Your Life on Rosacea

Almost half of people with rosacea report reduced quality of life, and one in five say their QOL is severely impaired, according to one meta-analysis. No wonder improving quality of life was the top priority among rosacea patients, according to one Cochrane review. If your rosacea is affecting you in any of the following nine ways, don’t downplay it. Be honest with your dermatologist so you can find the right treatment for you.

The discoloration and bumps from rosacea can make many people self-conscious, Dr. Sheu says: “It’s on the face, front and center.” And if rosacea causes papules (bumps) or pustules (pus-filled bumps), it can look like acne, making you feel like an insecure teen all over again. “Many are embarrassed that, as adults, they still have ‘breakouts,’” says Daniel Bach, M.D., a dermatologist at UCLA Health. Some may not even be aware that they have rosacea, and assume the “pimples” are their fault. Luckily, for those who seek medical help, simple treatments—like topical antibiotics—can often help clear the skin, he says.

Research shows a direct link between rosacea severity and the risk of depression. In one study of 200 rosacea patients, about one-third reported some degree of depression. And those with severe major depression rated their rosacea symptoms worse: an average of 5.5 on a 0-to-10 scale, versus a 3.1 average rating among those without depression. More worrisome, depressed patients may be less likely to stick to their treatment, the researchers note. Remember, rosacea can be treated, so if you’re struggling with your skin and your mood, see your doctor ASAP.

A change in your appearance (even a mild or moderate one) can impact the way you think about yourself. In fact, the vast majority of people with rosacea—90%—say its effect on their appearance has lowered their self-esteem and self-confidence, according to a survey from the National Rosacea Society. So if you’re struggling with yours, remember: That doesn’t make you vain. It makes you human. Keep working with your doctor to improve your treatment results, and if you need help building your confidence back up, a therapist can help.

In a survey by the National Rosacea Society, two-thirds of rosacea patients said their symptoms had a negative impact on their interactions at work, and half said they missed work because of their condition. One out of five even felt they had been passed up for a promotion because of it. At the same time, some work tasks may make symptoms worse—for example, nervousness during, say, a presentation may cause you to flare (which, let’s face it, doesn’t exactly help you relax), says Dr. Sheu.

Many people with rosacea may avoid social situations. In a survey from the National Rosacea Society, 72% of patients said they had refused or canceled social plans because of their condition. One of the big reasons why? They worry they’ll be misrepresented or judged. If you have a red nose or flushed cheeks, for example, others may assume you’re embarrassed, angry, or drunk. Plus, research shows that people with rosacea are more likely to experience social anxiety than the general population. And those with extensive papules score higher on social phobia tests than those without the bumps.

For some people with rosacea, putting on makeup can be time-consuming and annoying. “Some people don’t leave the house without makeup on,” says Jessica Gandy Labadie, M.D., chief resident in the department of dermatology at Northwestern University in Chicago. “That’s a big issue for some.” Dr. Labadie’s tip: Use oil-free foundation with a green tinge to help counter the redness. For many men with rosacea, shaving can aggravate sensitive skin. Switching to an electric razor may help. And for any facial product—makeup, lotion, aftershave—always test it on your neck or arm first. If it burns or stings, don’t use it.

Rosacea patients have described the feeling as hot, itchy, burning, or like a sunburn. “It’s just uncomfortable,” says Dr. Sheu. Luckily, treatments can help relieve the discomfort. But if you’re looking for instant relief, try a cold compress, suggests Dr. Sheu. Take a clean washcloth, dampen it, and put in the refrigerator or the freezer until it’s cold, but not frozen. (Extreme cold may make things worse, notes Dr. Sheu.) Apply it for two minutes on, two minutes off, as needed. “Let comfort be your guide,” says Dr. Sheu.

There’s no cure for rosacea, and finding the right treatment can take time, making you feel like you’ll never find it. “A lot of the treatments require a few months before you know whether or not it’s working,” Dr. Sheu says. “So sometimes patients feel frustrated.” In fact, finding the right treatment may take months to years, Dr. Sheu says. If you’re not getting the results you want, don’t be afraid to ask your doctor to refer you to a specialist with more experience. It may open up other treatment options, like laser- or light-based therapies.

Spicy foods. Chocolate. Wine. Coffee. Why do trigger foods have to be the good ones? Fortunately, you don’t necessarily have to say goodbye forever, says Dr. Sheu. “It’s a judgment call,” she says. “If you know the wine will trigger a flare but you’re with friends, or it’s a special occasion, you might have some anyway—and just be more vigilant about your treatment,” she says. Same goes for activities like exercise or being outside on a sunny day. It’s all about balance. “If we’re limiting our quality of life because we’re not enjoying the things we want to enjoy, that’s an issue,” she says.