ROKer question: How to Prevent Couperose


ROKer Ruth, asked about Couperose. She wanted to know the preventative measures, skin-care advice, and get some product recommendations to try.

Couperose, the cause: Couperose is a condition where redness appears due to the presence of small, dilated red blood vessels visible on the face. Couperose occurs due to poor elasticity of the capillary walls.

Normally, when there is a sudden rush of blood to the skin, capillaries expand to receive the increase of blood, then contract and return to normalcy. In a weakened state of elasticity, however, capillaries will expand, but do not contract and return to their normal state. This results in dilated capillaries with lingering blood cells, making them appear defined and red on the skin's surface. (This is perhaps why you, as you noted in your question, have had vessels appear then disappear, as those vessels might have been able to contract with time after all).

Couperose skin is often caused by certain hereditary factors: skin that is structurally thin and sensitive, and weak capillary walls. Exposure to extreme cold, harsh winds or extreme heat can also contribute to this condition. All skin types can be prone to redness, the only factor they have in common is structural thinness. Often structural changes of aging skin can contribute to Couperose skin.

Couperose is a similar skin condition to Rosacea, but Rosacea is a chronic skin condition involving inflammation of the cheeks, nose, chin, forehead or eyelids. Skin affected by rosacea can also be couperose, however with rosacea you also get an acne-like appearance of lumps and bumps.

How to Prevent: To answer the first part of the question, prevention lies in avoidance of the things that trigger the condition. Anything that causes a flush of blood to the face and dilation of the vessels is defined as a couperose trigger. The most common triggers for couperose skin are:

  • Hot/cold water on the skin: So avoid hot or cold showers, and saunas, saunas are hot too. 
  • Extreme temperatures: Bundle up when going skiing, and avoid deserts or the equivalent.
  • Strenuous exercise: A little difficult perhaps, or extremely easy, depending on which part of the fitness-scale you belong to.
  • Sun exposure: SPF
  • Alcohol: ....
  • Cigarettes: Should always be avoided.
  • Hot/spicy foods: how unfortunate!
  • Stress- well, yes.
  • Certain medications: like ACE-inhibitors, nicotinic acid, statins, and opitates.
  • High blood pressure
  • Harsh/overly strong skincare products: gentle is the key! 

Another valid point in regards to prevention, is the addition of vitamins associated to improvement of the vessel elasticity, such as:

1) Omega-3- fatty acids: in a study published in the June 2006 "European Journal of Cardiovascular Prevention and Rehabilitation", participants were given 2.4 g per day of omega-3 fatty acids for three years. Ultrasound evaluation of the carotid arteries showed increased elasticity.

2) Vitamin E: A class of vitamin E compounds known as tocotrienols were tested for their ability to improve blood vessel elasticity, along with other aspects of cardiovascular health and found to be helpful. The study, involved giving participants three different dosage levels of tocotrienols: 50 mg, 100 mg and 200 mg daily for two months, and the group given the highest dose had the highest incidence of  improved skin elasticity.

3) Vitamin D: Decreased levels of vitamin D and increased levels of phosphates are associated with increased arterial stiffness, according to a study published in the November 2008 "Clinical Journal of the American Society of Nephrology."

4) Vitamin C (if you're post-menopausal): Vitamin C supplementation has been shown to improve carotid artery elasticity by 26 percent in postmenopausal women but had no effect in premenopausal women.

Treatment: Gentle skin care, and a minimalist approach is key in treating couperose skin conditions. Dermalogica utracalming cleanser , - £21.68 with free delivery from lookfantastic, which has a number of skin calming and healing ingredients. You can even use it to remove eye makeup!

As you mentioned in your question, you had been told to use oil-containing- balms instead of water containing moisturizers. I see the logic in that when it's winter, but for the rest of the year there's no reason to be scared of water containing products.

Try this EmerginC D Red Daytime Emulsion 1oz: which contains a number of different types of vitamin E, skin calming aloe- vera, intensely anti-inflammatory mimosa bark extract, almond fruit extract, Biotin- important for proper cell function and  skin cell renewal, Vitamin K, a vessel contractor- especially good for this condition, and the list goes on and on.. $69 from skinstore.

EmerginC D Red Daytime Emulsion 1oz

As far as sun-care goes, this is especially important in regards to prevention. Try to opt for a low irritant, physical sunscreen such as Invisible Zink ESP Environmental Skin Protector SPF 30+  £27.50 with free delivery from feelunique.

At night it might be good to stick to the same anti-inflammatory ingredients found in the day-lotion $69.50 from skinstore, EmerginC D Red Nighttime Strengthening Balm 1.7oz EmerginC D Red Nighttime Strengthening Balm 1.7oz

If your vessels have broken or refuse to contract, you have a few options in laser treatments or sclerotherapy : "Various solutions - saline-based; iodine-based or ASA-based solutions; sotradecol, polidodecanol - are injected into the varicose veins, to “irritate” the vein walls. This produces a “fibrotic reaction”, which causes the walls of the veins to stick together. Within a few weeks, the veins are “sclerosed” under the skin, and disappear without a trace. "

Different types of lasers are used to dissolve the telangiectatic (dilated) veins , one of the most commonly used ones is the pulsed-dye laser.


  • PubMed: Effect of Diet or Very Long Chain Omega-3 Fatty Acids on Progression of Atherosclerosis
  • PubMed: Arterial Compliance and Vitamin E Blood Levels With a Self-Emulsifying Preparation of Tocotrienol Rich Vitamin E
  • "Clinical Journal of the American Society of Nutrition": Exploration of Association of 1,25-OH2D3 With Augmentation Index, a Composite Measure of Arterial Stiffness
  • "Hypertension": Ascorbic Acid Selectively Improves Large Elastic Artery Compliance in Postmenopausal Women