This is the first post in multi-part series I’m planning about a variety of rosacea treatments that I’ve tried. I plan to give in depth details on each treatment, what they do and why they can work for some cases of rosacea, as well as my own personal experience with each and whether or not each treatment made a difference in my condition. Some posts will contain pictures of my skin to show my progress with that particular treatment.
Before I get into any treatments, however, I’d like to start off and give an intro to rosacea, followed by some specifics about my case and my experience with the condition. There are currently 4 official subtypes of rosacea, of which I have been diagnosed with 2. However, rosacea is a complicated condition and not every treatment will work for everyone, even if they have the same subtype. The subtypes are grouped by primary symptoms, not by cause or etiology, and so people with the same subtype of rosacea can respond differently to the same treatments. This is part of the reason rosacea can be so hard to treat.
I mention this because these posts are not intended as a prescriptive resource for people with rosacea. I’m only sharing my personal experiences, and the things that have worked for me have absolutely no guarantee of working for anyone else. Also note, I am obviously not a medical doctor and all information I provide in these posts is coming purely from my own personal research and anecdotes. Do not use any of the treatments I will discuss without first consulting your doctor.
Okay, disclaimer over. Let’s talk about my subtypes.
Subtype 1: Erythematotelangiectatic Rosacea
This subtype is what people typically think of when they hear about rosacea. This subtype involves the facial flushing/blushing that many rosacea patients experience, as well as the non-transient redness that essentially looks like a consistent sunburn. The redness has a classic ‘butterfly’ pattern than spreads across the nose and cheeks, though other parts of the face can be affected as well.
The medical name for this subtype gives us some clues about the causes of this redness. Erythemato- is derived from the Greek word meaning red. Tel- refers to the ‘end’ or ‘terminus’, and angio- is the word for veins, vessels, and other vascular structures. Therefore telangio- is specifically pointing to the capillaries and terminal arterioles that form the ‘endpoints’ of our vascular system. -ectatic comes from the word ectasia, which means an expansion (usually abnormal) of a hollow or tubular organ. Putting it all together, erythematotelangiectatic rosacea means: Redness due to abnormal expansion of capillaries.
This subtype is my primary type of rosacea, moreso the non-transient redness than the flushing. I have the butterfly pattern of redness on my nose and cheeks, as well as my chin and the center of my forehead. The redness is not a uniform diffuse blush, but is instead rather uneven and gives my complexion a ruddy appearance. Here is a photo of my cheek to illustrate. Note that the following image was during a flush and is not indicative of my typical level of redness. I chose it to make the unevenness of my complexion easier to see.
As you can see, the pattern of redness is uneven, and there are a lot of PIE/PIH marks which worsen the appearance. This non-transient redness is and has always been my primary concern with my rosacea. It’s covered very easily with makeup, but as any skincare junkie can probably relate, I have the ultimate goal of getting skin I can show off without makeup.
Fortunately, I have not had much issue with the flushing/blushing part of subtype 1 rosacea. The above picture did occur during a flush, but my flushes are few and far between. Many people experience intense heat, itching, and sometimes pain during their rosacea flushing. I do not. I only get a moderate level of heat in a particularly bad flush, and I am able to shut those down pretty well by reducing the temperature of my face.
I do have a few triggers that will bring on a very minor flush, one that comes and goes pretty quickly. For some people, spicy food, hot beverages, humidity, even dairy products or fruits can be triggers for flushes. Thankfully, none of those are my triggers. Alcohol, exercise, and hot showers are my main ones, and public speaking can get my face pretty red.
A full-blown flush for me usually requires some combination of my triggers at the same time. My last flush was over the Christmas holidays when I was spending time on the Canadian West Coast with my fiance’s family. We went for a brisk walk outside to a nearby dock and back (exercise). It was pretty cold out, and there was a bit of an icy wind to deal with (cold weather). When we got home we settled in with some glasses of wine (alcohol). Thus my face became a warm, red beacon for the evening until I was able to do my skincare routine and cool down with a sheet mask. The mask, combined with my cooling layers of hydrating and moisturizing products, thankfully stopped the flush and I was back to normal after that.
Subtype 2: Papulopustular Rosacea
(Bumps and Pimples)
This subtype involves bumps and pimples that are caused by rosacea rather than being typical acne. The medical term for this one breaks down much more easily: Papulo- means papules, which are raised solid bumps that do not produce pus. Pustulo- means pustules, which are bumps that do contain pus, i.e. whiteheads. Papulopustular thus means: a condition of papules and pustules.
This subtype is my second subtype, and I have a pretty mild case of it. My bumps and pimples are extremely small and tend to present as small red dots. Inflammation is minimal, and any whiteheads that I do get are very tiny and heal very quickly. Picture below to illustrate one of my more severe breakouts. Same cheek as the above picture, but avoid comparing redness because this picture is taken with a different camera in different lighting.
Nothing too extreme. It really just worsens the ruddiness of my complexion. What has really bothered me though, is the texture. The bumps may be difficult to see but they make my skin feel rough and terrible. I thought for the longest time that I was just getting clogged pores, aka closed comedones. In my early skincare discovery days, before I knew anything about anything, I was using both a BHA and an AHA twice daily to try and smooth out my skin texture. Spoilers, it didn’t work because, spoilers, these are not closed comedones.
More spoilers, I found a treatment that DID work and I pretty rarely get these bumps anymore. I’m saving that info for a later post in this series.
My History with Rosacea
My rosacea emerged sometime in the 9th or 10th grade. I didn’t fully understand what it was until just a few years ago, however, and I didn’t get an official diagnosis until last year. I went approximately 10 years with this condition without knowing or understanding what it was or how to treat it. Weirdly enough, my mother also has rosacea. I’m not sure why she didn’t pick up that I had inherited it. I had complained of acne in my teenage years, and I probably did have regular hormonal acne in addition to developing rosacea. She probably thought it was just that, and figured I would grow out of it, because she never suggested to me that I might have rosacea and she never took me to get treatment for it.
For pretty much all my high school years, I just thought I had shitty skin. And I thought it was my fault. I thought I wasn’t washing my face enough, that I ate too much chocolate or junk food. I thought my skin was oily because I kept having spots, so of course I went for every anti-oil product ever. I was using so many harsh cleansers and scrubs and acne treatments and absolutely nothing worked. I remember using my brother’s freaking adidas foot scrub on my face just to try to smooth out the texture. I tried all the Clean&Clear products, OXY acne pads, and of course the Proactiv regimen just hoping something would make my face better. Nothing did.
Then I got really into makeup. I love makeup as a hobby in itself, but I think at some point I had just resigned myself to having terrible skin. Nothing had ever worked to change my skin, but I could hide the all redness with just a bit of foundation. I threw my energy into covering up and putting the focus on my lips and eyes. I got pretty good at it too, and I was finally able to feel good about my face and how I looked. Eventually I was wearing a full face of makeup every single day, and I cringe when I look back because I can’t even count the number of nights I went to sleep without washing my face. At that point, I didn’t even own a face cream. Ugh.
Anyway, in that makeup phase, I found Reddit and Makeup Addiction. After a while I started to notice the Skincare Addiction subreddit popping up. I had graduated high school and was beginning to get more interested in taking better care of myself. Learning about skincare became a part of that. I thought that if I actually learned about how to properly care for my skin with a routine, I’d be able to fix my issues, again thinking that my poor skin condition was my fault. I stopped using my harsh cleansers and started moisturizing religiously. I started trying a ton of different products, looking for ingredients to reduce redness and help with my awful texture. My skin got less flakey, and my makeup starting applying better, but I still wasn’t getting the results I wanted. I also got bored with the plain products and steps that were touted in the Western-focused subreddit.
Eventually I wandered over to the Asian Beauty subreddit, curious about snail mucus and the 10-step routine, and skincare exploded into an exciting hobby for me. My focus switched from trying to destroy my troubled skin to trying to nourish and care for it. My skin is softer, brighter, and healthier than it’s ever been since my rosacea developed. I discovered that what I thought was oily skin was actually dry and dehydrated skin that needed added moisture instead of being scrubbed and stripped. My skincare routine became an exercise in not only caring for my skin, but also caring for myself. I took more interest in my health, and after learning so much about skincare and about my own skin, I realized I needed more serious intervention to care for my condition. I finally got a referral to a dermatologist and received some real treatment.
I am happy to say that, for the most part, my rosacea is now under control. Unfortunately, neither Western nor Asian over the counter products have made much of a difference in my rosacea. The vast majority of the leg work has been done with medication and professional treatment. That isn’t to say that my skincare has done nothing, however. Despite not treating my blemishes or redness, my skincare routine has vastly improved the overall health and resilience of my skin, and it’s doing better and better all the time.
My journey with rosacea is certainly not over, though. My skin is better than it ever has been, but there’s still room for improvement in my eyes. I plan to expand this series as I explore more treatments for my skin, in addition to the ones I have already tried. I currently have 8 treatments lined up to talk about, with a 9th on the horizon. Thanks so much for reading, and I hope you enjoy the rest of this series.