotanicals.com/nl/107.html

Potential toxicity: Pizzorno and Murray (1999) report that although rare, hypersensitivity reactions have occurred and that aloe vera preparations should not be used for treating deep vertical wounds, such as those produced during cesarean delivery. In these cases, aloe vera may delay wound healing. Individuals who are hypersensitive to aloe vera may experience a burning sensation on the skin. It may be prudent to ask allergy-sensitive individuals if they have a possible allergy to aloe vera or to administer the patch test to ensure that a reaction will not result.

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Dilution rates for Rosacea:

• During exacerbation/acute phase: 1% dilution =  6 drops per ounce

• Daily treatment: 1- 2% dilution = 6-11 drops per ounce**
**I would recommend staying between 1-2%. If reaction occurs, either reduce to lower dilution rate or avoid the use of essential oils all together and focus on base of aloe vera gel, vegetable oils and hydrosols instead.

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Properties to consider when choosing essential oils include:

Anti-inflammatory: to soothe and relieve inflammation

Essential oils:

• German chamomile (Chamomilla recutita)
• Roman chamomile(Chamaemelum nobile)
• Cape chamomile (Eriocephalus punctulatus)
• Helichrysum (Helichrysum italicum)
• Lavender (Lavandula angustifolia)
• Myrrh (Commiphora myrrha)
• Patchouli (Pogostemum cablin)
• Sandalwood (Santalum album)**Ethically harvested **Endangered species.

Astringent: To cause the contraction of skin cells and other body tissue

Essential oils:

• Cypress (Cupressus sempervirens)
• Geranium (Pelargonium graveolens syn. P. x asperum)
• Neroli (Citrus aurantium var. amara Flos.)
• Patchouli (Pogostemum cablin)
• Rose (Rosa damascena)

Cooling: to reduce heat, soothe from heat

All the anti-inflammatory oils would also be considered cooling, one addition in this category would be vetiver (Vetiveria zizanioides).  Peppermint (Mentha x piperita) is a cooling essential oil but is not recommended in the treatment of Rosacea due to sensitivity reactions.

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Hydrosols to consider include: (these can be spritzed on the face as needed. be sure to keep hydrosols refrigerated!)

German chamomile, Geranium, Lavender, Rose and Neroli (Orange flower water).

Vegetable oils to consider:

Rosehip seed oil, Jojoba, Hazelnut, Sunflower, Tamanu and Coconut oil.

Other items to consider:

Cucumber water and freshly cut cucumber on the eyes to cool internally and to cool the eyes.

It is very important to avoid: all skin products containing alcohol, soap (consider using jojoba oil or baby castille soap with jojoba and tamanu added into it), and never exfoliate rosacea skin.

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Example recipe:

Gentle Facial Cooling Agent (keep in refrigerator to keep cool)

**This blend is also designed to support the Stratum corneum barrier function and to prevent transepidermal water loss.

• 1/2 to 3/4 cup aloe vera gel
• 2 tablespoons organic Rose Hip Seed Oil
• 1 tablespoon Lavender hydrosol
• 1 tablespoon German chamomile hydrosol
• 2 drops German chamomile (Matricaria chamomilla)
• 1 drop Vetiver (Vetiveria zizanioides)
• 3 drops Lavender (Lavandula angustifolia)

Instructions to make

1.  Combine aloe vera gel with rosehip seed oil and hydrosols.

2.  Stir well using a stainless steel whisk.

3. Add in essential oils. Stir again with whisk.

4. Pour mixture into suitable sanitized containers. I like to use the bottles that have a ‘lotion’ spout.  This makes it very easy and accessible to use.

5. Be sure to label with a positive name, e.g. Soothing skin lotion or Happy skin or Cool at last!

6. Store product in fridge and use as needed, at least 2-3 times a day or more during exacerbation. ALWAYS SHAKE PRODUCT BEFORE USE!

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CASE Study (Student in 1998 Advanced Aromatherapy Program)

Liza is a 30-year-old Social Worker who was first diagnosed with Rosacea in 1997. Her dermatologist has here using a topical antibiotic on a daily basis and taking oral antibiotics when she has flare ups. Liza is now interested in alternative methods of controlling her Rosacea that do not contain synthetics or involve taking oral antibiotics, especially since she is on birth control.

Liza has very fair and sensitive skin. She currently is using an Aveda cleanser to wash her face followed by an application of antibiotic cream and an Aveda moisturizer. She felt satisfied with the results of this routine so I decided to make her products that mirrored her current skin care regime.

I prepared the following:

Facial Cleanser: to use each morning

Ingredients: Fragrant Earth’s Cleansing Base (1 cup) to which I added:
2 tbsps of both Lavender Water and Rose Water as mild astringents,

• 3 drops Lavandula angustifolia (Lavender) for its balancing action on the skin and ability to sooth inflamed tissue,
• 1 drop Salvia sclarea (Clary sage) for its anti-inflammatory properties,
• 2 drops Myrtus communis (Myrtle) for its antiseptic quality,
• 1 drop Vetiveria zizanioides (Vetiver) to soothe the skin, and
• 2 drops Anthemis nobilis (Roman Chamomile) for its soothing effects, especially on sensitive skin.

Antibiotic cream:

• 3 drops Cupressus sempervirens (Cypress) for its balancing effect on the skin
• 2 drops Pelargonium graveolens (Geranium) for its antiseptic qualities and ability to help balance the skin as well
• 2 drops Citrus sinensis (Orange) to help rejuvenate the skin, Lavender for its antibacterial quality
• 4 drops Helichrysum iltalicum for its wound healing properties, and
• 2 drops Citrus paradisi (Grapefruit) to help tone the skin.

I added this synergy to 1 cup of Fragrant Earth’s Cream base that I had blended with 2 tbsps. Calendula oil, 1 tbsp. Jojoba oil and 2-3 tbsps. Rose hydrosol. Her moisturizer was made with the same cream base to which I added FE’s Gel base, Lavender hydrosol, Rose hydrosol, Centella asiatica and Calendula oil.

RESULTS:

Liza was very happy with the results and feels that her skin has maintained well since she has been off of her prescription medication. She also likes the texture of the moisturizer and is very pleased with the face ash and antibacterial cream and would like to continue with the treatment to maintain her Rosacea.

On a side note, at the time of treatment, Liza was also diagnosed with folliculitis, more prevalent under her left arm. Her dermatologist recommended a 30-day treatment of oral antibiotics. I voiced concern, not only because she was on birth control but also because we would not be able to get accurate results from the Rosacea treatment as antibiotics were also used to treat that condition.

Liza agreed and I made her a gel to use on the rash. I combined the Gel base blended with Lavender hydrosol and Rose hydrosol to which I added Lavender, Sandalwood (Santalum album), Geranium, and Frankincense (Boswellia carteii), all of which have great antibacterial properties and are soothing to the skin. After a weeks use, she noted that the rash was almost gone and was excited that she didn’t have to take the oral antibiotics.

NOTE: At the time of this student paper I was distributing Fragrant Earth products.  To learn more about their base cream and gel visit: www.fragrantearth.com

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REFERENCES:

Del Rosso, J Q. Advances in Understanding and Managing Rosacea: Part 1 and Part II. Clinical Aesthetic Dermatology, March 2012, Vol 5 (3).

Here are the papers as downloaded on April 12, 2012 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3315879/

Rosacea Research Part I

Rosacea Research Part 2

Pizzorno, J.E. & Murray, T. (1999). Textbook of Natural Medicine. London, England: Churchill Livingstone.

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