Blushing is charming–unless you have rosacea. Here's the scoop on this inflammatory skin disease, plus ways to get it under control.
When you were in your 30s or 40s, you may have noticed a slight ruddy tinge to your cheeks and nose that flared up even more when you were out in the heat or after a glass or two of wine. But as you headed into your 50s, 60s, or even 70s, it may have worsened.
There's actually a name for this condition: it's called rosacea. It's a common skin issue that causes redness across the nose and cheeks. Over time, it can spread to your forehead or chin and even to your ears, chest, and back.
If you have rosacea, you're in good company: Former President Bill Clinton, the late Princess Diana, and the late comedian W.C. Fields all struggled with the condition. It occurs in about 5% of adults over the age of 30. It's more likely to occur in women with very fair skin. It also seems to get worse with age.
Rosacea isn't life threatening, but it can make you feel pretty self-conscious. About 90% of people with rosacea say it has affected their self-esteem or made them feel embarrassed. It can also cause you to feel frustrated, anxious, helpless, depressed, and even angry. As symptoms progress, these feelings tend to get worse, too.
But there's a lot you can do to help treat rosacea. "It's important to recognize that rosacea is a chronic disease," Zoe Diana Draelos, MD, a dermatologist in High Point, North Carolina, told Dermatology Times this past April. "And because it's a chronic disease, it requires continued treatment…to prevent rosacea from worsening."
Here's a look at how to tell if you have rosacea, plus the best options to treat it and avoid flares.
How to tell if you have rosacea
There are a few telltale symptoms that indicate you have rosacea. If you have at least two of them, you're considered to have rosacea.
Persistent redness on your face
It looks like a blush or sunburn that doesn't go away. If other people frequently comment on how much sun you got when you haven't been outside, you could have rosacea.
You'll see this usually on the nose (it's got a fancy name, rhinophyma). It may appear bumpy, red, or enlarged from all this extra tissue. Men are more prone to rhinophyma than women.
You may notice that you seem to blush or flush a lot. Sometimes your face also feels warm or burning.
Bumps or pimples
You may wonder if–ugh!--you're developing zits in your 60s! Nope. These small, red, solid bumps aren't related to acne.
Visible blood vessels
You may notice them appearing on your cheeks and the bridge of your nose.
Sometimes, rosacea can even impact your eyes. This is known as ocular rosacea. Your eyes may water or be bloodshot. Your eyelids may redden and swell and even develop crusts.
Other, less common rosacea symptoms include:
- Burning or stinging sensations on your face
- Facial swelling
- Dry, scaly facial skin
If you do think you have rosacea, it's important to see a dermatologist. You might have another skin condition that looks similar to rosacea, such as eczema, seborrheic dermatitis, psoriasis, or lupus.
Treatment options for rosacea
There's no one-size-fits-all treatment for rosacea. Your doctor will recommend certain medications or procedures based on your symptoms. Here's a quick overview of what some of those are.
To treat redness
- Prescription medications brimonidine gel and oxymetazoline hydrochloride cream. They work for up to 12 hours to reduce facial redness. You need to use them every day.
- Laser treatments to zap away blood vessels that can cause redness.
- Green-tinted makeup to hide redness.
To treat thickened skin
- The acne medicine isotretinoin helps shed dead skin cells. Dermatologists sometimes prescribe it to treat thick skin.
- Surgery to remove thickened skin.
To treat lumps and bumps
- Azelaic acid. You apply it twice a day, in the morning and evening. It has anti-inflammatory and anti-bacterial properties, which means it can help get rid of redness and spots and bumps.
- Metronidazole gel or cream. Like azelaic acid, it decreases inflammation and kills bacteria on your skin.
- Sodium sulfacetamide and sulfur. These are often found in rosacea skin cleansers. Studies show it can get rid of these acne-like breakouts in six to eight weeks.
- Retinoid creams to help prevent future flare ups.
- Antibiotics like tetracycline, minocycline, doxycycline, or erythromycin. These are only used until your rosacea gets under control.
- Laser or light therapy
To treat eye rosacea
- Warm compresses
- Cleaning the eyelashes and eyelids with a gentle cleanser like baby shampoo
- Antibiotic eye drops or eye creams
Avoiding rosacea flare-ups
Preventing a flare-up is key to coping with rosacea. Here are some simple lifestyle steps to take.
Sunlight is the leading cause of rosacea flare-ups. Sunscreen, hats, and shade – recommended for everyone to help prevent skin cancer – are especially important for people with rosacea. Ask your dermatologist which brand is well tolerated by their rosacea patients.
Treat your skin gently
Use a mild cleanser to wash your face and rinse with lukewarm or cool water. Avoid washcloths, toners, astringents, and deodorant soaps–these can all worsen rosacea.
Modify your exercise routine
To prevent a flare-up, try to drink plenty of water and exercise in a cool place. You may need to reduce the intensity of your workout or try a different exercise, like swimming or yoga.
Besides all the other reasons to kick the habit, smoking may also worsen rosacea.
Alcohol makes you more likely to develop heart disease, dementia, and diabetes. It can also trigger your rosacea.
It's linked to many diseases, like heart disease, but stress is also a rosacea trigger. One survey done by the National Rosacea Society found that 90% of patients were able to decrease flare-ups by managing stress.
Avoid your personal triggers
Not everyone with rosacea will get triggered by the same thing, so it's important to figure out what your personal triggers are. Common ones include hot drinks, alcohol, spicy foods, heat, wind, and cold. Some blood pressure, migraine, anxiety, and glaucoma medications can also worsen rosacea, too, but don't just stop taking them! Ask your doctor if there's another option.
A rosacea diagnosis can be upsetting, but with treatment and lifestyle modifications, most people find a way to keep rosacea under control.
The right Medicare plan can help you cope with rosacea
Both Original Medicare and Medicare Advantage will cover most of your rosacea treatments, including doctor visits and medications. But expensive laser therapy is rarely covered.
Your Medicare Advantage plan may be able to help you with lifestyle modifications. Most Advantage plans offer a drug store discount or stipend that you can apply to gentle facial cleansers and sunscreens. You may also be able to bring your exercise indoors with a covered gym membership, avoiding sun exposure and temperature extremes.
Is your Medicare plan giving you all the benefits you deserve? Check out our easy-to-use Find a Plan tool.