Rosacea on my cheeks in my forties, advice on causes and treatment

[SaffySaffron]

I've developed rosacea on my cheeks. I'm early 40s so shocked and quite upset too.

Can anyone help or suggest what I should do? What's causing it? What should I do and use? Any suggestions welcome thank you.

To cover it if you want to, use erborian cc red correct. It comes out green, but when you rub it in it neutralises the redness.

You need Metronidazole gel (Metrogel). I got it from a dermatologist the first time (because despite multiple visits to the GP they couldn't diagnose me). You may need to use it every day and night for six months to get your rosacea under control, but once it is you shouldn't need to use it continuously. If you can afford a dermo appointment, get one, but if not ask your GP to write you a prescription.

I have mid-afternoon flushing too! I can tell from my face when it hits 3pm.

Hi OP. The most important first steps are identifying your personal triggers like heat, alcohol, spicy food, high-fragrance prod, certain actives like high-percentage AHAs. For skincare a gentle fragrance-free cleanser, niacinamide serum for redness/barrier support, & mineral SPF daily, though this can still be irritating for some. A derma referral is also worth pursuing.

When mine started getting worse, I started laser treatment. The first place was ineffective; the second (IPL) made a big difference, even after one session (i.e. what effectively looked like a port-wine stain on one cheek was gone). I've had a few other sessions. It can be painful, and with swelling.

Then I went to see a GP about something else, and was asked if I was, "...always so red". I'm now on a long-term course of antibiotics, applying ivermectin, wearing daily SPF and aqueous cream, so we'll see if that makes a difference. If not, something else will be tried.

I've been told that it can be to do with diet (e.g. eating a lot of spicy things, but I don't), sun exposure and stress.

I find when I drink more water and cut down on tea, fizzy drinks, white bread and cereal it eases. I use avene skin soothing cream, no acids ever ever and I use spf daily.

I also find when I use moisturisers or primers for red skin of ‘for roseacea prone skin’ I get one hundred times worse.

Glossier primer is the only one that suits my skin and weirdly most foundations or bb creams don’t affect me.

For all the people mentioning soolantra - is this for the sunburn type or just the acne type?

Rosacea is often caused by an infestation of the demodex mite, especially if you have the pustules along with the redness. We all have the demodex mites on our skin but people with rosacea often have many more than usual. Soolantra contains the active ingredient ivermectin which kills off the demodex mite. If your GP is reluctant to prescribe it you can buy it privately although it is quite expensive around £50. You need a pea sized amount applied at night time, it also has a moisturiser so you don’t need anything else. You might get die back where your skin will get worse before it gets better. Soolantra is a huge game changer for so many people, I would highly recommend you try it. It made a huge difference to me after 20 years of suffering on and off and not finding anything to help.

I've started to develop this too (also early 40s) and my mum and gran both had/have significant rosacea on their cheeks.

I've ordered azaleic acid to try as it's not expensive. If that doesn't work I'll try to the soolantra but as a pp said it's £50+ to buy.

Hope you get good results OP.

Hi OP… are your symptoms red cheeks/flushing, or do you have spot/acne type symptoms?

I had spot/acne symptoms and when I was first diagnosed was given a cream called Rozex which didn’t help get rid of the spots at all. I also had a 6 week course of antibiotics which helped slightly but didn’t solve the problem.

I honestly spent hours researching and looking for help, also spent loads of money on different creams, soaps and supplements!

After much investigation my view was that I needed Soolantra, which is a cream the NHS are apparently not keen to prescribe as the cost is quite high. I purchased privately from Superdrug and within a week my skin was so much better. Once the cream was finished I went back to the doctor and I now have it on repeat prescription, and use about twice a week at night, more if I sense a flare up is happening.

There is a Facebook group called Rosacea Tips and Support that I found really useful, and where you may get further advice.

Sorry for the long post!! Hope you get it sorted soon.

Mine was the sunburn type but I was progressing towards the acne type, which I gather can happen, so I was given Soolantra for the flushing and Skinoren (Azaleic Acid) to keep it from moving to the other type.

Thanks everyone for the messages. I'll have a good read of them all later.

Get a referral to a dermatologist, tho when I was referred they made me do all the GP treatments. Been on Soolantra for ages now, whenever I have a flare.

The consultant said it wasn't due to food but it so is for me. If I eat certain foods, I get a flare straightaway.

There's also a genetic element.

I do eat a lot of chocolate! I always have though. I hardly touch alcohol as I drive for a job.

If you are sure it's rosacea then visit your derm once, it's required. I had it and later it got resolved with my derm's script. Now I just follow a routine which help with my glow:
Morning:
Using water to wash your face,
Sebamed clear face gel,
Garnier spf
Cicaplast
Evening:
LRP moisturizer,
Tretinoin (0.1) from skinorac
Sebamed clear facial gel

Improving my diet made no difference to my rosacea. Zero. It came with perimenopause.

The only thing in my control that impacts it is sleep. Get enough = skin looks good. Not enough = flare up.

The thing that improved it about 80% was a 3 month course of antibiotics. After that I was able to manage it with azelaic acid and prickly pear oil.

Mine's on my nose and forehead, I suspect food related but after lots of trial I have never been able to pinpoint which foods aggravate it. I cleanse with micellar water and wash in warm water. Twice a week I wash my face with Head and Shoulders, which stops the pustules forming. To soothe my skin I use Prosacea gel which I get online as it's not available in the UK. A little goes a long way.

I'm glad I came across this thread. My DS (17) has just been diagnosed with rosacea after years of being fobbed off by Doctors saying its just teenage acne. He was so anxious about his skin (especially on his nose) that I had to pull him out of school in Year 5 and home school him. He will not leave the house in the daytime, and will rarely go out at night unless he is wearing green cover up.

He has just been prescribed Soolantra by our GP, so it's heartening to hear so many positive stories about it. However, he has only been using it for a week with no difference, so he has got it into his head that he needs laser treatment. I'm reluctant to go down this route until we see the dermatologist and get confirmation of his diagnosis. Plus we need to see if the Soolantra works!

Any advice would be most appreciated - I'm at my wits end, the poor lad has no life at the moment.

Mine improved dramatically when I switched cows milk for soya milk.

Oh how heartbreaking@GrossEncountersoftheTurdKind.

Does he have bumps or just redness? I think Soolantra does take a while to work, but it's most effective on the flushing type of rosacea than the type with pustules. I'm guessing from your description that your son has the latter type?

I think he really needs to see a dermatologist as I suspect he will need a course of antibiotics and, if those don't work, one of roaccutane. Please do either pester your GP for a referral or see a dermatologist privately if possible as it sounds like he's suffering unnecessarily.

Thanks for your reply. As he is only 17, the GP would only prescribe Soolantra in the first instance, as anything stronger cannot be prescribed to under 18's. He has bumps (kind of like acne) on his cheeks and chin, and his nose is very red and quite bumpy. If the dermatology referral doesn't come through in the next few weeks, I will seek private options.

We are finally getting help from CAHMS (after 4 years of trying) to help with his mental health/anxiety, but he truly believes all will be well if his skin clears up. It does break my heart every day, he is such a lovely gentle lad.

Antibiotics and Roaccutane can be prescribed to under 18s by dermatologists. It makes me both sad and furious that GPs know this and drag their heels on referring. It's hard enough being a self-conscious adolescent without an unnecessary added stressor.

I took my DD to see this dermatologist - she's private and very expensive, but she talks about her own experience with the psychological trauma of teenaged acne, so it might make interesting reading for you.

https://www.thebeautytriangle.com/addressing-acne-with-dr-anjali-mahto/

I hope everything comes together for your son!