Sandra Toccalino is a pharmacist with over 15 years of experience in the community pharmacy sector and GP surgery, working alongside a multidisciplinary team of doctors, nurse prescribers and dermatology consultants.  

Sandra joined our pharmacy team after completing her Clinically Enhanced Independent Prescribing Course at UCL, and is the first point of contact for patients seeking help and advice for managing various conditions such as acne, rosacea, eczema and pigmentation. 

We spoke to Sandra to discover more about rosacea and to find out her top-tips for treating the condition.

Rosacea is a very common but poorly understood skin concern. Could you please explain what is rosacea? 

Rosacea is a chronic inflammatory skin condition that usually occurs on the face. The nose, cheeks, chin, and forehead are usually the most affected areas by the disease. Rosacea symptoms can be temporary or long-term and the most common ones include redness, prominent blood vessels, bumps or pimples and spots. Rosacea sufferers may also experienceburning or stinging sensation when washing their face with skincare products or even with water and a dry or rough skin texture. 

Thickening of the sebaceous glands, particularly in the nose area, can occur for those suffering from rosacea for a prolonged period. In addition to the common symptoms, patients may experience anocularmanifestation of rosacea thatconsist of redness, dryness or burning of the eyes. 

What are the different types of rosacea? 

Rosacea is traditionally classified into four types: 

• Erythematotelangiectatic: patients present transient erythema (flushing) or persistent erythema with or without enlarged or visible blood vessels. 
• Papulopustular: persistent erythema with papules in the central area of the face. 
• Phymatous: thickening of the skin or sebaceous glands, particularly in the nose chin and forehead. 
• Ocular: burning or stinging sensation in the eye, light sensitivity, dilated blood vessels of the sclera or other parts of the eye, and periorbital edema. 

However, in clinical practice the diagnosis of rosacea is more dynamic as patients often present signs and symptoms of more than one type. 

In your experience, who is more likely to be affected by rosacea and skin irritation? 

Both women and men can suffer from rosacea. In my experience, the condition is more common in women, but the cases I have seen in men are more severe. Rosacea predominantly affects fair-skinned individuals, with the age of the patients ranging from late 20s to mid-50s. 

In your experience, what do you find are the main clinical indicators that suggests a patient may have rosacea and what does rosacea look like? 

The clinical indicators depend on the type of rosacea, for example redness on the cheeks, nose and forehead, accompanied by a burning sensation on the face could indicate erythematotelangiectatic rosacea.

Another commonindication are visible dilated blood vessels on the face. Persistent red pimples or spots indicate papulopustular rosacea, while bloodshot eyes and light sensitivity may be signs of ocular rosacea. 

What are the main rosacea triggers? 

There are various triggers for rosacea: Extreme temperature, sun exposure, stress, vigorous exercise, medicationandsome cosmetic products just to name a few. Patients should be educated about common triggers that can exacerbate their condition and try to avoid them when possible. 

What are the top tips you give to patients who want to treat their rosacea symptoms? 

I always try to educate patients, particularly the newly diagnosed, about the most common triggers of the condition. I always encourage patients to use a broad-spectrum sunscreen of SPF 30 or higher. It’s important to find a chemical-free formula that they can tolerate without irritation. 

For patients with telangiectasia, I recommend tinted sunscreen or an oil-free mineral foundation. In general, I advise them to avoid makeup that is hard to remove and products that contain alcohol, menthol, or eucalyptus. I advise them to avoid products that contain soap, sodium lauryl sulfate and glycolic acid. 

Why do you recommend the Colorescience All Calm regimen to patients that experience rosacea symptoms? 

I recommend the regimen because the products in it are formulated to address the various symptoms of rosacea. UV light is one of the main triggers for rosacea and the All Calm Clinical Redness Corrector SPF 50 provides effective protection from UVB, UVA and HEV (blue) light. It has a neutral green tint to neutralise redness and cover enlarged blood vessels.

The Brush-On Shield SPF 50 is perfect to apply on the go and top up, so patients enjoy full UV protection throughout the day. 

The All Calm Multi-Correction Serum can be used as part of the regime or as a standalone treatment that provides excellent results. It is formulated with a clinically proven BioSolace complex that helps to soothe and calm sensitive skin. In addition, it contains Crystalide which helps to preserve skin’s integrity andglycerinthathelps (provides) for(remove) hydration. 

The serum is ideal for patients who prefer a colourless and lightweight formula that still delivers a powerful boost of hydration. 

Are you experiencing any of the symptoms mentioned above? Take our quiz to find out if you may have signs of rosacea...