Severe rosacea flare-up: what to do?

February 5, 2007 9:44 PM

My rosacea has flared up really badly since December. I've gone from a rosy glow to angry red blotches and honest-to-God pustules for the first time. Yes, I'm going back to my dermatologist, but I need some hope that there is some damn thing out there that will help me. [more inside]

I'm 46 and have had mild to moderate rosacea for over 10 years. Topical Metrocreme and Rosacure have helped keep it in check, and I got laser therapy three years ago with good results for some stubborn broken capillaries. (I'm the before and after at the bottom of this page.)

I'm trying to avoid the Toronto cold as much as possible, I'm keeping my showers as tepid as possible, and I'm watching out for food triggers. The antibiotic I got from my dermatologist when this flare-up first started is doing NOTHING. I'm applying my topical medications daily.

I don't know if the extra dry air is aggravating it (I have a bedside humidifier set up until we get the real one installed on the furnace), or if I'm getting close enough to menopause that this could be an issue.

I was planning another round of laser with my doctor this spring, but it's the flare-up and pustules right now that have me worried. Have you or anyone else you've known improved after a bad spell like this one? What kind of treatments have made a real difference?

posted by rosemere to health & fitness (12 answers total)

Avoiding alcohol, hot coffee, hot tea?
posted by Slarty Bartfast at 10:03 PM on February 5, 2007

Those are on my food triggers list, thanks. I think avoiding these will mean that things won't get worse, or that they'll get worse more slowly. What I really want is to get back to my mild-moderate rosacea and stop these flare-ups and get rid of these pustules -- eek!
posted by rosemere at 10:09 PM on February 5, 2007

I don't know if you buy into the whole homeopathic medicine thing (I know I didn't, and am still very skeptical)... but if you would consider trying it, see if you can look up a Leah Dumbrava. She's a homeopathic practitioner specializing in skin conditions, operating in Toronto. She's really helped me with dermatitis symptoms when I thought I'd have to contend with a lifetime of cortisone, and she had some very encouraging before/after photos of her rosacea patients as well.
posted by Krrrlson at 11:20 PM on February 5, 2007

Have you ever tried researching holistic approaches towards rosacea? Try curezone.com. They've got a forum community there with people experiencing rosacea and a myriad of other skin ailments. So hopefully you can try asking some questions there.

I found that area useful. I had bad acne before and I discovered that bacteria and clogged pores weren't causing the problem, but a congested liver (as odd as that sounds). I did a lot of detoxification and changes in diet. It helped a lot to the point where I didn't need to use topical applications anymore since all it did was cover up the problem, not solve it. My next step is firing up a round of laser surgery to restimulate the collagen to repair old artifacts of past acne.

Holistic approaches may work for you, maybe not. But that's my suggestion :)
posted by Myles at 11:31 PM on February 5, 2007

I had a round of IPL treatments last year that worked wonders. I was not considered an extreme case, but I was to the point of pustules. There are different types of laser treatments (which your doctor has probably already discussed with you) so if you're willing to try the laser therapy again, it has greatly improved in the past 3 years.

My doctor, Dr. Peter Crouch, is known as a leader in the field of Rosacea treatments and travels around the globe giving lectures and people travel from all over to receive treatment. The treatments aren't a cure and the rosacea tends to return after 12 months or so, but it is a welcome reprieve.

It doesn't say where you are located in your profile, and I'm not suggesting you make a trip to Swindon for treatment, but you might contact Dr. Crouch and see if he has any advice for you or can recommend a treatment center near you. Also, check out some of the online forums for rosacea sufferers (if you haven't already) such as the Rosacea Blog. They also list treatments people have received and how effective they were for their particular cases.

I have tried eliminating food triggers and homeopathy/holistic treatments (as well as the topical creams) but nothing ever worked as well for me as the IPL treatment. YMMV
posted by medium format at 1:33 AM on February 6, 2007 [1 favorite]

Have you tried roaccutane (isotretinoin)? It's strong stuff, and has some disadvantages (must not be used where there is any chance of pregnancy, for example) but I believe it works for some. I believe there is a theory these days that continued small doses can be effective against bad cases of rosacea.

Worth discussing with your dermatologist if you haven't already tried it, anyway.
posted by Phanx at 2:57 AM on February 6, 2007

Homemade topical erythromycin. The topical antibiotics my doctor prescribed all contained alcohol that irritated my skin. So I put 1 erythromycin tablet in 2 tablespoons of warm water to dissolve. I use a few drops on my face daily and make a new batch every few weeks. My doctor doesn't necessarily advocate this, but sees no downside, and prescribes the antibiotic.
posted by theora55 at 6:05 AM on February 6, 2007

Dr. Hauschka's creams have helped a friend of mine with it. Also are you stressed? Try to get unstressed if you are.
posted by chickaboo at 8:44 AM on February 6, 2007

Have you tried roaccutane (isotretinoin)? It's strong stuff, and has some disadvantages

You bet it does. I had two rounds (for acne) and it barely helped, but had more side effects than I care to list. While there's not really any (apparent) lasting harm from me having taken it a few years back, the aggravation it caused exceeded the benefits in my case. (However, many others report having great results. If you do go the isotretinoin route, just make sure you're fully aware of all the potential side effects.)

Ever looked into jojoba oil? I've had good luck with it. As a bonus, unlike everything else I've ever done for my acne, it leaves my skin moisturized and soft.
posted by fogster at 11:31 AM on February 6, 2007

Someone close to me has rosacea; he's allergic to erythromicin, metrogel doesn't help, and the retinoids are too harsh for him. He uses 2% or 2.5% benzoyl peroxide and a mildly exfoliating toner. The BP is sometimes the one from ProActiv and sometimes Neutrogena Spot Treatment, applied on his whole face 2-3 times a week, pimples or not. He says a good, non-iritating moisturizer is important, as well.
posted by wryly at 12:00 PM on February 6, 2007

Jumping on the wryly bandwagon. The only thing, only thing that helped after years and years of dermatologists visits, salon treatments and way too damn expensive creams is the regimen on www.acne.org. A gentle cleanser, a generous amount of 2.5% benzoyl peroxide and a nice moisturizer. Jojoba oil works well for this purpose and will not clog your pores. Good luck.
posted by notjustfoxybrown at 12:39 PM on February 7, 2007

The best site on the web regarding dermatology issues that I've found is this one.

It has detailed/graphic photographs, symptoms and an excellent index (keywords).

It's possible you have atopic dermatitis, rather than rosacea. Here is more practical information about atopic dermatitis. Common allergens related to atopic dermatitis are: Eggs, peanuts, milk, fish, soy products, and wheat
Dust mites
Mold
Pollen
Dog or cat dander.
posted by nickyskye at 7:40 PM on February 12, 2007