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Could you help me know if I have acne rosacea?

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I have oily face.
It's red in some parts.
Once cheek is worst than the other.
My face itch sometimes and it's when it's oily.
I become red as a tomato when I'm nervous.

I would really appreciate your help.




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I think you may have keratosis pilaris of the face, also known as keratosis pilaris rubra faceii?

It could also be a sensitised skin barrier or irritation from daily wear and tear, or maybe mild dermatitis, however it seems like kprf to me. It could also be rosacea, there are a lot of differential diagnoses.

I have kprf, even though I'm pretty sure it's atypical for my skin type which is between type iii and iv on the fitzpatrick skin type chart. I have been diagnosed by a derm so I know for sure this is what I have.

I also deal with flushing and skin sensations for example burning, tingling, stinging etc multiple times a day on a daily basis. Flushing usually involves the sympathetic nervous system and therefore, although very common in people with kprf, it is also thought to have origins with some errors on the SNS' behalf.

In my opinion, this adds up, and when you think about it, it makes sense, a lot of people who have skin conditions or issues often have an underlying cause or other condition that is the root cause of it all.

I think the flushing involved in kprf/ rosacea type skin conditions is due to hypersensitive or overactive mast cells, which are located in nearly all systems of the body, including the skin, gastrointestinal tract, throat, lungs and much more. These are immune system cells which are responsible for releasing histamine and other chemical mediators such as prostaglandins and leukotrienes during inflammatory or allergy - related reactions, and can have powerful effects. 

So for example, if you flush super easily, like I do, in heat, embarrassment, after certain foods, etc, it may mean the mast cells in your body, including on your skin, are hypersensitive or overactive. It may also mean your body's enzymes responsible for breaking down histamine are not very efficient or are at low levels of efficacy, e.g DAO enzyme not functioning as it should/insufficient levels. These can cause histamine intolerance-related symptoms due to excess build up of histamine in the body as the body is unable to break it down efficiently. This can be seen clearly when as is the case when some people cannot eat large amounts of sauerkraut/kimchi, red wine, dark chocolate etc without symptoms related to histamine such as flushing, headaches, stomach pains, dizziness, panic attacks, anxiety, swelling and so forth. This so called histamine intolerance, is also related to mast cell activation disorders, which are more prevalent than was thought previously.

These disorders involve the same processes as is in histamine intolerance, many bodily systems are involved and are usually quite severe. Chemical sensitivy based reactions with things such as perfumes/ cleaning agents, and or alternating reactions to foods, clothing, stress, etc may also be indicative of a mast cell disorder, or even mastocytosis in some rare cases.

However it is thought that mast cell disorders, albeit in varying degress from mild to moderate to severe, are becoming increasingly common/ recognised in the general population even though it is still highly under recognised in clinican based settings such as your doctor's office! Dr. Afrin and his works are a good place to start is you think you may have a mast cell disorder! 

So basically, it is my personal belief that so-called rosacea / kprf/ other conditions, including pots and lyme etc, have mast cell irregularities in common, and it has been found that even metabolic issues such as diabetes and chronic fatigue syndrome/ M.E involve mast cells behaving in a disorderly fashion! Sorry I went off topic a lot there!

But you can easily see how seemingly unrelated bodily systems/ mechanic all work together in the end and that's why I believe rosacea / kprf with it's flushing and strong sensitivities to temperature, fragrances, emotions, stress and much more, are indicative of mast cell disorders themselves, at what maybe one would call a moderate to severe level, depending on how they affect one's life.

Unfortunately there is usually no cure, however eating a low histamine diet or supplementing with quercetin to stabilise mast cells, or anti-histamines to temporarily stop histamine receptors from firing if you have skin flare-ups etc may be very helpful, and also for with any other symptoms, such as gastro symptoms or headaches related to histamine - may be very helpful.

Also, kprf/ rosacea, since related to mast cell activity, it makes me wonder how many people who suffer with these type conditions, also struggle with other symptoms such as changing food sensitivities/ strong stomach upset, general body inflammation issues/ problems, headaches, migraines, random bouts of strong fatigue, dizziness, blood pressure or temperate dysregulation and /or POTS, which  is postural orthostatic tachycardia syndrome, related to livedo reticularis and blood pooling/ overall circulatory issues.

The above ended up being way longer than I thought oops! However the point I qm trying to get across is that seemingly only dermatological manifestions such as rosacea or kprf may have a deeper root cause as is the case for most people. Be sure to check out and/ or research anything you find interesting above online if you think it could apply to you, as it could improve your quality of life!

If you think you have keratosis pilsris rubra faceii, and have looked at images and flush according to the same triggers as rosacea, you may have it. Kprf usually has a baseline redness on the face, caused by irritation around the hair follicle caused by abnormal keratin deposition, and then if you flush it should turn a much deeper red and you may have sore heat sensations/throbbing on your face due to triggers. 

Using a gentle silicone pad to exfoliate, applying a 5% urea cream daily, and for some, using lactic acid or salicylic acid may be helpful for kprf.

If you want to really make a dent in kprf e.g it is affecting you  a lot, vbeam laser is a very effective option, known to help with the appearance and flushing of kprf, and may involve many sessions of it. However it may come back due to its typically genetic nature.

I have to say, skin conditions are not easy to deal with, in my opinion is especially not conditions that are histamine related, such as kprf or rosacea, as the flushing and extreme facial pain and discomfort due to daily triggers is beyond unfair and awful, due to them being genetic and always there. I feel for you if you have kprf, it's not that common, but is in a sense related to rosacea type 1 due to sympathetic nervous system irregularities and mast cell hypersensitivity/ dysfunction.

Hope this gave you some insight! If you have any questions please ask me we're all in this together! I brought up mast cell issues in this as awareness is lacking for sure.

A bit unrelated, however I have heard acne in some cases is related to auto-immune /immune system blips etc, which is also an interesting thought and fuels the idea that one condition is never singular and that the whole body and its systems are related! Hmm an interesting thought!

Best wishes!!


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