Go away, bumps and redness!!
March 8, 2012 6:47 AM   Subscribe

Fellow rosacea sufferers, can you tell me about your experience with treatments that have worked for you?

I have looked over previous rosacea questions, but I believe the most recent one was from 2009. I'm looking for current experiences with treatments and triggers and all that.

I was diagnosed with rosacea about a month and a half ago. From looking at pix on the internet, I'd say I'm in the "mild" stage. Also, I've looked for resources on the internet as well, and I'm not really extremely impressed with the level of information; it all seems pretty vague. Maybe I just haven't hit the right site yet.

Here are the few things I've tried/been prescribed and results so far. And maybe my expectations for the products are too high??

-- Desonide - .05% - meh, sort of takes away the redness, but not impressed
-- Doxycycline - twice a day X 4 weeks: I couldn't maintain this because the headaches became too unbearable - also, I'm concerned about relying on regular doses of an antibiotic to help take away/keep away the bumps
-- CeraVe (AM, PM lotion and the face wash): again, meh; and not sure what results I should be feeling/seeing, but symptoms still linger
-- Cetaphil: too harsh

What I've read a lot of positive reviews about, but haven't tried, are Metrogel and laser therapy.

(Note - I haven't been back to the derm for a second visit, but I plan to take more questions and concerns back to her, I just wanted to hear your experiences).

So, my questions for you include: are there any products or treatments that have completely "wowed" you with results in treating any or all the symptoms? I know we are all affected individually by this and our own triggers, but I'm curious what has really worked. Does a tube of Metrogel last a long time (I think it costs around $65)? Do you only get it by prescrip? What type of results do you see from a product that really works for you? For example, does both the redness and bumps go away quickly? Anything you've tried that keeps the symptoms successfully at bay?

Oh, and maybe one important thing, since I've been diagnosed and using some of the treatments mentioned above, although soemtimes the symptoms seem better one day, the next day, the red bumps will be in brand new places. So, I feel like it's getting worse actually, even though there are brief "calm" moments. Isn't there a way to stop it in it's tracks? Is this the "norm" for rosacea advancement? Also, does this mean that it'll just keep progressing?

Anyway, I think you get the point - I'd like to hear experiences with rosacea and treatment success or failures.

Thank you very much for sharing and your input!
posted by foxhat10 to Health & Fitness (19 answers total) 21 users marked this as a favorite
I take doxcycline once a day and it works very well for me. I haven't had headaches, though.
posted by DWRoelands at 6:54 AM on March 8, 2012

I was diagnosed recently too (relatively mild also, I think), so I can't say for sure what has worked yet. But the medications I've been using have definitely improved it so far.

-Oracea, which is doxycycline at a low dose, so that as I understand it it's not actually an antibiotic but an anti-inflammatory. No side effects for me so far, but the possible ones are very mild compared to the higher doses.
-Finacea (azelaic acid) in the a.m.
-A cream made up of three different things (I lost the original Rx but on the bottle it says Alcov/Niz/Metroc, if anyone here can decipher that) in the p.m.

It's been about 1.5 months and the dryness/bumpiness is gone, and the redness is faded, it's more like pink. I'm supposed to go back to the Dr in May, so I assume she thinks it should have improved more by then. Hope that helps!
posted by DestinationUnknown at 7:19 AM on March 8, 2012

I have very mild rosacea and I was prescribed MetroGel first, which seems to work well but takes a good couple of months to really kick in (the package insert says 9 weeks I think). Metrogel dried my already-dry skin quite a bit, so now I'm on MetroCream instead. The results are just as good, without the drying. Both products seemed to prevent flareups from my main trigger of super cold, dry air, and keep the redness and bumps at bay. However, my rosacea sounds milder than yours and YMMV.

Both are only available by prescription, but there are generics so you can save money that way, and the tubes last forever because you only need a very thin layer of the product.

Also, I use Aveeno Ultra-Calming Daily Moisturizer, which I believe helps a bit with the redness.
posted by dayintoday at 7:20 AM on March 8, 2012

My husband has mild rosacea and, over the years, he's narrowed down some of the triggers for it (for him):
  • drinking spiced rum (Captain Morgan, to be exact)
  • combination of consuming a lot of gluten (beer, bread) and drinking coffee multiple days in a row
For the record, he does not use any creams or medications. (He doesn't put anything on his face, ever, though - no makeup, and washes it with water.) And he just figured out these triggers for himself through trial and error. YMMV
posted by jillithd at 7:46 AM on March 8, 2012 [1 favorite]

Metrogel possibly helped bumps (or maybe not, they come and go for me anyway) and it peels - looks like your skin is coming off sometimes. No change with the redness but my GP only gave me enough for 2 months.
posted by missmagenta at 7:50 AM on March 8, 2012

I've tried lots of things over the years, but the thing that made a big difference for me was topical clindamycin lotion. I had been using metronidazole (a.k.a. Metrogel/Metrocream), but with limited success. I had to go on oral antibiotics to treat something else, and I noticed that the rosacea cleared up a lot while I was on that. I mentioned that to my dermatologist, and he put me on oral tetracycline for a month or two to see whether that improved things for me. Things continued to stay pretty clear, so he switched me to the topical clindamycin to see if that would work as well. It did, and I'm still using it about a year later. I'm still supposed to be using the metronidazole as well, but I'm less diligent about that. Both are available as generics.

Other than that, I'm just washing my face with Cetaphil's "gentle" skin cleanser (they have a "daily" cleanser, too -- skip that one).
posted by orthicon halo at 8:04 AM on March 8, 2012

Sounds like I'm similar to jillithd's husband -- avoiding or at least somewhat controlling the triggers I figured out plus washing my face usually just with water (and occasionally some Cetaphil, which isn't too harsh for me if I don't use it every day) and not wearing makeup led to much more improvement for me than any of the drug treatments I tried. Metrogel was very harsh on my skin, and the antibiotics caused other systemic problems for me (it turns out I'm allergic to some of them, which at least was a good thing to find out by trying different ones, I guess).

YMMV, of course, but for me, my rosacea (which is mild) got much worse the more I tried to treat it with the various things the dermatologist gave me as we looked for solutions. So I started dealing with the triggers, and that has been the best thing for me. In fact, it has been so long since I had a rosacea flare-up that I almost feel like I don't have it anymore.

Good luck, I hope you find something that works well for you too.
posted by stillwater at 8:08 AM on March 8, 2012 [1 favorite]

I've been using Metrogel (topical metronidazole) for years and it honestly doesn't seem to have an effect either way. A tube is costly but I have yet to finish one before the expiration date (over a year, seriously). About two years ago my rosacea started turning from mild to medium-bad (started getting more pimples and tiny red veins) so I went to a dermatologist and ended up on Doxycycline. I take it once a day (at night), I think it's 50 mg -- Oracea is the same exact drug, only slightly lower, and isn't covered by my insurance. The Doxy is generic and super cheap. It made a huge difference. I think my "triggers" are just a fair complexion and stress, so there's little I can do about it that I'm not already doing.
posted by chowflap at 8:09 AM on March 8, 2012

I think it's 50 mg -- Oracea is the same exact drug, only slightly lower, and isn't covered by my insurance.

Yes, Oracea is 40mg. Not covered by my insurance either - and shockingly expensive - but I got a coupon kind of thing from the Dr so I only have to pay $10. Don't know if that's available everywhere, or not.
posted by DestinationUnknown at 8:27 AM on March 8, 2012

Response by poster: A few of you have mentioned your own triggers, and I've read about the usual triggers (exertion, red wine, etc.) and I don't feel like I partake in many of the usual triggers (I know, it's individual). I don't drink red wine, and I'll have a glass of white wine maybe two times a month, if that. I've given up on long, hot showers (especially hot water on my face) and chemically-laden moisturizers. I don't lean towards or really like spicy foods, I'll have chocolate a few times a week, etc. etc. But - I won't give up my exercise - I enjoy running! But say if I give up the usual food and other known triggers, will running every day or every other make a flare-up really last a day or two and seem to get worse? Man, I hope not! This is really frustrating! But thank you all for your input so far!
posted by foxhat10 at 8:47 AM on March 8, 2012

My triggers seem to be the same as yours - hot water, alcohol, exercise. Cold weather, too.

I should go back to my creams - (clindamycin and a benzoyl peroxide lotion whose name I forget - Delos, maybe?), because they did work well, but I just have been lazy in that respect.

I've also found that Dermablend and Bare Escentuals Redness Remedy help to cover any flareups when I get them.

And it's not related to your issues, but I wanted to share my rosacea success story. I had pustules with my rosacea - imagine the skin of a 14 year old when you're 38 - and my dermatologist started me on spironolactone. Not only have I not had any breakouts since I started taking it, it unlocked some logjam on my water retention or my metabolism and I literally (literally literally, not figuratively literally) lost eight pounds in a week. The dermatologist was really freaked out by it at first and made me get my blood checked immediately to check that my electrolytes weren't out of whack, but they were perfect. I ended up down about fifteen pounds total.
posted by Lucinda at 8:59 AM on March 8, 2012

Response by poster: wow, Lucinda, I like that story!! that would be awesome, getting skin and weight loss treatment all at once :) I'm glad it turned out healthy for you, as well.

and yeah, unfortunately, I can relate because I'm having the skin of a 14 year old at 44! ugh.
posted by foxhat10 at 9:17 AM on March 8, 2012

Cetaphil is too harsh? Do you mean it stings a bit when you put it on? Or that it has a long-term effect?

The clear kind stings me, but only for a minute or three, like toothpaste or mouthwash stings my mouth. The white kind hurts me and is evil and bad (for me.)

Topicals take some time to work. Talk to your derm about something other than a steroid. I'd guess the wash and lotion advice is to be nice to your skin and keep it calm so the meds can work.
posted by Lesser Shrew at 9:19 AM on March 8, 2012

When my skin problems were (finally) diagnosed as rosacea -- I don't recall which form but my derm said it was the rarest and most difficult to treat of the variances -- I was put on Minocycline 100mg 1x/day, which cleared it right up (though I'm still slightly annoyingly red-cheeked, and flush really easily). I was also given Noritate, a metronidazole cream (and have had that filled as Metrogel as well) and Clenia (don't recall the generic name but the active ingredients are sodium sulfacetamide and sulphur, available as both a skin wash and cream) as topical treatments.

The topical stuff doesn't really seem to help much on its own, though from what other commenters have said I may have not been using it regularly enough. The minocycline does an excellent job of keeping the condition at bay and I find I don't really need the topical treatments when I'm using it, but the topicals don't seem to be enough on their own. A couple times I've tried reducing the dosage of minocycline or weaning myself back from it, but the condition always starts flaring up again, so I seem to be tied to oral antibiotics for the rest of my life. (Minocycline's also supposed to be not great as it can cause, IIRC, tinnitus and a weird condition of preventing bruises from fading, but I was put on Doryx for a while and got the WORST gas of my life.)

Casual research seems to indicate that a possible cause of rosacea could be an imbalance in the intestinal flora, which could potentially explain why oral antibiotics are the only thing that really work for some cases.
posted by the luke parker fiasco at 9:22 AM on March 8, 2012

After a particularly painful and nasty rosacea flare-up several years ago, dermatologist prescribed minocycline, which was a miracle cure for me. I've also used metrogel but stopped a long time ago. I now take minocycline caps (100mg) 2x a week and haven't had an episode since.
posted by lois1950 at 11:49 AM on March 8, 2012

My rosacea is pretty mild, so I haven't been willing to get on the medical merry-go-round to try and make it better (you know, try something for 3 months, face blows up, wait for it to settle down, try something else, rinse, repeat). The big thing for me is products--I've tried every "sensitive skin" cleanser and moisturizer that's made and all they do is make me red and irritated. I've given up on all of them and now I just rinse with tepid water, put on my homemade moisturizer (just water, olive oil, and emulsifying wax), and apply Neutrogena Sensitive Skin Sunblock and Physician's Formula foundation. As long as I stick to that and avoid my triggers, I do okay. My triggers are hot water, any kind of friction on my skin and cold, especially cold wind. Exercise doesn't bother me.
posted by WorkingMyWayHome at 4:16 PM on March 8, 2012

Response by poster: @ WorkingMyWayHome - that's an interesting homemade recipe. what are the ratios of the ingredients? Did you ever try Albolene? My derm recommended that, too. I tried it - once! It felt like putting crisco on your face and just tissue off, no rinsing. I mentally couldn't get past that. Is that what your homemade recipe is like?
posted by foxhat10 at 4:41 PM on March 8, 2012

I use the technique here, but make mine with 1/2 c. water, 2 T. wax, and 1/4 c. olive oil. You get a nice creamy texture, but once you put it on, it does feel oily (I use a little at a time and re-apply often to minimize this). I've tried making it with 1/8 c. olive oil and 1/8 c. cocoa butter and that resulted in a better texture--thicker and less oily--but it gave me a rash. Same with kokum butter, grapeseed oil, vitamin E oil, almond kernel oil, and aloe vera (I get all my supplies from Mountain Rose Herbs, BTW). So you can play around with the ingredients and proportions to see what you like. Olive oil is the only fat I've tried that doesn't give me a rash, but I suspect I'm a bit of an outlier on the skin sensitivity spectrum.

I'd never heard of Albolene before, but, yeah, it sounds pretty heavy and oily (mineral oil AND petrolatum!) I might give it a try if I see it in the stores here, but I'm not super-optimistic about skin products at this point. :P
posted by WorkingMyWayHome at 7:39 PM on March 8, 2012

Response by poster: It's been about a year that I was diagnosed with rosacea, I have posted in other rosacea questions what has worked for me, but as per the follow-up metatalk "request", I'd like to list out what the final regimen that has worked wonders for me. YMMV, of course, as we know with rosacea - it's different from everyone, but here's what has worked for me and what I have learned about my own rosacea in this past year:

Morning -
1. very light washing with CeraVe Hydrating facewash (versus the CeraVe Foaming facewash - was a bit too harsh)
2. sunscreen 30+ and moisturizer everyday - Elta MD

Evening -
1. wash with CeraVe Hydrating
2. CeraVe PM moisturizer

Also, my dermatologist put me on an antibiotic and spironolactone to be taken daily, although I don't take them daily since I've been without issues once they started taking effect.

The main foods that I have found to be an instigator would be anything with mint, which is hard for me around the holidays - I love peppermint! and spicy foods.

So, I hope this follow-up helps if you are reading this. And if you are reading because you have been diagnosed, hang in there - it is frustrating and expensive as hell in the beginning, but it will get better!
posted by foxhat10 at 6:40 AM on December 31, 2012 [2 favorites]

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