I was diagnosed with rosacea 15 years ago and I’ve been talking about it on my blog for about seven years. It’s still crazy to me that it’s not as well known as it should be – there are millions of people with this condition and, in my opinion, it should be as widely recognisable as acne or psoriasis. April is Rosacea Awareness Month and so I’ll be doing a few posts about different issues related to the condition but I thought I would start with a GIGANTIC post containing all the rosacea FAQs that I get every day from people all over the world. I’ve built up so much knowledge and advice in countless blog posts, so hopefully this post can become a central hub that I can direct people to. Please ask questions in the comments below, and I will keep adding to the post as we go along!
[Last updated 08/20]
As always, I want to start with a disclaimer. As I’ve mention many times before, rosacea is very individual: what works for me may not work for you and vice versa. However, this blog post summarises the things I have found work for me in the past 15 years through trial and error (and believe me, there has been a lot of error!) Please be careful, talk to your GP/dermatologist before doing anything drastic, and take care of yourself. There are a lot of resources at the bottom where you can get a lot more information but I’m hoping this will be a good jumping off point for you.
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Let’s start at the beginning and end at the end. Are you sitting comfortably? Then let us begin…
WHAT IS ROSACEA?
- Rosacea is a chronic skin condition with irregular facial flushing that can become more permanent over time. It can be accompanied by visible blood vessels, pustules, swelling, inflamed and irritated eyes, dry patches and – in severe cases – thickening of the skin.
HOW DO YOU PRONOUNCE ROSACEA?
- It’s pronounced ‘ro-zay-sha’.
WHAT ARE THE CAUSES OF ROSACEA?
- It’s believed to be more common in those who are fair and those who have pink-toned skin that flushes easily in childhood. Although it seems to run in families there doesn’t seem to be a genetic link (my mum and both my sisters have rosacea, although theirs is milder than mine).
- Theories that it’s caused by bacteria on the skin or in the gut, or by microscopic mites, have not been proved. There are also theories about a link to the gut, hormones, trauma… the list goes on!
ARE THERE DIFFERENT TYPES OF ROSACEA?
- In recent years, the traditional ‘type’ classifications (listed below) have been replaced by phenotypes. They are tricky to explain in a short sentence, so I’ve written a whole post about it HERE.
- Subtype 1 (erythematotelangiectatic) This is what people think of when they hear rosacea. This represents the redness, visible broken veins, and flushing.
- Subtype 2 (papulopustular) This takes all the same issues from Subtype 1 and adds in fluid-filled pimple and itchy bumps.
- Subtype 3 (Rhinophyma/Phymatous) Causes a thickening of the skin, usually on the nose. It’s much more rare that the other types an tends to affect men more than women. The most famous example is W.C Fields.
- Subtype 4 (ocular rosacea) This is characterised by red and sore eyes that often feel gritty. You can read my tips on how to deal with ocular rosacea HERE.
- Subtype 5 (neurogenic rosacea) is incredible rare and still not very well-known, even amongst medical professionals. Read more about it HERE.
- When I was first diagnosed I had Subtype 2 but now that I have my triggers under control and a better handle on my skin I now have Subtype 1. If I have a severe flare up, I will get a few small pustules but these tend to disappear within 12-24 hours.
WHAT DOES ROSACEA LOOK LIKE?
- As I explained above, it’s typically characterised by facial redness (in some rare cases it can present on the chest and back). It’s most common on the cheeks and nose, but can appear in other areas as well (for example, the right side of my forehead is prone to flushing). Sufferers often have a butterfly pattern across the cheeks, where the skin under the eyes is in stark contrast to the redness. It looks like a cross between deep blushing, sunburn and a rash. My skin takes on an almost mottled, purple appearance when I’m having a flare up. When my skin is calm, I still have persistent redness due to the broken veins now scattered across my face. For those with Type 2 it can look like acne to a layperson, with pus-filled bumps across the face.
WHAT DOES ROSACEA FEEL LIKE?
- I can often feel a flare up before I can see it: my skin starts to burn, it feels tight and itchy. It feels a bit like heat rash or sunburn with that awful throbbing, uncomfortable feeling.
IS THERE A CURE FOR ROSACEA?
- There is currently no cure. For every school of thought as to the causes of rosacea there is a ‘cure’ to go along with it. The only proven way to help your rosacea is to identify and eliminate triggers to put your skin into a form of remission. It’s more helpful to focus on controlling your rosacea rather than a ‘cure’. I’ve written about rosacea and denial HERE.
- I’ve never tried any kind of oral medication for my rosacea as I don’t want to take tablets for the rest of my life. However, it’s not something I’ve ruled out.
- I have been investigating laser treatment for rosacea for years and have seen some incredible results, along with some not-so-great results. It’s very pricey so I’ve been putting it off. If I ever decide to go ahead with it, I will of course take you along and blog the process.
- Rosacea is a progressive condition, so over time it will get worse if untreated. Which is why it’s so important to be diagnosed and to regain control of your skin. As your skin becomes more stressed and prone to flare ups, the capillaries weaken which means they are more visible which results in permanent redness.
HOW DID YOU GET DIAGNOSED WITH ROSACEA?
- At 21, my skin had been bothering me for a while but I didn’t know what to even say to the doctor. I didn’t know how to define it: it wasn’t acne, it wasn’t eczema, it wasn’t something that was always there that I could point out. But as it got worse and worse I decided that I had to do something and assumed that the doctor would be able to give me a cream or some tablets that would cure me instantly. There is no test for rosacea, they just look at you and decide. He knew immediately that it was rosacea and prescribed me Rosex (metronidazole) an antibiotic cream and sent me away with no other information, help, or comfort. The cream did not help (in fact it made my skin much worse, although I’ve heard that some people swear by it). I didn’t bother going back. I eventually found a lovely (female) GP who was so so much better and really helped me get a handle on my rosacea. If you don’t feel like your doctor is taking you seriously, tell them or ask for a different doctor. Research has shown the devastating effect a skin condition can have on self-esteem, socialising, and relationships so don’t let anyone make you feel petty or vain. I’ve written more about talking to your doctor about your skin HERE and HERE.
- I wrote a letter to my 21 year old self, talking about my rosacea ‘journey’, HERE.
- I wrote about the 15 things I learned from 15 years of rosacea HERE.
DO YOU RECOMMEND REGULAR MEDICAL APPOINTMENTS?
- If your skin is under control – like mine – I don’t think it’s necessary to regularly speak to a doctor about your skin. However if something is bothering you or you think that your skin *could* be better, I would highly recommend finding a dermatologist who can advise you. My personal recommendation is Dr Justine Kluk who not only specialises in acne and rosacea and is incredibly knowledgable but also had acne herself when she was younger, which I think gives her so much empathy as well as a deeper understanding of the psychological and emotional side of skin conditions. She reviewed my skincare routine, asked me about my diet and health in general, as well as examining my skin. She can prescribe any medication that she feels you may need and explains a recommended skincare regime in full (and the list wasn’t full of obscenely expensive brands – mine was mostly highstreet skincare).
HOW DO YOU FIND ROSACEA TRIGGERS AND WHAT IS A FLARE UP?
- I’ve written a lot about this over the years, so I’m just going to direct you to these blog posts that covers everything about identifying triggers HERE and HERE.
- I wrote a blog post about how to calm flare ups, even when you’re out of the house. You can read it HERE.
- I have designed some digital downloads that you can save, print, and use to identify and work on your triggers. Get the Rosacea Flare Up Diary HERE and the Rosacea Triggers Checklist HERE.
CAN A CHANGE IN DIET HELP ROSACEA?
- My Rosacea Triggers Checklist will be really useful if you are looking at your diet and the impact it may have on your skin. You can find it HERE. I’ve also designed a Rosacea Flare Up Diary which would work well in conjunction so you can diarise your flare ups – you can find that HERE.
- The first thing that I made an active decision to remove from my diet was dairy. So many forums and blog posts recommended this for a lot of skin conditions and it seemed like the easiest win for me (a lot easier than the below!) I did notice a big change in my skin and I notice straight away if I treat myself to some cheese or a delicious creamy pudding. I actually prefer almond milk to regular milk now and think many of the substitute products taste just as good.
- Gluten was a huge one for me. I actually cut out gluten because I’m intolerant, but soon noticed a difference in my skin which was a bonus. There are a few theories that stomach upsets and facial conditions are linked which I would definitely agree with from my experience.
- I haven’t cut out alcohol completely but I’ve cut down drastically. When I was first diagnosed I was at university and easily drinking upwards of 30 units of alcohol a week. Nowadays I can go weeks without drinking and am much more of a social drinker. I think when you see an instant correlation between your skin and your habits , it becomes easier to prioritise. When I want a glass of fizz I will have one, but I will bear in mind that the consequences will have to be dealt with the next day… rosacea is kind of like a visible hangover!
- My doctor recommended I try the FODMAP diet to get control over my intolerances and I don’t recommended undertaking it without the help of a GP. I’m not going to lie and say it’s easy, but from my POV it was worth it for my overall health and the benefits to my rosacea were a happy byproduct. You read about my FODMAP experience HERE.
- It’s also recommended you cut out or cut down on processed and sugary products. Basically you need to stop consuming most things that are fun or delicious!
- I wrote a post about how I coped with a holiday in Japan with my food restrictions, read that HERE.
WHAT SKINCARE IS GOOD FOR ROSACEA?
- I have tried a lot of skincare over the years. You can find my full library of Skincare Shake Ups HERE – these list my full skincare routines in detail. If there’s any specific product or brand you’re interested in, you can take a look at THIS POST which lists every skincare brand I’ve ever reviewed.
- My biggest tips for choosing skincare are: Read the ingredients and do a patch test. Remember up there when I said how important it was to find your triggers? I’m repeating that now. I can look through ingredients lists and instantly find things that I know my skin will hate, or I can make an informed decision on what I have to be more careful with. One example: my rosacea hates tea tree oil and witch hazel, but I recently tried out some nose strips that contain those ingredients. I simply cut the pieces to size so that those ingredients were nowhere near my cheeks – voila! Information is power, so arm yourself accordingly.
- Be gentle with your skin. I avoid manual cleansing brushes, I’m very careful with manual exfoliants but actually prefer chemical exfoliants (you can read all about different types of exfoliators HERE if you’re confused), and I avoid water on my face completely if I’m having a flare up.
- Avoid hot water on the face. I don’t get my face wet in the shower (as much as possible) as the temperature most of us prefer to wash our body is far too hot for our facial skin.
- Common ingredient triggers for me are fragrance, alcohol, menthol, tea tree oil and witch hazel.
- Many people incorrectly assume they have – or are actually misdiagnosed with – acne. This can have terrible consequences as products designed for acne are often terrible for rosacea. When I think back to all the products I used on my poor skin when I still didn’t know what I was doing I want to weep!
- I have lots of favourite skincare products but the brands I tend to go back to are Avéne and La Roche-Posay: they are so gentle, have so many great products, are not expensive, and I think they are available in most countries. You can see my reviews for Avéne HERE and La Roche-Posay HERE.
- I remove my make up using the Double Cleanse method, you can watch a video of me removing my make up and talking through the process HERE.
- I did an affordable skincare blog series for sensitive skin which you can find HERE.
- I’ve put together a guide to the vegan skincare I would recommend HERE – it’s not exhaustive but I love all of those products so it’s a good jumping off point if you’re vegan.
- If you’d like tips for caring for your skin on a long-haul flight, which can often be a nightmare for rosacea/sensitive skin, you can read all about it HERE.
- There’s a post HERE about how a humidifier in on my bedside table has helped my skin.
- Most importantly… have faith in yourself and give yourself time. You will soon know what your skin can and can’t handle, so just listen to what it’s telling you. It’s worth bearing in mind that skincare can take between 8-12 weeks to have a meaningful impact, so be patient.
WHAT SUNSCREEN IS GOOD FOR ROSACEA?
- I cannot stress enough that you need to wear sunscreen every time you leave the house (…obviously not when it’s night-time, that’s just silly). You need a minimum of SPF30 but I wear SPF50 every day and you can find my recommendations HERE, HERE and HERE.
- Bear in mind how close you sit to windows during the day as this contributes to your sun exposure – also think about car journeys and plane journeys when applying SPF.
- Try to find a broad-spectrum sunscreen: one that protects against UVA and UVB as both cause damage to the skin.
- Most people with rosacea/sensitive skin prefer mineral sunscreens vs chemical sunscreens. Mineral (sometimes called ‘physical sunscreen’) sits on your skin and reflects the sun’s rays (which means it also deflects the heat which is good for those with rosacea), while chemical sunscreens are change the UV rays into heat which is then released from the skin (which, understandably is not great for rosacea). Mineral sunscreens protect your skin from the sun as soon as you apply them, while chemical sunscreens need to have at least 20 minutes to sink in.
CAN LIFESTYLE CHANGES HELP WITH ROSACEA?
- I’ve written a blog post on my lifestyle changes and tips HERE but here are a few additions:
- Once you’ve found your triggers (my Rosacea Trigger Checklist will help with this) you need to work out if you can/want to eliminate them or how you can work around them. For example, heat around my face triggers an instant flare up so I try to leave my hair to dry naturally as often as I can. However, I’ve also accepted that sometimes I want to blow dry my hair or use hair straighteners/curlers. I now know how long my face takes to calm down after that type of flare up (between 15 and 30 minutes) so I factor that into my getting-ready time.
- Only you can make the choices about what you will eliminate and what you’ll accept consequences for. I barely drink during the week, but if I want a few glasses of wine at the weekend I do that accepting the resulting flare up. For some of you, it’ll be spicy food, hot baths, running marathons… each person is different and it’s your call on what you want to sacrifice.
- It took me a long time to realise that sleep (both quality of and lack of sleep) was a trigger for me, which makes sense as it’s putting stress on the body. You can read all about the impact of sleep on skin health HERE.
- Stress is by far my biggest trigger and is also the one thing that’s hard to predict and impossible to eradicate from your life. I was lucky enough to remove the biggest stress from my life (my old job) but being a freelancer comes with its own unique stressors. Try to find your own way to minimise the stress in your life, or if that’s not possible, how to learn to deal with the impact of it: meditation, yoga, reading, listening to music… whatever calms you down or takes your mind off things is invaluable to your skin health and sanity.
- Rosacea loves routine, so anything that messes with that will probably cause issues. I’ve shared my tips for how to survive holidays (covering travel, diet, relationships, skincare and more…) HERE.
- I’ve written quite extensively about the psycholigical side of rosacea:
WHAT MAKE UP WILL COVER ROSACEA?
- I have written a blog series on how to achieve a ‘Flawless Base’, covering everything from primers, foundations, colour correcting, and application. Take a look HERE.
- I did some videos for Pinterest, showing how to do a full face of rosacea-covering make up in 10 minutes. You can find them HERE.
- I have a YouTube channel where I upload reviews of make up and tutorials that show not only how I cover my redness but what products help my skin to feel comfortable and happy.
- I also post a lot of pictures of my skin and make up on Instagram if that floats your boat. I wrote a post about why I love crazy, bold make up – and how it helps me feel more confident in my skin – HERE.
- When it comes to make up tools, I am a total Beauty Blender obsessive: it gives a gorgeous finish (even with super high coverage foundation), doesn’t aggravate the skin as you’re not dragging it around, doesn’t disrupt dry skin… they’re just wonderful!
- I probably own about 30 foundations, with new ones being added to my collection every month. But my current favourite foundations are DiorSkin Forever (review HERE) and L’Oréal Paris True Match (review HERE).
- For some people, foundations can be a little bit daunting or feel too heavy on the skin. If you are looking for a light product that will take the edge off the redness then you will probably like a BB cream or tinted moisturiser or one of the subtle products I wrote about here. These feel a lot like skincare and offer light coverage, which means you will still be able to see redness, spots, pigmentation etc. My recommendation would be the Garnier BB cream.
- Colour corrector products often scare people off because they look so intense and unwearable. The basic premise is that all colours are on a colour wheel, and by finding and using the opposite shade on the wheel, you can counteract it. For example, dark purple under-eye circles can be counteracted with peach coloured products. Redness is typically neutralised by using green or yellow products. I’ve done a video showing how to use green concealer HERE. I’ve also done a blog post specifically about covering thread veins/broken veins which you can read HERE.
CAN MEN GET ROSACEA?
- Although rosacea diagnoses are more common in women they tend to be more severe in men. However many doctors believe that the genders are equally as likely to have the condition, but men are less likely to go to the doctors about it until it progresses to a more severe level. Many of the tips I have in this post are suitable for both genders as the triggers and issues tend to be the same.
- I wrote a review of some subtle make up tips for men who want to take the edge of their rosacea. I cannot imagine how hard it must be to be a man who feels like he has to go barefaced because society has decided that make up is a female-only product. I could rant about this all day!
WHAT IS THE EMOTIONAL IMPACT OF ROSACEA?
- I’ve spoken a little about the emotional impact of rosacea on my blog and on social media. I think it’s something that many doctors do not take into consideration, when actually it’s something that can not only result in severe emotional issues but can also have a huge impact on the rosacea itself. Worrying about my rosacea is guaranteed to make my skin worse, so it’s important that you view treating the inside as well as the outside as equally important. You can read my thoughts on this in more detail HERE.
- I believe that positive affirmations have had a huge impact on my confidence levels and general skin positivity. I wrote a blog post HERE about what they are, how to use them, and shared a link to the ones I designed (!!) especially targeted for skin positivity.
- There’s a post about the impact of rosacea on mental health HERE.
- I wrote about the lack of support from the medical community and why, because they aren’t considered life-threatening , skin conditions are often dismissed. You can read it HERE.
- I’ve written about what it’s like to live with someone with rosacea, from my husband’s point of view, which you can read HERE.
CAN I STILL EXERCISE WITH ROSACEA?
- Anything that gets your heart rate and body temperature elevated is typically going to trigger a flare up. I’m not telling you to stop exercising because that’s a terrible idea (plus exercise is great for stress which – as we know – is a huge rosacea trigger), but if you are really looking to eliminate causes of flare ups then perhaps consider forms of exercise that are medium-intensity. Yoga, pilates, and walking are all great but perhaps avoid any moves that put your head below your heart.
ROSACEA IN THE MEDIA
- I recently took on Facebook/Instagram with my #UndesirablesOfInstagram campaign. You can read the full story HERE, but the short version is that Instagram were removing images and suppressing hashtags of skin conditions and visible differences. When I questioned the rejection of an advert showing my rosacea, they told me they didn’t allow images that show an ‘undesirable’ appearance. I started the campaign and so many of you stood with me to show them that this was unacceptable. We won that war, but the battle continues as they still use their narrow beauty ideals to control what we do and don’t see.
- I wrote a blog post about the ridiculous link people make between morality and skin, often seen on social media (you can read it HERE).
ARE THERE ANY CELEBRITIES WITH ROSACEA?
- Cynthia Nixon has done lots of work to raise awareness of rosacea, including some YouTube videos. I even remember watching her in SATC years ago and thinking ‘her face looks like mine sometimes!’
- Amy Schumer has been vocal on social media about her rosacea which is incredible as it’s still such a misunderstood and under-diagnosed condition.
- Lisa Faulkner is another person who has spoken about her skin in the media, helping to raise awareness.
- Renee Zellweger apparently has rosacea, but I’ve not seen her address it directly.
- I often see Cameron Diaz listed as having rosacea but have only ever heard her talk about her struggles with acne so I’m not sure if this is myth.
HELPFUL RESOURCES FOR THOSE WITH ROSACEA
Looking for some next steps?
- Follow me on INSTAGRAM for lots of rosacea updates.
- Get more information on rosacea and my journey so far in my ROSACEA FAQ POST.
- Join my private rosacea FACEBOOK GROUP.
- And I’ve linked my digital downloads designed by me to help you get to grips with your rosacea: grab the Rosacea Trigger Checklist and the Rosacea Flare Up Diary.
Phew, that’s a lot of information! I will keep updating this rosacea FAQs post as time goes on and as I get more questions, but let me know if there’s anything missing or something you’d like me to cover.
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Lex
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I too suffer from Rosacea and have done for 15 years it started during my second pregnancy and has got gradually worse. I have some major flare ups possibly induced by stress I am interested in knowing more about gluten and diary free do you thing it makes a difference. Also I wear make up everyday and always choose perfume free or hypo allergenic however I still feel it flares my skin up so try to have makeup free days. I am not good at putting on make up and just wander if I am using the right products I found your price on face to face very interesting . I also take antibiotics daily to combat my Rosacea thankyou Debbie Smith
HI
I have just been diagnosed with Rosacea in the last month up until then has thought I had a really bas allergic skin reaction. I have type 2 which has been triggered I think from exam stress but I love exercise and going out an enjoying myself so could be anything really.
I have been using some natural based honey products from Bee Good and so far have found them gentle on my skin so could be worth having a look at for your blog.
I am interested in different foundations to try as using Clinique currently and while it has great coverage by the end of the day my skin is very tight so shall be trying Loreal as you have mentioned.
Your blog is great and saw you on the Katie Piper show last night, really pleased to see Rosacea being featured, has made me feel a lot better
Try bare minerals liquid gel and powered with a primer I’ve just had a make over and it’s fab
I have been reading about kanuka honey. Have you ever heard anything about this?
Hi. I have rosacea and thread veins. I have tried laser and v beam and has only made it worse. I can’t find a good make up to cover my skin as it is very very oily and make up dosent stay put long. Have spent over 30 yrs trying to cover these problems and am so tired of never finding something that will cover it and stay on. Any help would be very grateful. Katharine
Hiya im a man struggling with rosacea for 8 months currently lined up for pdl laser, I found your blogs very comforting as there aren’t really any male rosacea bloggers, it’s so hard to cover and ive found this so life altering it just really sucks,keep up the good work
Your “contact me” section is not working but I’d love to join the facebook group!!
I have never been diagnosed with rosacea, but I too have bumpy, red, flaky skin which can be extremely itchy. I’ve had it since I was a child, and continue to have it today (if it’s not rosacea, I’d like to know what it is!). My mom took me to the dermatologist who diagnosed it as acne (I was a kid of course that’s what she’d diagnose it as) and I remember getting concentrated salicylic acid for my face. I screamed because it burned so horribly and made my face so much more bumpier and redder. My mom said I was overreacting whenever she would give me a new wash to try and I told her how itchy and burning my face felt. I’m 28 and finally found peace with using the Clinique Redness Solutions kit. I don’t use the primer (simply because it chalks up and comes right off my face), but I love the wash, cream, and even cream foundation. It’s a bit pricey, but it’s been so worth it in me even being comfortable going out in public. I remember crying and being fed up with myself, and begging someone to bring me to the store to buy this and try it. She put the cream on and it felt like I had stuck my face in a cooling ice bath, it felt so wonderful! Then she put on the foundation on half my face and it was like I miracle I had to buy it all. It’s been heaven for me.
I’ve tried doxycycline (Oracea). It did absolutely nothing except cause me digestion trouble, and of course I had to follow a full course of probiotics treatment to restore the mess left by the antibiotics. And of course once I stopped Oracea my face got worse than before I started it. It took a couple of weeks to get back to (my) normal. I don’t recommend antibiotics to anyone. Too much trouble for nothing.
I tried Robaz. Didn’t work. I tried Dalacin C solution; that one almost worked for a while then nothing…
What seems to be working? Completely cutting out sugar and coffee. Which makes everyday life less fun but it’s worth it.
I’m so jealous of those who can tolerate makeup to cover their raging red burning faces. I can’t. My skin is so intolerant and hyper reactive that I can’t even cleanse most of the time. Anything on my face and I’m left in a world of pain. I’m so unhappy and feel like I just survive…I don’t live as I have no confidence and feel so horrible compared to those who can at least cover their rosacea and give themselves the ability to feel stronger and able to face the world. My skin is my life and no one understands that I can’t just ignore it….it’s basically staring right back at me every day.
I just listened to you in Woman’s Hour and looked up your blog. You are doing fab things to help sufferers. I wish the feature had been more detailed though, I’m not up to speed with modern treatments but in my day the only thing I was offered was Oxytetracycline, my body stopped tolerating it and constantly gave me thrush.
I was diagnosed in my mid 20’s and my Mum developed rosacea in her early 40’s.
I’m now 57 and had some rough times with the condition. Triggered by stress at work and it was also dreadful in both of my pregnancies.
I can saw that as I approached my 50’s the condition began to ease and has been better post menopause. If I drink alcohol my nose will flare up with spots. The sun is the worst thing for it and would recommend factor 50 everyday. I use Avene products, I have found this brand to be the best. But I will always have a red nose but I have learned to live with it thanks to Bare Minerals.