Rosacea
What is Rosacea?
There are 2 main types of rosacea: 1) redness with small visible blood vessels, and 2) pimples and pustules. Rosacea is seen in adults, and you can have more than one type. It is usually over the bridge of the nose and onto the cheeks but can spread over time to the central forehead and chin. Rosacea runs in families and gets worse in certain environments (more sun exposure, drier climates). There are a couple of rarer types of rosacea: 1) rosacea of the eyes, and 2) rhinophyma. These need treatment from a dermatologist.
How do I treat rosacea?
Most people with rosacea will benefit from a few simple steps:
Avoid common triggers, including hot beverages (coffee, tea, hot chocolate), spicy foods, hot (temperature) foods, chocolate, alcohol, and extreme temperatures (bundle up when cold).
Azelaic acid is quite helpful, and it is safe for pregnant women. My favorite option is The Ordinary’s azelaic acid suspension, but another good option is azelaic acid cream.
Sulfur is an excellent anti-inflammatory (anti-redness) product. It comes as a bar soap (wash), gel, or mask. It comes in higher percentages (10%) and lower percentages (3%). Sulfur smells like rotten eggs, but the smell is often masked in the products and doesn’t stay on your skin. See instructions for the wash below.
Moisturize: Apply lots of CeraVe moisturizing cream to fight the dryness on your face.
While waiting for the redness to get better. There are two great options for reducing redness in the short term. I recommend Clinique’s Redness Solutions base. It is great cover-up. Also, oxymetazoline quickly reduces redness for 1-3 hours - it is great if you have a special event. You spray the nasal spray into your hand and apply it to the red areas.
CAUTION: Frequent use of oxymetazoline causes “rebound” redness, where the redness comes back when the medicine wears off and can be more noticeable.
Additional tips:
Reduce stress: Just like other chronic health conditions, rosacea gets worse with stress. This site has lots of simple, helpful tips for reducing stress. When a big deadline at school or work, a difficult conversation, or an illness or death happens, you can expect your rosacea to get worse. If you know a stressful event is coming up, start treating your problem areas before they flare.
Eat healthier: Most people with rosacea notice that when they eat poorly (fast food, junk food), their rosacea flares. Often we eat worse when we are stressed. A good way to improve rosacea and reduce flares is to switch as many meals as you can to whole-food, plant-based options.
Protect your skin from UV damage with a daily facial moisturizer with sunscreen (SPF 30 or more) every morning. I also always recommend sun-protective clothing like wide-brimmed hats.
Steps for using a medicated Sulfur wash:
Once you get into the shower, rinse your face.
Lather the sulfur bar soap in your hand and apply the soap to your entire face. Leave it on for at least 5-10 minutes for the medication to soak into your skin before rinsing off.
Sulfur bar soap can be used once or twice a day as your face wash. You do not need another face wash. Avoid exfoliating face washes.
NOTE: Apply lots of moisturizing cream to fight the dryness.
What if my rosacea isn’t getting better?
Usually, the steps above can help most people get their rosacea better. Sometimes prescription creams or pills are needed, especially if there are any eye symptoms. If over-the-counter options are not working, look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
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