Rosacea 101: Going To The Doctor

Today’s post is all about going to the doctor when you suspect you may have rosacea. I have a lot of blog posts that talk about how to live with rosacea but I realised that a lot of worry and confusion comes before you know whether you actually have the condition!

Here’s the usual disclaimer: I am not a doctor. I am not medically or dermatologically trained in any way, this is all advice from my experiences and basic common sense. If you have any tips or advice about going to the doctor about your rosacea that you would like to add to this list, please leave a comment below or come chat to me on Twitter, Facebook, or Instagram.

So let’s start with the basics…

Why do I need to go to the doctor?

It is very important that you get an official diagnosis. Firstly, you need to make sure that what you have is rosacea. There’s a chance that your skin condition could be something completely different that, if undiagnosed, could get worse or cause more issues. Secondly, your doctor can give you access to not only other experts who can help, but also medication that may lessen your symptoms.

Be prepared.

Before going to the doctor make sure that you know exactly what you want to say and what you are hoping to get from your meeting. In the UK you are limited to 10 minutes per appointment so it might be helpful to have some notes prepared: think of the questions that you want to ask, and if you have identified your triggers it might be helpful to list those as well. My digital downloads may come in helpful for this process: Rosacea Trigger Checklist and Rosacea Flare Up Diary.

What type of rosacea do I have?

I have seen an alarming number of people who have been diagnosed with rosacea but don’t know the type (myself included). There are four different types and their treatment differs so it’s very important that you know which you are. [EDIT: rosacea classifications have changed, read more about that HERE]

• Type 1 Erythematotelangiectatic (try saying that when drunk!), this is the type that I have. It is commonly characterised by overall redness, flushing and visible blood vessels.
• Type 2 Papulopustular is often referred to as ‘acne rosacea’ (a term I hate because of the resulting confusion – products and treatments recommended for traditional acne are typically terrible for rosacea). When I was first diagnosed this is what I had: you have the redness of type 1 but it is also accompanied by swelling and breakouts.
• Type 3 Phymatous rosacea is the noticeable thickening of the skin. This is most common on the nose (known as Rhinophyma).
• Type 4 Ocular rosacea: overall irritation of the eyes, including a gritty feeling, swelling, stye-like bumps, sensitivity, and watering.

To medicate or not to medicate?

Medication is not the be-all-end-all solution to rosacea, but obviously GPs are more likely to want to recommend this as a solution. I have only tried Metronidazole (Rosex) and it made my skin a lot worse so since then I have avoided medication and prefer to treat my skin with lifestyle, diet, and skincare changes (more info on that can be found HERE).

Personally I think that these should be the initial focus of medical advice rather than jumping straight to medication. However, I appreciate that this approach is not suitable for everyone and that some people do have wonderful experiences with medication, but I just wanted to bring this up. I’m definitely not one of those ‘Booo big pharma! Drugs are bad!’ people, I just think we sometimes jump to medicate too quickly. If you do decide to go down the medication route, make sure that you research it thoroughly to know which is best for you. Here are some things to think about/bear in mind:

• What is a typical response to the medication? It is useful to know what to expect so that you are not disappointed and to avoid unrealistic expectations.
• You should try any new medication for a minimum of six weeks as this is the typical skin cell turnover time and therefore you may not see any changes or improvements before this time.
• It should go without saying that you shouldn’t continue using something if your skin becomes painful or if you have a serious irritation from it.

Don’t gloss over the psychological effects.

It can be hard to fit everything in a 10 minute appointment, but do not play down the impact that rosacea is having on you psychologically. For some, the effect of a skin condition on their mental health could actually be the primary issue they are concerned with: people with skin conditions are more likely to suffer with anxiety or depression and it can have an enormous impact on your life. You could be struggling to accept the changes in the way you look, worried about the condition worsening in the future, finding it hard to socialise/go to work/date, or even feeling a sense of loss of your life before rosacea. These are all valid reactions and feelings so do not play them down. It’s also worth remembering that stress and anxiety exacerbate rosacea, so treating the psychological side to your skin condition can often help enormously with the physical symptoms.

Ask about additional support.

If you would like to be referred to a dermatologist, or if you would like to talk to someone about any mental health issues you are having, please ask your doctor. And keeping asking until you get what you want.

You are not vain.

You are not wasting the GP’s time and you are not over-reacting. I have written about the psychological effects of rosacea HERE, but the main message of that post is that even though rosacea isn’t life threatening that doesn’t mean it can’t kill you. The impact on your self-esteem, mental health, relationships, job and social life should never be ignored so please don’t feel like you won’t be taken seriously. And if you’re not taken seriously, do not be afraid to ask for another doctor. You are taking a huge and important step by going to the doctor and, even though I don’t know you, I’m proud of you.

[2019 update: I wrote THIS article about talking to your doctor where I also share some stories from sufferers – these are not designed to scare you, they are there to show you what you should NOT accept and why we need to keep pushing for better treatment]

Those are my main tips and bits of advice. I hope that this helped and that your appointment goes well. If you have any questions, want to let me know how it went, or just want to get some nerves out before going to the doctor, the comments are open and I’m always up for nattering on social media if you want to talk.

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 here are the links to my digital downloads again: Rosacea Trigger Checklist and the Rosacea Flare Up Diary.

Lex