I don't want to look like W.C. Fields...

October 18, 2009 12:10 AM

Living with rosacea... tips please.

I've been to the dermatologist. I've tried Metrogel and Doxycycline. They work ok but are expensive with my insurance so I am not on either right now. About once a month or so my right cheek and chin explode with outbreaks and I HATE it. Facials really do help, but I don't want to have to spend hundreds of dollars on facials every time I feel an outbreak coming on. I know that food intake is supposed to matter, but I haven't found that so much. I eat healthy and my alcohol intake isn't crazy.

Any tips on living with this and what to do when I feel an outbreak on the horizon? Is there anything that will help other than having an expensive facial or filling myself with expensive chemicals from the dermatologist? Right now my right cheek is almost purple with a volcano of healing-but-angry skin. I'm not a fan of looking like WC Fields on a bad day.

Oh, and no... I'm not more stressed than usual... actually I'm less so.

P.S. - Yes, I've read the other rosacea threads. Since a lot of them seemed to be answered by people who weren't going through rosacea themselves I figured it might not hurt to ask again and see if anyone had new comments.

Thanks in advance for the help folks!

posted by miss lynnster to Health & Fitness (27 answers total)

I'm sure you've heard it all, but this is what works for me. Stay away from ALL caffeine. I drink caffeine-free soda and tea, but mostly water. Avoid sunshine as much as possible. Whenever in the sun, always have a sunscreen or metrolotion or gel on. And, I suppose mostly my willingness to fork over the money insurance doesn't pay for metrolotion and the RE10 cleansing solution. Be diligent in their usage. Following these guidelines I have been able to successfully avoid outbreaks since 2002. I feel for you Lynn. Wishing the best for you.
posted by netbros at 1:52 AM on October 18, 2009

God I feel your pain so bad. A run, a second in the sun, or sometimes nothing at all turns me into Rumpole of the Bailey. Metrogel was the only thing that worked for me, however this study suggests a link to bacterial overgrowth in the small intestine, which - when treated with an antiobiotics - had tremendous results in their trial. I find this very interesting, as I have colitis, so my intestine is all messed up anyway...
posted by smoke at 4:05 AM on October 18, 2009

sorry, better link here
posted by smoke at 4:08 AM on October 18, 2009

My dermatologist says I'm allowed to put exactly three things on my face. Water for washing, sunscreen, and that cream he prescribes that I can't afford.

What this means, is I had to stop touching my face, and I had to stop using soap on my face.

Every now and then I get a break out near my mouth, but mostly I credit the sunscreen with keeping my skin clear.

Caffeine doesn't make mine worse, and I exercise quite a bit lately, but that's new so it doesn't get any credit for keeping things calm.

I never learned how to wear makeup, so if you're putting blush or any of that stuff on your cheeks, maybe quit that for a while and see if that helps.

(Mine happens in the nose, forehead, and around my mouth areas. Still very mild. I do expect that it won't stay this mild forever.)
posted by bilabial at 5:07 AM on October 18, 2009

I have a pretty mild case of rosacea, a mostly horizontal band from one ear across the middle of my face to the other ear, but this is what I do to KEEP it mild:

I wash my face ONCE a day with PanOxyl, a bar soap. If I use it more than once a day, it dries the heck out of my face to the point where my skin flakes. But if I skip it, I get rosacea papules like crazy. I found this at my local CVS.

I cleanse my face once (occasionally twice) a day with Eucerin's Sensitive Skin Redness Relief Soothing Cleanser. It's expensive ($13 or $14 per tube) but not as expensive as some creams and lasts quite a while since you don't need much each time. It can be hard to find, but my local Rite Aid (was a Brooks) carries it while the local CVS stores don't.

If I'm going to be outside in the sun for more than 20-30 minutes, I moisturize with Cetaphil's Daily Facial Moisturizer (SPF 15). I've tried a LOT of different facial moisturizers because I have mixed skin - forehead, nose, and chin are super greasy while my cheeks are super dry - and this is the only one I've found that doesn't make me break out in zits in the greasy parts and actually soothes the dry parts. When my cheeks get hot and I feel like I'm going to have a rosacea breakout, this stuff helps cool my face down.

And I quit drinking completely. Which sucks, but it helped. I haven't noticed anything dietary, but I don't eat mammals except for pig (pork).

Also, there's a difference (in my mind) between mental stress and physical stress. I suffer from a bad case of oral herpes, so I did a LOT of research on this topic. Mental stress is when you're working too hard or dealing with a lot of emotional pain. Physical stress happens when your body has to deal with stuff like too much red meat, too much sugar, not enough roughage, too much alcohol, etc. In order for your body to handle those conditions, it can become stressed even while you feel pretty relaxed.

I'm not paid to talk about any of these products by the by - gotta buy 'em like everyone else.
posted by kjccreates at 5:34 AM on October 18, 2009

This really sucks, right? My rosacea involves flushing and redness, but I don't have much direct experience of breakouts. However, I've spent enough time digging around about rosacea in general to throw out a couple of ideas.

1) Topical zinc, as neutral and unscented as you can get, is often reported to calm rosacea breakouts and general skin inflammation. You may be able to find some zinc oxide cream in the baby department of the drugstore that doesn't have a lot of scent added to it. You may also find something in the sunscreen section, or you may need to spend a few bucks at a compounding pharmacist to get what you need. There are some over the counter cleansers/masks, such as Garnier 3-in-1, that include zinc, but it's also a scrub, which you may find irritating, and it is scented.

2) Topical sulfur (again, something you may find in some commercial products, but probably requires a trip to a compounding pharmacist), is smelly, drying stuff, but many people swear by it. There is also a fair bit of medical literature showing significant improvements. This is not a double-blind study, but results look pretty good.

3) Zinc sulfate supplements. At least one study shows definite improvement from taking these supplements.

On preview: I bet bilabial's sunscreen includes zinc.
posted by maudlin at 5:35 AM on October 18, 2009

(Forgot to add: obviously, try any topical treatment carefully and slowly. I found out the hard way that topical sulfur actually irritates me a lot and causes me to break out pretty badly. I think that's a pretty rare reaction, but I just want to point out that nothing is guaranteed.)
posted by maudlin at 5:38 AM on October 18, 2009

Things I've found help with my rosacea (obviously, YMMV):

1) topical zinc (in my case Eucerin Sensitive Skin 30 SPF facial moisturizer)
2) vitamin D
3) drinking plenty of water

Making sure that the proportion of vegetables (especially non-starchy ones) is high in my total daily consumption of food also seems to help. My bad flare-ups tend to happen 2-3 times a year.

I found the gel formulation of Metrogel actually was making me break out and had to stop application for a while - the dermatologist switched me to a cream formulation. When I develop bumps there's still nothing that works better than a course of antibiotics, though.
posted by needled at 6:36 AM on October 18, 2009

Response by poster: Oh, I should add... anything containing sulfur as an active ingredient is not an option. I'm super allergic to all sulfites. (Yeah, I know, seems like they're in everything... it's been an adventure.)
posted by miss lynnster at 7:14 AM on October 18, 2009

I tried so many of the things mentioned above, and everything helps for a while, but not permanently. So I took another tack. I just stopped worrying about it. Now, full disclosure, I'm a 54-yr-old woman who has never been particularly attractive , so I don't have that much vested in how I look. If I'm going to an event where I don't want it to be an issue (and yes, everyone from friends to family to students to total fucking strangers have made remarks, ranging from "look at your adorable rosy cheeks" to "wow, what's wrong with your face." unbelievable- I have a SKIN DISEASE, people thank you for pointing it out in case it hadn't managed to ruin my day yet), anyway I resort to make up if I don't want it to be an issue, which is seldom, since make up makes it worse for a couple of days.
posted by nax at 7:27 AM on October 18, 2009

Yeah, I think everyone's rosacea is different, which is super cranky-making. Mine is exacerbated by sun (you can see a line where my sunglasses rest on my face) and temperature changes. This means I've been fretting about it a lot lately.

I've tried many products after the prescription stuff was mostly useless. Metrogel made my face burn for hours, and all my dermatologist could say was to put moisturizer on underneath. Whatever.

I've had good luck with Mario Badescu products, found through a rec on ask.me. There's an anti-redness kit, even, that I've had good results playing with. I think the prices are reasonable but I spend a lot of money on skincare stuff so I might not be a good barometer.

I also, god help me, got a sample of DermaDoctor Calm Cool & Collected the other day at Sephora. It's an $85 (*sob*) moisturizer meant specifically for rosacean skin. And damn it if it didn't take the redness out of my face IMMEDIATELY. I think it will last a long time -- the sales associate filled the teensy Sephora sample tub only about halfway, and I think I'll be able to get a week out of it -- but that price tag gives me pause. I'm going to give it a little more time to see how the bump situation turns out. If it makes them get smaller or retreat altogether I'm going to take the plunge.
posted by sugarfish at 7:36 AM on October 18, 2009

Oh, and I definitely wear a higher SPF sunscreen than 15. I'm using now a Clarins SPF 40 but it might clog my pores so I'm looking for something less expensive.

I've also heard good things about La Roche Posay, which is much more affordable. It's available at some CVS stores, but none near me, so I haven't tried it.
posted by sugarfish at 7:38 AM on October 18, 2009

I have rosacea too, and it blows. "Oh...it looks like you got some sun yesterday" Grrr.

Anyhoo, I find that my most severe flushing is triggered by changes in temperature and dry skin, so winter is a challenge for me. I keep my bumps in check by using metrogel daily, using a very gentle cleaner (Fresh soy cleaner), and using a very gentle, rich lotion. I only wash my face in the shower in the morning, unless I wear sunblock or get dirty (in which case I wash and moisturize again at night). I get a bump or two occasionally now.

I went through a period a couple of years ago where one of my cheeks was purple, bumpy and painful. I had to take antibiotics (doxycycline) for a few months to get it under control. Once it's under control, metrogel alone works good enough. I know that metrogel is expensive, but a tube lasts a long time - almost 1 year for me.
posted by shrabster at 7:41 AM on October 18, 2009

Sugarfish has a great suggestion - go to Sephora and ask about the products. That's how I found out about cleansers and lotions that seem to work for me. Also, as nax and sugarfish said, I have to change products occasionally because they seem to stop working after a while.
posted by shrabster at 7:44 AM on October 18, 2009

I get some pretty bad flare-ups. Stress seems to be a contributing factor.
I got a dermatologist's sample of Luxiq some time ago and I use that to quench the burning and itching. It burns (pretty bad) when applying the small amount needed but the itching and pain is almost gone minutes later and I am good for a while.
I am not your doctor, I am not any kind of doctor. PLEASE seek the aid of a doctor for this as there can be serious side effects from using corticosteroids.
posted by Drasher at 8:25 AM on October 18, 2009

One person anecdata. I have a friend who has had this condition forever, and claims to have finally cured it with two simple measures: super diligent use of very high SPF sunscreen (and avoiding the sun on his face with hat visors etc.) and a daily dose of 2000 IU of vitamin D3. He's had only one outbreak since 1999, when he quit taking the D3 for a few weeks. Recent studies seem to indicate that supplementing with that amount is safe, but he also has yearly checkups where his vitamin D status is evaluated.
posted by VikingSword at 8:31 AM on October 18, 2009

I believe I've posted this before on rosacea threads:

As a beauty I am not a star
There are others more handsome by far
But my face, I don't mind it
For I am behind it.
It's the people out front that I jar.

:)
posted by nax at 9:11 AM on October 18, 2009

I found metrogel super freakin awful and harsh, fwiw.

I've used eucerin spf 30 (it has zinc) face moisturizer for years and years. Awesome.

Last spring, I started using i.d. bare minerals (the cover-up powder I use most often, but I have the whole set) and wouldn't you know it? Just like the commercials on teevee, I have noticed an improvement in the redness. And thanks to your question, I can report a major reduction in break-outs. In fact, it's been so long since a break-out, I've almost forgotten I used to get them regularly. I got the kit from sephora.

Lots of good tips and insights on this thread, thanks:)
posted by jbenben at 9:52 AM on October 18, 2009

I have a pretty mild case of rosacea - mostly redness and bumps on my nose and the area around my nose/under my eyes. It's mild enough that I don't watch my diet or steer away from caffeine, sun, etc., but noticeable enough that I used to get comments about it.

I've found that Daybreak Lavender Farms has a great product for helping keep the redness and bumps in check: Calmez Vous. For me, the tub of brown stuff (Rose'n'Rassoul Oat cleanser) is what really works. I can skip all the other parts of that cleaning routine and still the redness/bumps are controlled. The price for the tub alone is $24.95, but the one I have currently has lasted me at least six months of daily use.

For make-up, I use the same kit that jbenben mentions.

Good luck!
posted by LOLAttorney2009 at 11:48 AM on October 18, 2009

Whoops... there was apparently a price increase! The Rose'n'Rassoul Oat cleanser tub is $34.95. Still, if it lasts six months, that's not too expensive. Also, it smells divine!
posted by LOLAttorney2009 at 11:52 AM on October 18, 2009

This is the BHA exfoliant that I've found helps my (mild) rosacea more than any other skin stuff I've tried, and that includes the sample of Metrogel the doctor gave me. It has reduced the redness considerably--I mean to the point where other people have commented on it. If the 1% strength doesn't work for you, there is also a 2% strength, but I've tried both and found the 1% was enough for me.

I think the cleanser I use helps too, but I notice it if I skip the BHA stuff for too long.

Good luck--I hope you find something that works for you that doesn't break the bank.
posted by hurdy gurdy girl at 1:58 PM on October 18, 2009

I was diagnosed with rosacea several years ago—I'm half-Irish, and my mother has it, so I get to enjoy the party too.

Just recently, on a whim, I stopped using the mild daily facial cleanser I'd been using. For two weeks, nothing has touched my face except warm (not hot) water, and (when I shave, which is infrequently) Barbasol shaving cream, a sharp razor, and Nivea for Men moisturizing aftershave lotion.

And my skin is now the clearest it's been since I was twelve. There's still a persistent, blotchy blush to it, which is annoying, but the pimpling and roughness are almost entirely gone (and what's left appears to be on its way out).

(Metrogel seemed to help a little for me, but was hardly a miracle cure.)

So, if you haven't already tried the do-nothing approach, it's worth a shot.

sugarfish, I'm going to memail you in a few weeks to find out how that DermaDoctor stuff is working out :)
posted by ixohoxi at 3:02 PM on October 18, 2009

My mother had rosacea something terrible a few years ago & tried everything that's recommended, and it all failed. Then she bought Clinique's Turnaround Concentrate and it cleared up almost entirely, nothing a very sheer powder doesn't hide when out in public. Most of the time she has no redness at all, just very infrequently. Maybe it's the salicylic acid content that helped, it's very small, maybe 1% at most. She also uses the same brand 'mild clarifying lotion' (not the 1, 2, or 3. the mild) which also has a small salicylic acid content.
posted by zarah at 4:48 PM on October 18, 2009

Well, before I was diagnosed with rosacea a few weeks ago, I had always sought out gentle lotions, potions and makeup for my sensitive skin. Now I'm using these products exclusively and it has made a big difference.

I do best on Oil of Olay moisturizer for sensitive skin. It's about as basic as you can get. I didn't like the Cetaphil or Eucerin moisturizers because they always felt really heavy and greasy on my face. The Oil of Olay is a classic, it has SPF and it feels great on my skin. It's not expensive, either.

I prefer the Cetaphil bar soap over any other type of non-soap soap (for my body and my face). But, the Purpose cleanser is better, in my opinion, than the Cetaphil liquid cleanser. So I have switched to that. Bonus: it is better at taking off makeup, too.

Metrogel never really did much for me. I have had much better results with Finacea. I use it every other night (I have a mild case--mostly treating redness rather than pimples). All of the prescription rosacea manufacturers have rebate programs now--so look into those at the manufacturers' Web sites. Sometimes it's a rebate check, sometimes it's a discount card that you use to get your co-pay paid at the point of sale. Also, load up on samples at your dermatologist's office whenever you go (prescription and OTC). Don't be ashamed to ask. I always tell them I travel a lot for my job, which is true, and they give me a lot of samples.

I use Bare Escentuals mineral makeup for foundation. It works very well. I would use this even if I didn't have rosacea.

Clinique has the line for rosacea and redness. I have the yellow powder. I'm not really convinced it is all that great... yet.

Best of luck!
posted by FergieBelle at 5:05 PM on October 18, 2009

Response by poster: Seems we've gone through a lot of the same stuff. I did go to Sephora and ask already, and they recommended some clinique rosacea stuff. I honestly haven't noticed a huge improvement with it. And I switched from Prescriptives Virtual Skin to Bare Minerals/Escentuals two years ago... definitely love that.

I'll have to take some time to sort through the answers to see what I want to do. I think the main thing right now is I NEED TO STOP TOUCHING MY DAMN FACE!!!
posted by miss lynnster at 8:38 AM on October 19, 2009

Response by poster: BTW, thanks for all of your answers and support. Yeah, it's such a frustrating thing. The flushing gets embarassing at times but I've given up worrying about that since I can't really control it. This pimple and bump thing has to stop though. Especially since I'm gainfully employed again so I'm making presentations and walking around dressed up all the time again. A skin problem isn't as much of an issue if most of your time is spent hanging out at home. People really do tend to wonder if something must be emotionally or physically wrong with a 40-something woman with pimples all over her cheek... that I eat badly or am stressed out or whatever... and I want to fix that.
posted by miss lynnster at 8:44 AM on October 19, 2009

re: the Metrogel - you should be able to get a manufacturer's discount card from the prescribing doctor, no matter what insurance you're on.
posted by elizardbits at 4:46 PM on October 19, 2009