Rosacea can be relatively mild, just light flushing, or more intense with small cysts and textured skin (that can be mistaken for acne)

Rosacea is a common skin condition, manifesting in facial redness in various degrees. It can be relatively mild, just light flushing, or more intense with small cysts and textured skin (that can be mistaken for acne). It can also irritate the eyes. The cause is unknown, but a number of factors have been correlated with rosacea: genetics, overactive immune system, malfunctioning facial blood vessels, weather, bacteria, mites, hormones, and stress. It tends to afflict those who are fair-skinned.

Fight the Flush

First things first: sunscreen. UV light can exacerbate rosacea, so slather on that mineral-based sunscreen (zinc oxide is also an anti-inflammatory).

Azelaic acid, which naturally occurs in some grains, has a number of beneficial properties: It’s anti-inflammatory, antibacterial, an antioxidant, and a mild exfoliant; it combats hyperpigmentation and prevents widening of blood vessels.

When it comes to rosacea, this cocktail of benefits can help by calming redness, reducing texture, and improving skin tone. Azelaic acid is available over the counter: 10% strengths by brands like The Ordinary and Naturium; higher strengths require a prescription. It can be applied both morning and night, and pairs well with Vitamin C serums. It should not be paired with other “actives,” like retinol.

Time to Call in the Cavalry?

For extreme cases of rosacea that involve bumps and pustules, Ivermectin — yes, lice treatment — can help. Rosacea can be caused by mites on the skin, and Ivermectin destroys those mites: 0.5% strength is available over the counter, but 1% can be had by prescription. Dab a little on your skin at night, then top with moisturizer, like Vanicream Moisturizing Cream.

Pure aloe gel, whether bottled or direct from the plant, can also soothe. It can be mixed with water in a spray bottle and shpritzed on.

Until now, I’ve been hawking retinol as a treatment for nearly everything. But with rosacea, proceed with caution. Retinol has been found to be helpful with malfunctioning blood vessels that can manifest with rosacea, like spider veins, yet rosacea skin is still sensitive and can be triggered by retinol. So, if brave, start with a very weak strength (like Byoma Retinol Oil) then very slowly go stronger. Exfoliating acids like glycolic acid should be avoided completely.

If one wants to tame rosacea for an event, one can use oxymetazoline nasal spray (aka Afrin); mix a few drops into moisturizer and dab where needed. Oxymetazoline constricts blood vessels, and therefore reduces facial redness. However, it should not be used too often, lest there be a rebound reaction, in which the skin reacts with even more redness — definitely not for daily use!

Reminder: Patch test! Rosacea reactions are very individual; what worked for one may cause flare-ups in another.

Acid You Can Handle

Hypochlorous acid (HOCl) is produced by our immune systems to break down the cell walls of invading pathogens. A weak acid but a potent antioxidant, it’s actually more powerful than bleach in destroying bacteria and viruses while being ridiculously mild on skin. It’s not a new discovery; it’s been known for 200 years, and was even used in World War I for wound treatment.

So why don’t we all know about it? HOCl is an unstable composition, so bottling it and mass producing it wasn’t viable — until now. A chemical suspension has been discovered that can keep it shelf-stable, provided that it’s kept away from light and heat (don’t leave it in the car).

While it’s a powerful antimicrobial agent, it also amazingly soothes inflammation and redness in numerous skin conditions, including acne, psoriasis, eczema, and rosacea. Because it calms inflammation, it can help with wound healing while also keeping pathogens at bay.

It is excellent for rosacea. It can be sprayed or swiped on the face once or twice daily, and while it can be used as the same time as azelaic acid, it should not be combined with vitamin C serums or retinol. For those with rosacea in the eyes, apply the compound by spraying it onto a cotton round, then held against the eye. Note that there can be an initial chlorine-like smell that will dissipate.

Options are the Prequel Universal Skin Solution Dermal Spray or the Walgreens Cleansing Spray.

Sulfur is your stinky friend, since it’s anti-inflammatory, anti-bacterial, and mildly exfoliating. De La Cruz Acne Treatment has 10% sulfur; apply a ten-minute mask at night after cleansing for ten minutes, then wash it off. Alternatively, cleanse with a sulfur soap, like Joesoef or Biosulfur Grisi (available on Amazon). When cleansing, use cool water, as heat is a rosacea trigger, and any other cleansers should be gentle like Cerave Hydrating Facial Cleanser.

Finally…

Rosacea has also been linked to diet, like spicy foods, alcohol, and hot drinks and dishes. Start a food diary to see what foods cause flare-ups. An anti-inflammatory diet is recommended.

As always, for further assistance, seek out a highly recommended dermatologist.

(Originally featured in Family First, Issue 968)