How to treat rosacea

Avoiding and treating flare-ups of this adults-only skin condition can help keep it from getting worse. Flushing, blushing and stubbornly red skin on your cheeks and nose are major clues, but other hints are burning, stinging or itching facial skin as well as raised red patches and even swollen spots. Read on to learn more.

The most important step in avoiding outbreaks is learning what triggers them. Tops on most people's lists are sun exposure, emotional stress and hot weather, but there are plenty more. In a survey of people with rosacea, about half said that wind, heavy exercise, drinking alcohol, taking a hot bath, cold weather and spicy foods set off a reaction.

To pinpoint your triggers, keep a rosacea diary (use a small notebook or even a desk calendar). Write down common triggers you're exposed to and record days when symptoms flare up. After two to four weeks, you should see a pattern; triggers usually jumpstart redness within a few minutes to a day.

The sun's ultraviolet rays aggravate rosacea simply by reddening the skin. But that's not all. Dermatologists from Boston University have found that sunlight also seems to trigger the production of compounds that spur the growth of blood vessels close to the surface of the skin. Your best protection is to stay in the shade during the brightest hours of the day, and wear a broad-brimmed hat and apply sunscreen to your face when you leave the house.

Don't let your sunscreen aggravate your skin, though. Choose a formula that contains dimethicone and cyclomethicone. In one study, these additives protected against the irritation caused by the sun-blocking ingredient Padimate O. Or try a sunscreen formulated for babies, which may be milder. Also look for the ingredients zinc oxide and micronized titanium oxide, which deflect some of the sun's heat and therefore help prevent rosacea flare-ups.

 Many doctors begin treatment by prescribing antibiotics such as tetracycline for 12 weeks or so to help reduce bumps and redness. But that's not a cure. In one study, two-thirds of the people who took a course of tetracycline for rosacea saw skin problems return within six months. That's why doctors also prescribe a skin-calming cream or gel containing metronidazole, or azelaic acid for long-term use. In one study, people who used metronidazole for six months after antibiotic treatment were about half as likely to have redness or bumps return as those who didn't use it.

Skin-care products such as cleansers, moisturizers, sunscreens and makeup can easily irritate and redden your skin if you have rosacea. To avoid irritation, choose mild, hypoallergenic cleansers and moisturizers, wash with lukewarm (not hot) water and avoid rough stuff like scratchy washcloths, loofahs and abrasive skin-care products. If your skin stings when you apply sunscreen, makeup or medicated creams and gels, wait a half hour after washing so your skin is completely dry.

Ask your dermatologist about a retinoid product. These vitamin A–based skin creams and washes speed cell turnover and are usually used to control acne and reduce wrinkles. Recent studies suggest they may reduce two visible signs of rosacea: redness, and tiny blood vessels near the surface of the skin. Proceed with caution, though; retinoids can irritate the skin at first, so start with a low-dose product.