Hey friends, it’s been a while since I’ve talked about rosacea, but I wanted to discuss when rosacea flares up and a lot of questions you have surrounding rosacea. I was diagnosed with rosacea around 8 years ago (August 2012). I’ve managed to get my rosacea under control for the most part. What I mean by that is that I now rarely experience painful flares. So let’s dive in and explore Rosacea!
To be clear, I am not a doctor or a medical professional. I am sharing my experiences with rosacea, what I do when rosacea flares up on my face, the medications I’ve tried to treat rosacea, along with the skin care products that have helped me control it. Please see the full disclaimer at the bottom.
What is Rosacea?
Rosacea is a skin condition that causes redness to the skin, often accompanied by small, red, pus-filled bumps on the face, similar to acne. Rosacea mostly affects women with fair skin, but men can easily have it as well. More than 16 million Americans have this condition. It requires a medical diagnosis from a dermatologist. This is a chronic condition that can last for years or be lifelong.
How Long Have You Had Rosacea?
I’ve likely had rosacea since I was about 15, which is when my face started to turn red all the time. I’m now almost 42. By that point in time, I would cake powder foundation on my face to hide the redness. I used heavy makeup to conceal my redness from rosacea. When I did not use makeup to conceal it, my family would ask me if I was ill, because apparently having a red, flushed face makes me look ill. I became very self-conscious of my bare face because of rosacea and would rarely show it. It affected my self-esteem and made me feel ugly.
What Does Rosacea Look Like?
Often, you’ll see broken blood vessels on your face from rosacea. Some of the other symptoms you’ll get when you flare are a stinging and burning of your face like it’s on fire or the worst sunburn you’ve ever had. Sometimes you’ll end up with really rough, dry skin, though I blame some of that from the medications I’ve been prescribed. You may also see larger pores, broken blood vessels in your eyes, bumps on your eyelids, or redness on your nose.
Here’s What Rosacea Looks Like on Me
Here’s what rosacea looks like on me from a recent rosacea flare up I had in April 2020. This photo was taken on my Google Pixel 4 front facing camera. You can see how my cheeks are flushed red, my nose is red, my chin is pink, my forehead is red. Please ignore the cupping mark on my neck. However, I included my neck and shoulders here so that you can see how my face looks darker and redder than the rest of my body. What you can’t tell from the photo is that my face is burning and very painful during a flare.
What Causes Rosacea?
Fun fact, doctors don’t know exactly what causes rosacea! They have some theories though. Some theories involve your gut bacteria being out of whack, mites that live on your skin becoming too plentiful, sun damage, or your genes.
In my case I’m about 50% Irish and rosacea is often referred to as the Curse of the Celts. I also experienced significant sun damage as a child around 12 years of age when I fell asleep next to a pool and ended up with second-degree burns that needed medical treatment. All those sunburns as a kid really do cause damage to your skin. You can check out the National Rosacea Society for more information.
Is There a Cure for Rosacea?
No, there is currently no cure for rosacea, but there are things you can do when rosacea flares up. There are only a couple of treatment options for rosacea, which I find frustrating. I believe that there are only a few treatment options for rosacea because it’s a condition that primarily affects women, not men. If rosacea primarily affected men, I think we’d see more treatment options.
Can Rosacea Affect the Eyes?
Yes, rosacea can affect the eyes. It’s one of the many reasons you should get your eyes examined by an eye doctor for your health.
Can Rosacea Be Painful?
Yes, unfortunately, rosacea can be very painful, especially when it flares up. I’ve had people mock me for complaining about the pain, but I’m sure they couldn’t make it a mile in my shoes, if you know what I mean.
Is it Rosacea or Serborrheic Dermatitis?
You absolutely must see a dermatologist here in the USA for a diagnosis of rosacea or serbhorrheic dermatitis. I happen to have both. My rosacea is on my face. My serbhorrheic dermatitis is between my eyebrows and on my scalp. I’ve pretty much got the serbhorrheic dermatitis between my eyebrows cleared up, but my scalp flares when my allergies are bad. I have to treat my serbhorrheic dermatitis with a medicated shampoo.
Why Rosacea Acne Happens?
For me, when I experience a rosacea flare up, I’m also likely to get rosacea acne along with it. I call it acne because it looks like acne, but most acne treatments don’t do a thing for it. I’ve had some rosacea acne flares stay on my face for 30 days or longer, which is frustrating and upsetting.
However, that was before I found two skin care products to help me control it. I’ve had the best success over the past 6 months by treating my rosacea acne with The Ordinary Azelaic Acid Suspension 10% and Milk Makeup Matcha Toner.
My Rosacea Trigger List
- Foods: paprika, bell peppers, raw garlic, green tomatoes, eggplant, (most nightshades for me), soy
- extreme temperatures
- biting winds
- hot humid weather
- freezing cold weather
- extended time in hot tubs
- extended time in hot baths
- fragrance in skin care
- fragrance in makeup
- lavender oil
working out(fixed my biggest trigger with IPL laser treatments)
I keep a list of my rosacea triggers. They can vary greatly from person to person. If I ingest nightshades that I’m intolerant to (paprika, bell peppers, raw garlic, green tomatoes, eggplants, etc) I’m likely to have a rosacea flare up in addition to the other issues that nightshades cause me, which can include triggering a seizure. Alcohol can be a trigger for my rosacea flares, which is one of the many reasons why I don’t drink much. Hot tubs and hot baths can cause me to flare if I stay in too long. Hot, humid weather can cause a rosacea flare for me. Freezing cold and biting wind causes me to flare. Extreme temperatures are just hard on me.
Fragrance in skin care and makeup often causes me to flare. Lavender oil is one of the biggest culprits for my skin. Most makeup wipes cause me to flare, too. And over exfoliating causes flares for me as well. It truly is different for everyone, so use a journal to track your rosacea flares.
I used to have a very painful rosacea flare up every single time I worked out. I couldn’t handle the pain from it and I went to my dermatologist for a solution. Previously my dermatologist had only offered me topical solutions or oral treatments for treating my rosacea. The topical solutions really messed up my skin. I went from combo skin to super dry skin peeling off my face from the medications and my skin became super thin.
I went and got a second opinion from another dermatologist who recommended IPL laser treatments. I was furious that my first doctor hadn’t mentioned IPL laser treatments as a better way to manage rosacea since the topical medications caused me significant issues. My skin type permanently changed from combo to super dry after using Aczone and some of the other medications. It has literally taken me years to get my skin to be closer to just ‘dry’ instead of extremely dry skin.
I strongly recommend you keep a list of your triggers and avoid the things that cause them.
Can Rosacea Be Treated?
- Prescription Topical Medication – such as Ivermectin, Azelaic Acid, Brimonidine, Metronidazole, and Sulfacetamide
- Prescription Oral Medication – such as Oracea (this is an antibiotic), Amnesteem, Claravis (these are oral acne medication)
- Prescription Minimizing Medication – such as Mirvaso
- IPL Laser treatment
Yes, there are a few different ways to treat rosacea. You can treat the symptoms of rosacea with medication. You can minimize the symptoms of rosacea with IPL, at least in my own personal experience. The FDA has approved the following for treatments of rosacea: Ivermectin, Azelaic Acid, Brimonidine, Metronidazole, and Sulfacetamide.
I’ve tried several different prescription medications and hated the results for how they screwed up my skin. Aczone left me with permanently dry skin. Metrogel Cream seemed to make my skin thin and I was afraid of it killing the collagen in it, so I discontinued using it.
I had great success taking Oracea pills daily, but when my insurance stopped covering it and I had to switch to the generic, the generic didn’t work for me. I had to literally take 4 pills of the generic to get it to work half as well as 1 pill of the name brand. When I asked my dr to write the script so that it was necessary for me to take Oracea, not the generic, my insurance refused to cover it and I was told I would have to pay $250 every month out of pocket to stay on the name brand, so I quit that as well. This is just another example of how screwed up healthcare is in the USA, when insurance companies, not doctors, control your scripts. That’s not prioritizing the health of the patient.
I tried Mirvaso, which worked sporadically well. If I used Mirvaso it was fine for 12 hours, but then 12 hours later, my skin would ‘bounce back’ with a bad rosacea flare. And you can’t use it twice within 24 hours, so I stopped using it too.
IPL Treatment for Rosacea
Because working out has become very important to me over the past decade, I got 7 IPL laser treatments done to my face to prevent flare ups from working out. IPL laser treatments are very painful, in my experience. They put protective metal goggles on your eyes and zap you in the face with a laser over every inch of your skin. I’m not gonna lie, I’m Skin Type 1 on the Fitzpatrick scale. It hurts like hell to get IPL done. It basically feels like they’re snapping a rubber band against your skin, over and over again. But I would rather go through IPL than a flare up. After my 7 IPL treatments, my rosacea flares have become few and far between. I had my IPL treatments in 2014-2015 and I should probably go for a touch up treatment sometime in the next year.
While IPL is not cheap, this is what I would recommend to anyone who is suffering from rosacea like I was. I was having a daily flare up after every workout at the gym, which was intolerable. IPL helped remove most of the surface redness my skin used to have. I still have some pink surface tones to my skin, but it’s not as bad as it used to be.
Dave used the Google Pixel 4 camera to snap the photo above of my bare 41 year old face. You can see how, compared to the photo of me flaring, that I have less redness but still an overall pink overtone to my face on my cheeks, nose, forehead and chin. You can see the little bits of sun damage I have on my face, fine lines, wrinkles and my hooded eyes. And you know what? I think my skin is beautiful, despite my rosacea.
I sincerely wish my dermatologist had told me about IPL the day I was diagnosed with rosacea, because I would have just signed up for IPL Treatment appointments then. The medications, in my opinion, just don’t compare to how well IPL has worked for me. I even made a video talking about my experience with IPL for treating rosacea.
How I Treat My Rosacea
As I mentioned above, I paid for 7 IPL laser treatments on my face to diminish the blood vessels close to the surface of my skin that caused painful flare ups. I gave up on all the topical medications that were prescribed to me because they made my skin worse. I had to give up on the oral medication that worked well for me because I wasn’t willing to pay $250 a month out of pocket because my insurance refused to cover it.
Since having IPL to treat my rosacea, I’ve had the most success controlling my rosacea flare ups and rosacea break outs with two skincare products: The Ordinary Azelaic Acid 10% Suspension and Milk Makeup Matcha Toner.
Adding up the costs I spent on my 7 IPL treatments, they were cheaper overall than the medications that I bought that failed me. If I had just done IPL, I would have saved more money. That is why, in my opinion for me, IPL was the best option for treating my rosacea and reducing my flare ups. IPL was more effective and less expensive. It just looks more expensive at first because you’re paying $200 for a treatment vs. $75 or whatever your insurance will charge you a month for these medications.
The Ordinary Azelaic Acid 10% Suspension
The Ordinary Azelaic Acid Suspension 10% is only $7.90 at Ulta. I use this at night once a week if my skin is normal. If I’m experiencing a flare up I use it every day during the flare up. I can’t believe how well this $8 product works for my skin with rosacea versus the $75-$250 prescription products made for rosacea that I’ve tried in the past. My friend Cin, who was the first to suspect I might have rosacea back in 2008-2009, was actually the one who suggested I try this and I love it. She also has rosacea and usually shares her tips for what helps her with me. I’m so grateful for her!
Just so you know, The Ordinary Azelaic Acid Suspension 10% is not specifically marketed by Deciem as a treatment for rosacea, but the ingredient Azelaic Acid is on the list of FDA approved treatments for rosacea. It is marketed as an antioxidant that brightens skin tone, reduces skin texture, reduces the appearance of blemishes, and is pH balanced. It’s formulated without alcohol, oil, nuts, gluten, parabens, or sulfates. It’s also cruelty-free and vegan.
In my personal experience when rosacea flares up, the The Ordinary Azelaic Acid Suspension 10% works better for my skin with rosacea than any of the topical prescriptions that I’ve tried in the past.
Milk Makeup Matcha Toner
When rosacea flares up for me, this green tea toner comes to the rescue! The Milk Makeup Matcha Toner is $28 at Sephora. I use it twice a day every day in my current skincare routine. I started with the mini size of this and tried it when I had a rosacea acne break out on my chin. I was shocked and pleased by how fast it cleared up for me (practically overnight!) after using this product. It’s why I now use this toner twice a day. Additionally, this is what my partner Dave uses to help clear his breakouts. I strongly suspect Dave has rosacea, as he has very sensitive skin and a lot of redness, and he’s more fair complected than I am.
This toner is not marketed as a treatment for rosacea, but it is a critical component in my skin care routine since I found it. The Milk Makeup Matcha Toner is cruelty-free and vegan. It’s also Leaping Bunny Certified.
What My Face Looks Like Today
This is me, fresh faced with only my Supergoop Unseen SPF 40 sunscreen on today. I hope you find my when rosacea flares up guide helpful! If you have rosacea, how do you handle when rosacea flares up? Have you tried IPL laser treatments? Have you had success with any of the prescription medications?
Again, I am not a doctor or a medical professional. This information about rosacea is for general informational purposes only. Information in this post may not constitute the most up-to-date information. All liability with respect to actions taken or not taken based on the contents of this site are hereby expressly disclaimed. The rosacea content on this posting is provided “as is;” no representations are made that the content is error-free.
This is helpful! I have come to the conclusion that I have Seb. Dermatitis between my brows too (runs in the family and symptoms match up) and I’ve no idea how to combat it. Would you mind sharing how you combatted it? Not only is it painful at times of extreme dryness, it’s making my eyebrow crease wrinkle extremely prominent and I’m only 27! Please, please?! You’re my makeup and skincare unicorn!
Thank you, while I don’t have Rosacea I have several friends who do. It is always nice to be able to share useful things with them
Mary W says
Thank you for posting an honest open article about Rosacea. Two of my family members have it and now I understand how much they suffer. I did not realize that Rosacea could be so painful. You do have beautiful skin today. All your hard work has paid off!
Cassie Tucker says
Travis has rosacea and we’re trying to find products that work for him in helping with the redness. We haven’t learned the triggers yet but we’re trying to work on that as well. I’m going to try the Milk Makeup Tatcha Toner and see if it works for him.
Yes, it has no cure but flare ups can be managed. I also use IPL for my own patients with rosacea but it’s very limiting because this device cannot be used for slightly darker skin type so you are a perfect candidate for this procedure because your skin type 1
What skin types do they recommend try IPL for rosacea? Just type 1 or 2? or 1, 2, 3? on the Fitzpatrick scale.
25 Sweetpwas says
Sounds like you have found some nice products and have a nice balance on it all. Your photos look really great even with the red its not that bad! yay!
Ice queen 81 says
In USA you have more choices and Cruelty free choices to treat any skin problem. Over here is difficult and if you order you pay more in custom fees and taxes than the value and price of product itself. Do not have i rose sea but have delicate skin and cant use any kind of product or make up
Excellent, informative post for those with pink cheeks who don’t know what it is! I had rosacea as a toddler, and over the years, it has gotten better. I still have pinkish cheeks but they are more normal. I was told that rosacea may be part of an autoimmune disorder. At any rate, I am glad that yours is under control and that IPL, though painful, was helpful for you. Your skin looks fabulous! I was wondering about the Supergoop Unseen SPF 40. Do you like it more than the Coola liquid in the pink dropper bottle?
This is such a helpful article. It’s nice to see that you’ve got two skincare items that work. The IPL has come a long way since they first got the machines so it might not have helped as much back when discovered. My mom had a very mild case of Rosacea which she called Rosieola. She never really had the pain you do which I’m glad about.
gloria patterson says
WOW I didn’t know anything about rosacea before. Now that I know I can more understand some of the things a friends has said. Going to share with her
Great post! I don’t have rosacea, but know people who do and I think they might benefit from this information. I do want to check out that matcha toner, any sort of green tea is so soothing for the skin in my experience. I have skin that’s quite prone to sunburn, and sensitive to fragrances, and becomes all-over sensitive during my cycle so it’s a constant battle to find things that keep it calm.
Beauty and Fashion Tech says
I get Rosacea flare ups from time to time. I haven’t’ for quite a while though so knock on wood that it stays that way!
Rachel Runyan says
Thanks so much for updating this! It’s super helpful. I think I am developing rosacea, and I’m working on getting a dermatologist referral from my PCP. I’ve had light redness on my nose and cheeks for years, but this last year I’m seeing broken blood vessels, increased redness, and now I’m getting a little redness on my chin and lower forehead. I ordered that Ordinary product to try, too. I’m 1/16 Irish, 1/16 Scottish, and 1/8 Welsh, so I’ve got the fair skin and the genetics. Fortunately, I don’t get any pain or acne…yet. I feel really bad that yours is so painful. I’m so glad the IPL helps.
Lola Seicento says
This is an very informative post, Courtney! I will send it to my friend with Rosacea!
I have read that centella asiatica is good for soothing red, irritated skin. There don’t seem to be many cruelty-free options containing this ingredient at this time, though. I have tried a CosRX centella toner, but it didn’t do anything for my skin (possibly because the concentration of centella is too low to make a difference). I am considering trying Purito’s Centella Green Level Buffet Serum next.
OMBFG, that’s what i was thinking. I don’t have rosacea (i have a rheumatology dermatologist; don’t get me started.) but the progression of inverse psoriasis. Nobody knows much about it IP. I get redness and lines face, neck, scalp, ears, etc…and that’s just the head region, from heat, wind, cold, pressure. There’s a neurological component with ~5 kinds of pain and combinations/permutations of those pains. There’s also an vascular component with swelling and redness, esp in hands and feet. Well, i changed to Cosrx Centella toner, Cosrx mild AC line whatever toner, Purito green level toner (that is thicker like an essence) and the Purito fragrance free buffet. The derm said ‘my skin looks great, and i don’t need him.’ WTF about the pain, which seems to be progressing into mixed connective tissue disease, with Raynaud’s and oh, effin forget it. He doesn’t see me after 20 minutes sun at 4P with 50 SPF. I look like my face is melting off like a horror movie. I also used seawater based stuff and have a Cica cream from Bioderma for occlusion, if needed. Let me tell you, centella overkill has made my face good enough to fool the docs and no one knows I’m in pain all the time…because centella and other anti-inflammatory s/c does zero for pain.
I have rosacea and have had it for years. I tried Metrogel with no success and Mirvaso and experienced the same rebound effect, to the point where it broke down my skin barrier so bad it looked like my skin was being eaten. I learned about The Ordinary product and just bought it a little while ago so don’t have results to share yet. I will definitely be looking for the matcha toner. THANK YOU for sharing your experience and advice. I feel too often those suffering with rosacea, suffer in silence. It can be debilitating.