sensitive dry and flaky skin, sebum and sebaceous glands

Written by on May 9, 2008 with 11 Comments

From:  “Linda Sy MD”
Date:  Mon Jan 4, 1999  4:35 am


It has always been my (previous) belief that the “dryness, flaking and sensitivity” in rosacea patients are associated with and initiated by genetically hyperactive sebaceous glands that secrete more sebum than non-rosacea individuals. The oil (sebum) dries on the skin forming a thin flaky film much like what we see in cradle cap in babies (we call this seborrheic dermatitis). For some reason, the normal resident microorganisms on the skin, flourish in this oil-rich milieu and probably produce some end-products(free fatty acids?) that cause inflammation.

This in return causes redness and irritation. The skin’s immune system tries to control this inflammation by vasodilatation, sending more blood supply to the area thus causing telangiectases (broken blood vessels). The rosacea patient perceives this “rash” as allergy or dry sensitive skin and is reluctant to use moisturizers or sunscreens or soaps on his/her skin because all these products seem to cause burning and stinging. These sensations, BTW, are real. What happens next is that the skin does become drier, unprotected and more inflamed- perpetuating the vicious cycle. At the same time, sebum plus dry flaky dead cells clog pores causing pimples (acne/peri-oral dermatitis). This is a theory.

In conclusion, 3 factors are involved: sebaceous gland activity, inflammation and vascular reactivity. To make things more confusing, are the various triggers. Which is the horse and which is the cart? Are less severe individuals less sensitive and perceive their skin as oily/combination while the more severe perceive their skin as dry and sensitive? Can careful selection of cleansing products, sunscreen, moisturizers, topical anti-microbial etc.  prevent mild rosacea from becoming severe and even maintain control? Anyway, I hope that when we conclude the test, (which incidentally, involves a good mix -males, females, diff. ages, diff skin types) we’ll be able to shed some light!

Linda Sy M.D.
Linda Sy Skin Care

—–Original Message—–

From: David RuizdelVizo
Date: Saturday, January 02, 1999 2:26 PM
Subject: [rosacea] Re: rosacea and wrinkles

Dr Sy:

I notice that some with Rosacea can use body lotions and moisturizers with much success. However, I have never been able to use those products because they consistently produce severe reactions — red, burning skin with lots of pimples and bumps. Even if I use body lotion that’s non-comeodegenic (sp?), and use separate towels for my face and body, my face reacts horribly. My derm doesn’t take this concern seriously. I have been diagnosed with atopic dermatitis, acne and rosacea. Anyway, I hope these new products that you’re testing can work for people like me. Good luck to you, and thank you for taking our concerns seriously.

Matija Mosunic

—Linda Sy MD  wrote:


I have not heard of any data about rosacea causing wrinkles. As a matter of fact, many of my patients w/ rosacea have less wrinkles because of the amount of sebum they have on their skin. A couple of theories why some rosacea sufferers may look older than their chronological age could be: 1) they have very fair skin that burns easily and they were afraid to use any or adequate sunscreen, thus getting sun-damaged and wrinkled. 2) They have inflamed easily irritated skin like some of you and because of this, did not use lubrication. This causes severe dryness, inflammation and flaking that give the skin a dull wrinkled appearance. The skin is akin to a piece of hide. If dehydrated and not oiled properly, while being exposed to water, wind, chemicals, sun etc – it shrivels up, cracks, becomes brittle and easily irritated- in other words, burns and stings like crazy.

How to manage this or prevent this? The answer is to find the proper products that will lubricate and protect yet not cause problems or interfere w/ the treatment medications. It may not be easy but that is the point of my project. With the help of 12 volunteers, I hope to conclude w/ some basic answers to some puzzling questions.

Linda Sy M.D.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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11 Reader Comments

  1. I have suffered exactly this for many years! It is worse in the summer. Somethimes my face is fine–no red, no flaking, itching etc. Just about EVERY lotion/moisturizer/makeup/sunscreen causes this rosacea thing to emerge. I have light skin and pale blue eyes. I suffered some extreme sunburns when younger.

    I would love to know just what products/substances I could use to protect my “hide” from cracking/wrinkles etc.


    Thank you.

  2. CJ says:

    That is the best theory I’ve heard so far, too bad they haven’t found a cure yet 🙁

  3. Anne says:

    I have finally found relief from my rosacea after many years of suffering intermittently.

    Here’s what I’ve done:

    Lysine 500 mg, 3x/daily

    Wash face with cold water only in am and with aloe cleanser in pm.

    Aloe based cleanser with NO STRONG/Bad ingredients which I found through ingredient research on the internet

    Pure Squalene oil smoothed on face/neck after face cleaning

    Gel/lotion with 5 supposed ingredients for good skin (NO SLS/fragrances/dyes/petroleum ingredients etc.) also researched on the internet

    Then moisturizer with researched ingredients from internet.

    Very ight mineral makeup dusted on with a brush.

  4. Stephanie says:

    To the Doctor,

    Please help me. Please e-mail me at home and thank you for keeping my e-mail private. I had controlled rosacia for years. When it started flaring, I got on doryx which helped a lot. I had an occasional pipmle in my 50s. But all of a sudden, I’ve developed this rash on my face which my dermatologist says is rosacia related seborrhea. A biopsy confirms this. All of the medication that he gives me to help the rash causes acne. He says it won’t but it does in my case. I have used topical steroids. They are known to cause acne. I tried a little pimecrolimus but that supposedly causes acne too. Is there anything to treat this seborrhea rash that will not cause acne? Can anything be compounded by the pharmacist? Please help! Stephanie

  5. Jessica Johnson says:

    I have knowingly had rosacea for about 3 years now. I have red hair, extremely fair skin with freckles and blue eyes. I live in Florida and wear sunscreen daily and hid under clothing from the sun. I had been using Ovace facewash with finacea gel for a year and that cleared up the small rash like symptoms and didn’t dry my face out. That regiment has ceased working and I have been using the finacea, ovace and two obagi rosaclear products the hydrating complexion corrector and the spf 30 moisturizer. The trouble is now I have pimples again on my chin around my monthly cycle, the small bumps are back on my forehead and now I have dry flaxy skin on my nose and forehead. What products do you recommend I try to get my skin back under control. I am getting married later this year and would love to have clear skin or at least no flaky skin. I can handle the flushing but the flakiness gets to me. Any and all suggestions are welcome!

  6. LL says:

    Jessica (and others) I just recently discovered that zinc oxide (not nano zinc oxide) seems to work well by calming my face down diminishing redness, itchiness and zits too. It does look whitish for awhile after application but my complexion is rather pasty to begin with… Since it can be drying i use a lot of pure jojoba oil first. I’m continuously experimenting… but the particular product I am trying at the moment is actually an inexpensive diaper rash cream which is all natural, fragrance free (most important for me) with no petroleum or parabens or any irritants like that.

    I’ve also been using a fragrance free pure castille soap (made from extra virgin olive oil) which has worked better than anything Ive tried so far.

    Improving diet has helped too. As well as switching to fragrance free hypoallergenic laundry detergent not make from petroleum products.

    Don’t know if that helps. Like i said, I’m still experimenting.

  7. md says:

    help my skin is red,itchy,flaky skin,dry skin and also it gets oily when i don’t wash my skin my eyebrows and hair falling out

  8. Sarah says:

    I got diagnosed with rosacea at only 16 yrs old. I have struggled for years to find what worked best for my skin.
    My skin is so dry that even 100% pure olive oil soap will irritate it. I am 28 now and for the last 4 1/2 years I have been on a skincare routine where i only wash my face with an all natural soap every two weeks. i lightly massage it with a washcloth to remove any dead skin. It is extremely irritated after washing it and this is why I only do it every couple weeks. I use Jojoba oil every day on my skin. It helps alot with keeping some moisture in it. Also oil has cleansing properties as wierd as that may sound so it helps to remove any daily dirt that might be there. My skin has never been better. My skin looks pretty normal now and i am alot happier too.

  9. EM says:

    Hi, I’m not sure if I have this but whenever I’ve typed my symptoms on google, it has led me to this.

    I am 19 years old, with a pale complexion including freckles. I would say that my skin is combination because although it has mostly been slightly dry I can often get an oily and dry forehead.

    Over the past week I have suffered very dry skin in blotches that are the slightest pink however it has become even worse as the week has continued. My akin has started stinging for the past four days and that too is getting more painful, even lying on the side of my face on my pillow is painful. I have tried sudocrem and e45 which is mainly for babies so it’s the purest moisturisers however they ridiculously stung my face even more.

    I’ve not used anything differently.

    Is this rosecea? Or something different. Can anyone help?


  10. Hazell says:

    Hi EM
    Just read your post about sudocrem also E 45 my experience with using both wasnt good as they contained Lanolin which I found out I was allergic to, I use cetaphil gentle wash and cetaphil moisture cream when I wash using the cetaphil wash I only pat my skin dry with a very soft towel. Both of these products are fragrance free also lanolin Alcohol free which work okay for me as I have very sensitive skin.
    My doctor sent me to a dermatologist who tested me for allergys which has been helpful , I also was first diagnosed with Seborreic derm then 6 month later rosacea plus papules and pustules which I have antibiotics for. I now keep out of the sun using sunscreen as it only make the redness worse for me.


  11. Lea Thibo says:

    Just experienced my first rosacea outbreak. Steroid cream helped but dried my face out bad. The area most affected was beneath my eyes. The rash is gone but seems to have left wrinkles. I look like I aged 10 years in 3 weeks. Hopefully still in the healing process and not permanent. Any suggestions will be appreciated

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