The “sluggish pipes” behind stubborn redness

Today I’m bringing you a clinic pearl straight from inside The Skin Barrier Solution private community as I know this topic is getting a lot of buzz rn - but a lot of you aren't feeling confident in the science behind the role of the lymphatic system in rosacea and chronic inflammation.

Recently, one of our practitioners asked: “How are rosacea and the lymphatic system linked?” Here are the cliff notes 😆

It’s all about the waste…

Think of the lymphatic system as the skin’s drainage and waste-clearance network. When flow is good, tissues stay bouyant and inflammatory “messengers” are cleared. 

Studies have shown that skin biopsies from rosacea patients had dilated and in some cases remodelled lymphatic vessels. The physiology of the lymphatic vessels was not normal, or healthy, and therefore not able to do its job properly . Going back to our analogy; the pipes had stretched, twisted, and were essentially blocked. 

When those “pipes” become sluggish or structurally altered, fluid and waste linger → more puffiness, more redness, and longer-lasting flares. This also feeds back into the nervous–vascular–immune cross-talk we see in rosacea.

What emerging research says...

Now this is where it gets really exciting! In one 2022 paper I came across whilst researching this topic for my student, they reported a case study on someone on the more extreme end of swelling (diagnosed with Morbihan’s disease who hadn't responded to medication) that a short sequence of osteopathic lymphatic techniques dramatically reduced swelling. You can read the study here, the B+A’s are pretty impressive!. 

Role of manual lymphatic drainage in rosacea...

What they found was that the manual lymphatic drainage, or in this paper osteopathic techniques, were basically like giving those blocked pipes a little push, encouraging fluid to move and inflammation to clear. The B+A pics are pretty dramatic. Now this paper looked at an extreme case of rosacea, but it makes sense that even in milder rosacea, where the skin looks just a bit puffy or inflamed, there could still be some degree of lymphatic “traffic jam” happening. 

If the drainage system isn’t moving freely, even subtle congestion could worsen inflammation, contribute to the miscommunication between the nervous - vascular - immune system that we see in rosacea and prolong flare-ups. 

So what does this mean for your client care? 

Well, aside from facial massage and bodywork, it's a strong argument, IMO, for educating your rosacea clients on practices like the lymphatic facial brush whose clever little brushes have been designed to activate the lymphatic system....? Though I wouldn’t use directly where the barrier is severely compromised.

Also, as you well know, the benefits of practices like lymphatic massage are also going to be of great benefit to the nervous system too. The lymphatic system is closely linked to the nervous system, so calming touch, slow rhythmic massage, and manual drainage don’t just help with puffiness; they also soothe the stress response. And we know stress is a huge trigger for rosacea. So bodywork can work two ways at once: helping the skin’s drainage system and also calming the nervous system, which indirectly reduces flares.

So, in summary:

• The lymphatic system = skin's waste and water drainage system

• In rosacea, the pipes don’t flow properly → fluid builds up, redness lingers, inflammation worsens. 

• In extreme cases like Morbihan’s disease, this shows up as dramatic facial swelling, but the same principles apply to milder forms too. 

• Bodywork like lymphatic massage is like gently unblocking or nudging the pipes to flow again - reducing swelling, supporting skin healing, and calming the nervous system at the same time. 

This is the kind of nerdy-but-practical support our therapists get inside SBS every week - taking emerging mechanisms and translating them into safe, client-ready steps. And I just LOVE answering these questions and getting to geek out on skin! 🤓

Got any burning questions about rosacea? Lymphatic system? skin barrier health and more? I'm here for them all! Comment below or pop me a DM.