If you notice redness on your face or chest that waxes and wanes but never goes away entirely, you may have a case of rosacea. Learn how to identify the symptoms, and discover the treatments that work best.
Scientists consider the condition something of a mystery, but most believe a mix of genetics and sun damage kick-start this tendency to flush easily and often, at almost everything—and sometimes nothing at all. "There's an extreme sensitivity to environmental factors coupled with overactive blood vessels," says Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center in New York City. "Instead of a momentary blush, the redness can last for hours." Everything that causes flushing can lead to a flare-up of rosacea. Sun is the number-one trigger, according to the National Rosacea Society, affecting 81 percent of people, and stress ranks second, at 79 percent. Over time, the constant ruddiness can change the physiology of the skin. The muscles in blood-vessel walls thicken from opening and closing, resulting in a sort of perma-flush visible across the nose and cheeks. If the condition is left untreated, broken capillaries and red bumps can crop up.
MILD ROSACEA
IF YOU SEE: Constant redness on cheeks and nose that worsens under some circumstances.
YOU MAY HAVE: Mild rosacea. "Many women with rosacea look flushed all the time but then get even redder when they take a hot shower or have a glass of wine," says Jeannette Graf, an assistant clinical professor of dermatology at Mount Sinai Medical Center. Exercise and high temperatures can also cause the color to deepen and spread.
TREAT IT WITH: Easy fixes include exercising in an air-conditioned room, cutting out spicy foods, and minor adjustments, like leaving the lid on your latte to keep steam off your face—whatever it takes to keep skin cool. Use products made for sensitive skin, with ingredients that hydrate (the humectants in La Roche-Posay Toleriane Ultra help), soothe (Simple Nourishing 24HR Day/Night Cream has antioxidants for this), and strengthen the skin's protective moisture barrier (ceramide-rich Elizabeth Arden Lift and Firm Day Cream). Ask a dermatologist if your skin can tolerate retinoids, which, along with sunscreen, can stop the release of inflammatory chemicals that create new blood vessels, says Graf.
MODERATE ROSACEA
IF YOU SEE: Patches of red with scattered broken capillaries.
YOU MAY HAVE: Moderate rosacea. The tiny vessels aren't really broken; they're just visible below the skin because their clear walls have lost elasticity over time and are swollen with blood.
TREAT IT WITH: "Lasers hit the iron molecules in vessels, heating and sealing them from the inside out," says Bank. Note that your skin may look even redder right afterward; soothe it with a cold pack. It can take a month for the seared capillaries to disappear fully.
SEVERE ROSACEA
IF YOU SEE: Persistent redness with acne-like bumps.
YOU MAY HAVE: Severe rosacea. Blooming mainly around the nose and cheeks, small red bumps give already flushed skin a rough texture. "The microscopic mites living in our oil glands and hair follicles play a role here," says Zeichner. We all have these, but people with rosacea are overly sensitive, and their immune systems jump into action to protect them. The result: bumps.
TREAT IT WITH: These bumps aren't the familiar type caused by acne, which is why pimple creams don't help; most tend to irritate rosacea. Prescription creams and gels with anti-inflammatory ingredients (metronidazole or azelaic acid) can shrink rosacea bumps in ten weeks. A low dose of oral antibiotics can do the job, too. Currently in clinical trials, a cream with the drug ivermectin has been shown to clear bumps in as little as four weeks. It could be available by year's end, says Zeichner.
