I’ve never had skin problems my entire life, not even in my teenage years. I had the occasional breakouts but my acne prone Dad was quick to offer me Proactiv which almost immediately took care of the issues. I had never been to a dermatologist’s office either. So imagine the irony when I moved to NYC to start my dermatology training and developed the worst skin condition I’ve ever seen on my face. After a few visits with NYU dermatology faculty, I was diagnosed with rosacea and started on appropriate treatment. But this disease is hard to treat and its waxing and waning nature drives me crazy! Here are my thoughts on how to live with and fight rosacea.
What is rosacea?
Rosacea is a common skin condition usually affecting lighter-skinned individuals that causes redness and acne-like bumps on the forehead, cheeks, and chin. There are 4 types of rosacea (I have a mix of #1 and 2)
- Erythematotelangiectatic: redness and easy flushing and blushing of the cheeks as well as superficial blood vessels visible on the skin
- Papulopustular: redness, acne-like breakouts and bumps on the skin, swelling
- Phymatous: thickening and distortion of tissue usually on the nose like this picture
- Ocular: irritated red eyes and swollen eyelids
What are some triggers?
My first symptom was redness and flushing that wouldn’t go away. I flushed at random times, sometimes with a trigger and sometimes for no identifiable reason. Over time I started realizing what my triggers were – embarrassment, hot humid weather (thanks NYC), alcohol, exercise, cold weather, sunlight, spicy food. I always flushed with alcohol ingestion since college, since I’m Asian and I’m missing the enzyme aldehyde dehydrogenase – see my post on
why that happens here. But after moving to New York my flushing with alcohol got a lot worse, sometimes to the point where my cheeks turned a scarlet red and stayed that way for hours. A big thing to avoid redness is to avoid your triggers as much as possible. My rosacea actually improved a lot during the winter when the climate became cooler and I was less sweaty. I also try to drink less alcohol now since I know my face will turn many shades of red from just a few sips.
How do you treat it?
At first I thought I had a contact dermatitis (skin allergy basically) to some new product I was trying. But after I cut out almost all products, I realized my skin was still red and inflamed! I asked around my co-residents and then finally saw Dr. Cohen, a world expert in contact dermatitis. He was the one who finally suggested rosacea as a diagnosis. After realizing that this was my skin condition, I started making lifestyle changes and taking medication to fight the rosacea. I have a mix of two types of rosacea, the erythematotelangiectatic type (flushing and redness) and the papulopustular (little bumps all over my face). The treatments below are for these two types of rosacea, not the phymatous or the ocular rosacea types.
Luckily, there are makeup products out there for hiding redness on the skin! Here are some of my favorite products for hiding the erythema:
So there’s my two cents on living with rosacea. I still have days when my face looks almost back to normal but the majority of days I still look flushed. It improved a bit in the winter but I’m bracing myself for the summer when the sunlight + extra humidity will likely make me flare again. On the plus side, I guess I never have to buy blush 😛
Anyone else out there with rosacea or have tips for how to combat the redness? Would LOVE to hear!