So, you’re dealing with rosacea. The semi-good news: You’re not alone. The U.S. government estimates that more than 14 million people are living with this chronic skin condition. Celebrities like Cynthia Nixon, Sam Smith, and Lena Dunham have spoken openly about dealing with rosacea, which causes mild to severe symptoms of facial redness, bumpy skin, burning, and visible blood vessels.
Dealing with rosacea is not exactly a bowl of cherries, but it can be successfully treated with a combination of lifestyle modifications and prescription medications. The earlier you can spot the disease, the quicker and more effectively you’ll be able to pursue a treatment that works. Step one if you suspect something’s up with your skin? See your doctor. “You should see a board-certified dermatologist for diagnosis, as there are other conditions that can be mistaken for rosacea,” says Ivy Lee, M.D., dermatologist at Pasadena Premier Dermatology in Pasadena, CA. “You’ll have a thorough discussion of treatment, which often includes prescription medications and streamlining routine skincare regimens.”
With the help of your dermatologist, you can figure out an effective and cost-efficient plan to treat rosacea. The exact approach will depend on your specific situation, but here are a few options your doctor may want to explore with you.
Everyone’s triggers are slightly different, but the most common ones include sun exposure, stress, alcohol, spicy foods, and heat. Once you figure out which of these things (or others) bothers your skin, you’ll be better equipped to avoid flares in the future.
Given that sunshine is a major rosacea flare trigger, the easiest treatment may be a quality SPF product for your face. “Sun protection is key for everyone and is also the most important lifestyle modification for someone with rosacea,” says Laura Ferris, M.D., Ph.D., an associate professor of dermatology at the University of Pittsburgh School of Medicine. If you have sensitive skin (as many people with rosacea do), the American Academy of Dermatology recommends trying a mineral sunscreen containing titanium oxide or zinc oxide.
If your condition is mild, your doctor may simply recommend changing up your skincare regimen to include more skin-sensitive products. “For mild cases of rosacea, gentle over-the-counter moisturizers and sunscreens can be effective,” Dr. Lee notes. Your skin needs space to heal, so try not to layer on harsh products or cosmetics day after day. Give it the necessary air it needs to breathe.
Prescription Topical Creams
Your dermatologist will assess the severity of your rosacea and determine how to proceed based on those findings. Often, you’ll begin treatment with a topical medication. These include cleansers, gels, or creams that contain ingredients like metronidazole (an antibiotic), azelaic acid (which kills bacteria and helps skin renew itself), and brimonidine (reduces redness). Others contain the active ingredient ivermectin, an anti-parasite medication. These products are designed specifically to target the mites (yes, mites) on your skin thought to be involved in the development of rosacea.
Antibiotics known as tetracyclines are sometimes used in the treatment of rosacea for their anti-inflammatory effects. Other anti-acne meds, like isotretinoin, may be prescribed for treatment-resistant rosacea, but these cannot be given to a woman who is pregnant or thinking about becoming pregnant because of serious side effects. Oral meds are often used in combination with topical therapies to get the most out of your treatment plan.
If your rosacea is severe and not responding to these other methods of treatment, your doctor may recommend further intervention. Devices such as lasers are often used to treat redness, says Dr. Lee. In addition, laser therapy can dramatically reduce the appearance of blood vessels and bumps on the face. The downside? This treatment approach can be pricey, and you’ll likely still need to change your lifestyle in the long-term to prevent symptoms from returning.
In very rare and specific cases when rosacea has persisted long enough to leave a lasting impact on the skin, your doctor may suggest surgery. One instance is rhinophyma, a thickening of the skin around the nose which can sometimes inhibit your ability to breathe properly. Your doctor will explore these options with you if surgery is necessary.
Living with rosacea can be physically uncomfortable and emotionally frustrating, and your symptoms are unlikely to go away the minute you start your treatment plan. “Rosacea is a chronic disease, so few people see results with one treatment,” Dr. Ferris says. “But with a good regimen, most people see results in a month. We then try to maintain those results by avoiding triggers and staying on a simple regimen that can be done daily.”
The exact length of time it will take for your symptoms to improve depends on your type and severity of the disease. “A patient’s phenotype, or how rosacea appears in the skin, determines how easy and quick it is to clear,” says Dr. Lee. “For example, if a patient has centrofacial redness due to broken blood vessels, one to three laser treatments can eradicate those vessels and clear the skin. For other phenotypes of rosacea, it may take more time finding the optimal combination of prescription medications and non-prescription skincare products.”
Bottom line: If you don’t see results right away, don’t give up. With trial, error, and a bit of patience, you and your doc will figure out a path to clear, healthy skin.