What would you recommend for this skin problem?

[margaritasbythesea]

I know this is a big ask as it is quite specific, but please bear with me. I would really appreciate any help.

Late last year I developed rosacea. I live in a hot country and was then under quite a lot of stress, so one or both was probably the trigger. I had just got rid of severe eczema on my hands so was convinced I could get on top of it and determined to do so.

Things I did were:
to use Soolantra
use suncreen constantly
stop washing with a cloth, exfoliators and any kind of foaming cleanser.

My routine, if it can be called one, is minimal. Morning is a cleanse with Cetaphil, light lotion moisturiser, sunscreen, makeup- Evening is make up off with cetaphil, Cerave moisturise which has niacinimie, bed.

My rosacea is well under control, so I am loathe to fiddle with the routine. However, as a result of something in the routine I am now getting millia. They are not really bad but are definitely a problem with my skin now. I am guessing it is either the cerave moisturiser being too rich (my skin doesn´t like anything rich at all) or the sunscreen. I have stopped using the moisturiser in the morning to see if this helps but it doesn´t seem to make any kind of difference.

I am thinking of some kind of chemical exfoliant rather than rubbing my skin with something scratchy but I am, quite frankly, terrified of doing so as I think exfoliation was partly the cause of the rosacea (at least stopping it made a huge difference).

I am a very fair skinned redhead in my 40s, if that is of any help.

Is there anything you could suggest to stop the millia while not provoking the rosacsea, please.

I'm interested in an answer to this. Question, how do you remove the makeup grime and cleanser without a flannel or cloth?

A dermatologist or facialist will sort milia out. Don't try and do it yourself as you risk damaging the skin.

I just splash cold water on my face, Theconifers.

Thanks LondonLady - I might go for that but I would really like to know why they have just started as well as how to get rid of them. Is it something about my new routine? Too many heavy creams maybe?

Hopeful bump.

I get rid of milia easily and gently using a warm flannel and a sterilised needle- never damaged my skin and can do it more gently than a beautician. Ice pack after to counteract any redness.

I use Eucerin 10% urea cream- fantastic for rosacea prone skin.

Thanks Dame. I have that cream but felt it might be too thick for me. Perhaps I will switch back for a few weeks and see.

I was wondering if any of these things I read about like Glycolic pads and retin A would help? I am very scared of the retinoid though because of the sun issue.

I'd steer clear personally. I don't find the cream too rich at all so it's worth a go.

Hmm. Maybe you´re right. I did read about Retin A being good for dealing with milia but am too afraid of it provoking sun sensitivity (or even more of it).

Milia are actually caused by dryness/dehydration.

www.drbaileyskincare.com/info/blog/what-are-milia-and-what-causes-them

Thanks for the link. I shall have a read.

That's very interesting. I didn't know there was a direct link between rosacea and milia. Hmm.

She does suggest Retin A and Glycolic acid though. I wonder which I should try first. Maybe the glycolic because of the sun issue. There is no way I want to rub my skin with anything so I am not going near a Clarisonic. I´m off to see what options there are with Glycolic acid.

Thanks for the link.

I don't think Glycolic or Retin A is advisable at all to someone with active Rosacea, especially one who lives in a hot country as it is both highly inflammatory and sun sensitising. That and the Clarisonic rec make me go a bit at that article.

It is a thing with Rosacea that the pores are wide but don't fill up like with blackheads so it is more prone to Millia and physical sunscreen can exasperate that, but most Rosacea sufferers don't tolerate chemical sunscreens well so it's a tough trade-off. You could try a physical/chemical mix sunscreen like the EltaMD one (it's the SPF42 or 46 one).

If you can get it on prescription Azelaic Acid may help, but I don't know how it works in conjunction with Soolantra. That pretty much goes for all active ingredients you could consider, is there a reason you aren't asking your dermatologist/GP for help with this aspect of it?

I did have a private dermatologist for a bit who prescribed the Soolantra (you can just get repeat prescriptions of it here without going back). I haven´t been to the health service GP or dermatologist because they both treated me like a complete idiot who was making a fuss when I went with a quite severe rosacea and the milia are really quite mild. I am hoping to nip it in the bud myself before they get very bad.

So you don´t think it will be the moisturiser causing it, just the rosacea itself?

Many thanks for your advice. I will follow up what you´ve told me including the sunscreen.

It could be, Cerave, whilst tolerated very well by a lot of people, equally doesn't work for some. It's a gentle and low irritant but more of interest to those with skin barrier issues (which rosacea technically is, but the issues have a different underlying cause) often as a result of too drying treatments/prescriptions for acne so it compensates with lipids and ceramides which you may not be deficient of.

It could be several factors, sunscreen, the Cerave, or even the Cetaphil. Using it just by rinsing off may not be getting everything off as thoroughly especially if you wear heavy/long-wear makeup and Cetaphil can be a bit harsh too.

Have you ever tried the Rosaliac line from LRP? I think the UV light gel would be lighter and it has a good amount of Niacinamide in it. It does also contain a chemical UV in it (would still use a separate SPF regardless) but it's a new gen stable one so less likely to be irritating, but still a possibility of course. Eucerin also has a few good products but I don't know what's available to you locally.

Btw high % Urea has exfoliating properties (v. gentle) so I don't think it's a bad idea to try it for a bit and see if that improves the situation somewhat.

That´s extremely helpful, thank you. I have just realised that, although I have had it for a long time, I have only in the last three months or so added the Cerave back in. The milia have only really starte din the last 6 weeks or so so I am going to swap back to Eucerin as you suggest and see how I get on.

I will have a look at the LP Rosaliac. I had a bad reaction to the Effaclar so have tended to leave them alone, but it isn´t based on anything more than that.

I´ll swap things out slowly and see how I get on. Thank you once again.