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Experts Discuss Rosacea

Experts Explain Everything You Need to Know About Rosacea

Everyone tends to have a little pink in their cheeks now and then, but a constant redness on your chin, cheeks, and nose could mean something else. Our friends at Charlotte's Book sat down with the experts to get answers to all your burning questions about rosacea.

Rosacea affects over 16 million Americans, making it one of our most pervasive skin conditions. But it's also one of the least understood: 95% of people diagnosed aren't familiar with the signs and symptoms, and aren't aware that if left untreated, rosacea can cause significant psychological, social, and (of course) skin-related problems. As the U.S. population ages, the medical community has recognized a surge in rosacea and is working to reveal root causes and develop new, more effective, treatments. Recently, Charlotte's Book Premiere Provider and expert dermatologist Dr. Cybele Fishman, MD, told us about a study linking your gut bacteria to the presence of rosacea.

Given the pervasive nature of rosacea and the many complications involved, we weren't surprised to have several reader questions asking for help tackling the basics: how do acne and rosacea differ? What's the best way to treat the condition? Will makeup make things worse?


To help us answer these questions, we turned to Charlotte's Book Premiere Provider Dr. Doris Day, MD, and Mary Erhard, Director of Medical Communications at the National Rosacea Society. Together, they respond to these reader questions:

1. What's the difference between rosacea and acne?

Rosacea is very different than acne. Acne typically occurs more in your teenage years, although you don't always outgrow it in your twenties. Acne is bacteria-related, and it includes a combination of red pimples (some below the skin, called cystic acne), blackheads, and whiteheads. It's treated with very specific medications that can sometimes make rosacea worse. Rosacea is something you tend to grow into later — meaning in your late twenties, early thirties, and even later. Rosacea is a on the skin, sometimes bumpy, which is why the condition is sometimes confused with acne. Rosacea can also affect the eyes and the nose. It has a variety of triggers: alcohol, stress, extremes in temperature, and spicy foods can all affect the severity and appearance of rosacea, depending on your unique situation. Understanding your triggers can result in more control over your rosacea, and there are also treatments (very different than those used for acne) which can be employed to minimize the appearance of rosacea.

2. Over the counter treatments for rosacea aren't working for me. What should I look for in a rosacea treatment?

So many people who come in to treat their rosacea have often been treating it as if it were acne and they're making it even worse. Or the ingredients they're using are too harsh, triggering a flare-up in their rosacea. If over the counter treatments aren't working, we recommend seeing a dermatologist to get a proper diagnosis (check Charlotte's Book for a list of approved, expert dermatologists in your area). That said, there are some newly FDA-approved medications:

  • Soolantra: 1% ivermectin cream that helps reduce rosacea-specific red bumps.
  • Mirvaso: A topical gel. The only drug that's FDA-approved to temporarily reduce the redness of rosacea, and that can have a very big impact because that redness can make you look embarrassed, or stressed.
  • Oracea: A doxycycline pill that reduces rosacea-related bumps.

3. My rosacea is very pronounced on my forehead, nose, and cheeks. Is it safe to use makeup to cover it up? What makeup ingredients should I look for that won't irritate my sensitive skin?

Rosacea can often be more prominent in the central face. Makeup shouldn't be used too much to cover up rosacea (it's important to see your doctor to get treatments). But if you do need to cover it up, look for makeups that will contrast and balance. Green covers up red, so a good primer with a slight green tint can help take the edge off the red. Look for makeup that doesn't have salicylic acid or parabens — both can trigger rosacea. Look for products designed for sensitive skin, because their ingredients tend to be better for people with rosacea.

Overall, makeup should be worn for fun, not to cover up a medical condition. If you're having a bad flare-up day, some advice I got from a makeup artist is to make another area pop: emphasize your eyes so that's what people notice, not the redness. It's not always about fighting and covering up the condition. Sometimes it's about distraction instead.

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