By Erin Lukas
Updated Dec 26, 2016 @ 12:00 pm
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Did you know that millions of Americans are seeing red everyday thanks to rosacea? The chronic skin issue that’s characterized by redness and tiny, acne-like bumps and legions on the face has a list of triggers that’s so long we could write a whole novel series on it and we still wouldn’t have revealed the complete story.

Since common activities like eating spicy foods, taking too-hot showers, and a few too many glasses of wine can result in flushness or prolonged heat, it can be difficult to tell if you’re just experiencing a reaction or full-blown rosacea. To help demystify the issue, we turned to dermatologist Manjula S. Jegasothy MD, CEO and Founder of Miami Skin Institute, to find out what exactly causes rosacea, and how to get your skin to calm down.

WHAT IS ROSACEA?

Rather than a condition, rosacea is an inherited skin type that’s characterized by hyperactive blood vessels on the face. “Generally, rosacea manifests as rosy cheeks when a person is in their 20’s or early 30’s,” says Dr. Jegasothy. “Depending on the genetic predisposition, the severity of the rosacea can either remain stagnant throughout a person’s lifetime, or progress to enlarged oil glands (which look like yellow or white waxy pin-point bumps all over the face), permanently enlarged pores, or broken capillaries on the face.”

HOW DO I KNOW IF IT'S ROSACEA OR REDNESS?

Since a couple of glasses of wine or winter’s chill can trigger flushed skin, determining whether the inflammation you’re experiencing is rosacea or temporary irritation triggered by diet or environmental factors, is what makes diagnosing it tough, to put it mildly.

Tracking the pattern of your redness is helpful in determining whether or not the situation is serious enough to visit a dermatologist’s office. “If the redness you see persists for longer than three weeks or comes and goes over a period of months, then it’s necessary to see a dermatologist,” explains Dr. Jegasothy. Since the rosacea can mimic the symptoms of other skin conditions and vice versa, she stresses that it’s not a good idea to try to self-diagnose.

SO, HOW DO I TREAT IT?

Luckily, there are simple methods of treating rosacea. Although it takes some trial and error to find the formulas that work for you, a variety of topical gels, lotions, and creams prescribed by a dermatologist can be used. “Most patients decide which topical prescription agent soothes them the best through trial and error,” Dr. Jegasothy says. “Typically, I give my patients 3-4 samples to try, which they do for one week each, and then decide on a favorite.”

However, if a person’s rosacea goes beyond redness and is characterized by a lot of acne bumps, a low-grade dose of an antibiotic like doxycycline, which is used to treat bacterial infections including acne, may be necessary as well for a short or long period of time, on a case-by-case basis.

WHAT PRODUCTS SHOULD I USE?

When choosing products for your daily skincare and makeup routines, Dr. Jegasothy suggests sticking to formulas that are catered to sensitive skin types. Again, finding the right product lineup that won’t further aggravate rosacea takes testing and time. “If they find that they can tolerate these [products for sensitive skin], then they can move on to try other products, usually one by one, to see which individual product and ingredients suit them or irritate them,” she says.

Throughout this process, she stresses the importance of recognizing the ingredients your products contain and which ones don’t sit well with your complexion. “In general rosacea patients should be careful with glycolic acid and retinoid,” explains Dr. Jegasothy. “However, I find that with careful monitoring, many of my rosacea patients can eventually use the anti-aging benefits of both over time.”

WHAT HAPPENS IF I IGNORE IT?

Every person’s rosacea is different, but simply leaving it alone and hoping it will heal itself will actually do the opposite—it will only get worse. “If rosacea is left untreated, the flushing and heat symptoms can exacerbate,” explains Dr. Jegasothy. “When worsened, the enlarged oil glands can become permanent, requiring a cosmetic procedure such as Hyfrecation (where tissues are destroyed via electric current), cautery of the individual bumps, and capillaries can become very stubborn to treat, even with multiple VBeam laser treatments.”

Overall, she says that she sees most people with untreated rosacea develop a waxy, thickened skin that can be cosmetically unpleasant as they approach their 50’s and 60’s. How to Choose the Best Rosacea-Friendly Beauty Products

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Image zoom Aveeno Ultra-Calming Foaming Cleanser

Cleansing is an important step in any skincare routine because it removes makeup, impurities, excess oil, dead skin, and toxins. More often than not, if you’re dealing with rosacea, your skin is on the dry side, so Dr. Gmyrek recommends using a non-soap cleanser, which contains less than 10-percent soap in its formula. “Soap emulsifies and removes oils from the skin creating further dryness,” she explains. “Non-soap cleansers also have a more neutral pH (i.e. they are not acidic) so they tend to be less irritating than soap based cleansers.” The cleanser should be applied using your fingers and cold to lukewarm water to prevent aggravating your skin.

$7; drugstore.com Courtesy

Image zoom Dr. Jart+ Ceramidin Liquid

Moisturizers act like Saran Wrap for the skin, by helping support its barrier function that keeps water in and harmful environmental elements out. “When the barrier of the skin is damaged by the inflammation associated with rosacea, then allergens and irritants can enter the skin more easily, causing more redness and inflammation,” says Dr. Gmyrek.

When picking out a moisturizer, the doctor suggests a product with ceramides and humectants that aid in repairing the skin’s barrier and that bring hydration to the skin, such as glycerin and hyaluronic acid. As for ingredients from which you should keep your distance? Alcohol, witch hazel, fragrance, menthol, peppermint, and eucalyptus oil will all spur further irritation and redness. A moisturizer should be applied following a cleanser, but Dr. Gmyrek recommends waiting several minutes after you gently dry off the cleanser for your skin to damp skin to dry even further before moving on to the moisturizer.

$39; sephora.com Courtesy

Image zoom Bare Minerals Originial Broad Spectrum SPF 15

If you’re self-conscious about redness caused by rosacea, a foundation can help even out your skin tone. Dr. Gmyrek suggests using mineral-based makeup because they don’t penetrate the skin but simply sit on top of it, and are less likely to result in additional inflammation. For extra prevention against potential irritation, the doctor says to choose a foundation with no preservatives.

$28; beauty.com Courtesy

Image zoom NYX Concealer Wand

To target specific areas that require extra attention when masking redness, apply the color wheel theory of complementary colors by dabbing on a green-based concealer to cancel out the harsher red spots.

$5; nyxcosmetics.com Courtesy

Image zoom Radical Skincare Skin Perfecting Sunscreen SPF 30

The sun has a significant relationship with rosacea. According to a National Rosacea Society survey, 81 percent identified sun as a major trigger of their rosacea. Needless to say, if you have rosacea, wearing sunscreen year-round should be a priority. Dr. Gmyrek recommends that “sunscreen should be applied every 4 hours and it should be labeled ‘broad spectrum’ meaning that it blocks both UVA and UVB rays. It should have an SPF of at least 30.” When it comes to choosing a sunscreen, she suggests one that is mineral-based that contains titanium dioxide and/or zinc oxide to block out damaging rays, because chemical-based sunscreens that absorb rays have been found to trigger irritation.

$55; dermstore.com Courtesy 1 of 5 Advertisement