I see many people needing assistance with redness and skin flushing. Many have tried every topical “miracle formula” out there, to no avail. When we get started on a naturopathic protocol to address the inside-and out causes of Rosacea I get incredible results with my patients. It is estimated that this chronic inflammatory condition affects p to 15% of certain populations, with an increased prevalence in fair-skinned individuals1. 

I would love to assist you and your loved one in overcoming the uncomfortable issue of Rosacea and facial redness and have put together the below four step naturopathic protocol for addressing Rosacea.  

If you benefit from this protocol, we would love to hear from you! Please share your before and after photos with us here. 

Before we get started, let’s understand Rosacea a little better.  

What is Rosacea 

There are two most common types of rosaces: 

1. Erythematotelangiectatic Rosacea: this subtype of Rosacea is most characterised by its frequent episodes of transient facial flushing and persistent, skin redness and red/broken capillaries. It may be accompanied by facial puffiness, burning, or stinging.  

1. Papulopustular Rosacea: characterised by ‘whitehead” pustules, which are pus-filled blemishes, and red, swollen bumps. These typically appear on the cheeks, chin, and forehead and are frequently misidentified as acne.  

Although it is not as common, Rosacea can sometimes cause the skin to become bumpy and thicken, especially on the nose. Rosacea tends to run in families and to affect people with fair skin, although darker skinned/olive complexions can also get it, with it often misdiagnosed as it can often appear as red acne breakouts that come and go or dusky brown discolouration vs typical skin redness.  

What causes rosacea?  

Whilst there is no known cause, a few factors seem to be common in those affected by rosacea. Light skin with a thin barrier, a genetic predisposition, Helicobacter Pylori, facial blood vessel abnormalities along with low Vitamin C have all been associated with this condition.  

One of the most common factors I see across people with Rosacea is that they have a gut health issue which can present as Irritable Bowel Syndrome (IBS), reflux or a disrupted gut microbiome post a stressful period or medication such as anaesthetic or antibiotics. This is why I focus so much on healing the gut as you will see below.  

Your 4-step naturopathic protocol for Rosacea 

STEP 1: Understand your triggers.  

Whilst there is often no one factor contributing to Rosacea, understanding and reducing triggers is one of the most effective ways to manage symptoms whilst you work on addressing the underlying issue.  

The below activities/elements may exacerbate the dilation of blood vessels associated with Rosacea, leading to inflamed skin that appears red and flushed: 

• Hot baths, showers, spas or saunas 

• Sun/UV exposure 
• Strenuous exercise 
• Expose to wind, snow or a change in temperature 
• Stress or anger 
• Air conditioning  

Foods and drink can also be a common cause. The four C’s’, is a group of foods known to cause increased blood flow to the face resulting in flushing and irritation for those with Rosacea. The four C’s and other foods which may make your Rosacea worse include: 

• Citric acid found in berries, oranges and tomatoes 
• Chocolate 
• Chilli  
• Caffeine 
• Spices such as cinnamon  
• Preservative 202 found in many wines, vinegar and dressing 
• Alcohol in particular wine  
• Histamine rich foods such as yeast, mature cheese, dairy and processed (in particular smoked, canned and deli meats)  

STEP 2: Heal your gut lining  

There is undoubtedly a strong link between gut microbiome health and incidence of Rosacea. In a study of over 50,000 patients, the prevalence of celiac disease, Crohn’s disease, ulcerative colitis, Helicobacter pylori infection (HPI), small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome were all higher among patients with Rosacea as compared with control subjects2. Interestingly, even increasing fibre in your diet and reducing the transit time of food through your digestive tract (improving motility) has been found to reduce symptoms of Rosacea3. 

Low stomach acid has also been shown to be linked to skin flushing and Rosacea symptoms.  

In my practice I talk patients through this by explaining that a weak or “leaky” gut lining which can be caused by an imbalance of gut microbiome (or H.pylori, SIBO and IBS) can lead to particles and proteins of foods entering the blood stream when they shouldn’t be if your gut lining was intact. These bodies are considered foreign by your immune system which launches an inflammatory response. This inflammatory response leads to a rush of blood, dilation of blood vessels and as a result the skin redness and flushing we often see in Rosacea. To combat gut imbalance and work on healing the gut lining, recommend a four-pronged approach as follows: 

1. Balance your gut microbiome - Deploy anti-microbial herbs containing berberine to weed out the “bad” gut bacteria. My go to for this is Golden Seal a berberine containing herb (which is in short supply so use it sparingly). Cycle using this supplement for two weeks at time (two weeks on, two weeks off) at the recommended dose for 2 months. Use in combination with Edible Beauty Inner Essential – Skin+Liver tablets which contain anti-inflammatory herbs, berberine and turmeric root to improve gut and skin health whilst simultaneously improving liver clearance of toxins and unwanted microbes whilst you perform this cleanse. 
   
   
   
   
2. Restore your gut lining – use Glutamine, Slippery Elm, Aloe vera to help to restore your gut lining. Slippery elm and Aloe contain mucilage which help to coat and seal your gut lining, improving symptoms of IBS and a leaky gut. You will find these in our Inner Essentials – Skin+Gut Renew powder. 
   
   
   
   
3. Add healthy gut bacteria – Home-made dairy-free yoghurt and coconut kefir are a great way to re-inoculate the gut with healthy bacteria. However, going too hard with fermented foods may cause your symptoms to worse so start off very slowly with fermented foods, I recommend just a tablespoon of coconut kefir to start with then adding 1 teaspoon of sauerkraut 3 weeks after starting the protocol. Build to 1 tablespoon over the course of the next 3 weeks and from there add 1 tablespoon each week until you are having about 3 tablespoons daily. I find the probiotic Saccharomyces boulardii immensely helpful in improving gut imbalances. 
   
   
4. Add fibre – Fibre has been shown to directly positively impact Rosacea symptoms. Try to get your 30 grams in daily. I recommend taking 3 tablespoons of flaxseed meal daily, along with healthy low-GI fruits such as berries, kiwi fruit and stone fruits. If you are having grains turn to low GI grains such as buckwheat, quinoa or amaranth.  
   
   
5. Consider hydrochloric acid supplements – if you suspect you have low hydrochloric acid, symptoms include gas, bloating, difficulty digesting protein you may need to supplement with HCL. Take 1-2 tablets of high quality hydrochloric acid with every protein containing meal to ensure you are absorbing and breaking down proteins and foods properly. If you have white clouds on your finger nails you may also be suffering from a zinc deficiency (often linked to HCL deficiency). Supplement with 50 mg of Zinc Picolinate daily for 2-3 months.  

Step 3: Strengthen your skin barrier topically and internally  

When it comes to alleviating symptoms of Rosacea, strengthening your skin barrier is essential. This ensures that the capillaries on your face are not as reactive to external or internal elements that cause dilation and flushing.  

Internal skin barrier support  

My go-to for improving skin capillary strength is Vitamin C, however the key is using plant-based C which is entrapped in plant cell walls such as that found in our Native Collagen Powder. Taking more than 500 mg of synthetic Vitamin C (most commonly Ascorbic Acid) can result in increased oxidation rather than helping ot prevent it. Our Native Collagen Powder which contains 4 times your RDI of Vitamin C per teaspoon. Made with a blend of Hibiscus, Kakadu plum and native Australian ingredients.   

External skin barrier support 

Getting into a good skincare routine is so important when it comes to treatment of Rosacea. 

1. Change up your cleanser. Dermatologists who treat Rosacea will agree that it is best to go from a gel-based cleanser to a milk-based cleanser which will prevent further aggravation of redness and irritation. Our 1 Belle Frais Cleansing Milk is a calming and hydrating cleansing milk which contains calming oils such as Camellia Seed Oil and gentle fruit extracts along with Wattleseed which is rich in amino acids to strengthen and repair.
2. Strengthen your skin capillaries. Using a plant-based Vitamin C is important when it comes to strengthening skin and reducing broken skin vessels. Our No.3 Exotic Goddess Ageless Serum. is our antioxidant serum containing hyaluronic acid along with the world’s highest plant based source of Vitamin C via Kakadu Plum and other Australian natives including Riberry. 
3. Nurture your skin microbiome. Studies show that in addition to your gut microbiome impacting your skin health, your actual skin microbiome can also dictate whether you are susceptible to skin redness. Our Microbiome Calming Milk is the perfect milk serum to restore your skin barrier and balance your skin microbiome. With pre, and postbiotics it is a highly recommended support for anyone experiencing skin redness and Rosacea.
4. Rebuild your skin barrier. The skin needs a strong barrier to protect it from redness triggering elements such as the weather and environmental pollutants. Our & Coco Bliss Intensive Repair Creme is the one product I would say is a must-have for anyone suffering from red or unhappy skin. It contains Ceramides, the ultimate skin-restoring ingredient as it contains cholesterol and fatty acids, the two primary components of the outer barrier of the skin.  Niacinamide works nicely alongside Panthenol and Vitamin E to reduce skin inflammation and restore the skin.  
   
   
   

STEP 4: Avoid these common skincare ingredients 

Whilst we have discussed many food-based triggers for Rosacea flare ups, you also need to make sure you are not applying anything topically that may be making your skin redness worse. I do want to provide you with a caution list of avoid ingredients that I have seen trigger redness: 

• Fragrance – look out for synthetic fragrances. Natural essential oils are generally okay, we use calming Essential Oils in our Edible Beauty Skincare such as rose and sweet orange which are gentle and non-irritating. Essential oils that may cause irritating include tea tree, rosemary, jasmine, peppermint and cinnamon.  
• Synthetic vitamin C – Ascorbic acid can be irritating and cause skin sensitivity when used in topical products. Avoid synthetic C and used plant-based C as you will find in our No.3 Exotic Goddess Ageless Serum.  
• Drying alcohols - for example denatured alcohol, isopropyl alcohol. Witchazel found in many toners can also be irritating.  
• Sulphates - found in cleansing milks and exfoliants. 

• Circulation-boosting extracts including ingredients like gingko, Coq10 and mint.  

I also recommend avoiding exfoliating until your skin barrier has completely healed and restored. Even gentle and natural exfoliants can cause sensitivity. I also recommend avoiding anything invasive and beauty treatments such as microdermabrasion which can damage your skin barrier making flushing worse. Retinol is also harsh and sensitising, if you are keen to continue using retinol our phyto-retinol formula (Beauty Reset Drops) is in a base of squalane and can support redness reduction and skin barrier restoration.  

I hope the above protocol is useful to you! Please do let me know if there is anything I can do to support your skin healing journey.