The Rosacea Diaries: Part 1

Part 1: How to accept and manage rosacea. 

This blog is written from my experience with rosacea, jazzed up with the thoughts I am experiencing on the way and honesty about the absolute idiotic mistakes I have been making lately. I am not a healthcare professional and I cannot give you medical advice. At all times, you should discuss your diagnosis with your doctor and always follow their advice.

Ohoy there! It’s me again. Miss what-da-heck-is-my-skin-doing-now. Also known as Karoline, BYBI’s Graphic Designer. I am not sure if you remember me, but I wrote a little something on perioral dermatitis (POD) This time I am gonna touch down on MY experience with rosacea (perioral dermatitis and rosacea is actually thought to be linked to each other), triggers & treatment and how a balanced diet and probiotics have helped me manage my flare-ups (but also how make-up and wine can make it worse).

Sorry in advance for giving you half of my life story, but rosacea is basically invading my private life and I thought I’d give you all the juice. A little spoiler alert: It’s a long one, but a goodun'. I’ll be as honest with you as possible - heck - I’ll even share images with you of my burning, rosy cheeks (you can look forward to, not only my persistent redness but also, my very persistent selfie-face). Because hunnay - you are NEVER alone when it comes to dealing with a skin condition.

So. How do you deal with rosacea? What is the right way of living with it and how can you get rid of this pesky redness? And more importantly - how do you feel great when you have a sh*tty break-out that doesn’t want to go away? Whilst I can’t tell you the exact way of sorting it (oh boy, I wish I could) because everyone is different, I can tell you how I have come to terms with the ‘condition’, advise you on how to keep your skin looking dewlicious and fricking great with rosacea and how I have implemented BYBI into my routine. Because, you deserve to feel absolutely f*cking stunning in YOUR OWN SKIN, and I have been doing all the do’s and don’ts - just so you don’t have to repeat all my mistakes.

Before I was ‘diagnosed’ (erk, I bloody hate this word) with the condition I was living by a complicated 5-step skincare routine using ALL the acids and chemical peeling masks I could get my hands on. I was using a glycolic serum from REN, a retinol serum from Murad and in between using ALL the chemical, acidy peels I could get my hands on. AHA? Hit me. Vitamin C serum? I’m here for it! I was even taking baths with perfumed bath bombs from LUSH (yeah, POD and rosacea doesn’t exactly love that, unfortunately). Then, there was a period where I was living for nuggets and prosecco (please forgive me for my lack of healthy choices, I had just finished my degree). And, I won’t lie. When you normally live by a healthy routine and suddenly mix an unhealthy lifestyle with a WAY too dangerous skincare cocktail your body will say stop. And mine did, resulting in my rosacea journey starting - perioral dermatitis.My body has been quite forgiving with me in my younger years and I've never really dealth with health issues - but karma is a less nice gal and she decided to come back on me as a pesky little satan that I gotta live with for the rest of my life.

Yo chick, what exactly is rosacea?

“Rosacea is a common chronic inflammatory skin disorder, and the development is believed to be multifactorial.”

If you suffer from rosacea, you will most likely already know that rosacea is an inflammatory skin condition that can cause redness, pustules, visible blood vessels and a thickening skin on the nose. It mainly affects caucasian skin and comes in 4 subtypes, where people can suffer from multiple subtypes. 

The less sexy part, that you might not know: People with rosacea have a higher presence of the skin mite Demodex on their skin. The Demodex mite can affect the TLR2 receptor (a receptor that activates an inflammatory immune response) resulting in the above-mentioned symptoms. Newer studies indicate that the balance in your gut-microbiota can have a high influence on your skin and some studies have even linked rosacea to IBS [irritable bowel syndrome] which is just another good reason to treat yo’ cute gut-bacterias like you would your best gal pal). 

Flare-ups of rosacea are often ‘triggered’ by external factors like the weather or internal factors like diet and alcohol. Sudden emotional triggers or exercise can also cause a very sudden flare-up of redness. It’s still unknown what causes rosacea, but it's more common in women.

Often, the best way of dealing with rosacea is prevention, rather than treatment. This means preventing flare-ups by eating healthy - aka foods that don't cause flare ups - protecting your skin and using calming products. Rosacea can however, be treated with topical antibiotics, oral antibiotics or gels like Azelaic Acid (anti-bacterial properties) or Brimonidine (alpha-blocker, improving redness). An ‘alternative’ treatment for redness can be beta-blockers (heart rate medication) but this method isn’t proven to be an effective treatment for rosacea. 

For a long read and detailed information on rosacea, see HERE. For the mite, explanation see HERE. 

That tiny tat of redness. Do I EVEN HAVE rosacea?

It’s important to highlight that everyone’s experience with rosacea is very different - people have different grades of it, it can affect their confidence and self-esteem in very different ways and not all can control it anyway. 

My rosacea is mainly subtype 1 - redness. It got diagnosed when I was dealing with POD back in 2018. I was in denial because;

1. I didn’t want to have a permanent inflammatory skin condition 
2. Mine didn’t look anything like the images and I'd barely experienced flare-ups for a year

Spoiler alert: everyone's rosacea is different, there are multiple subtypes and just because yours doesn’t look like the images googles serve you, doesn’t mean you don’t have it. 

It kinda went away during February 2019 but as we all love a plot twist, it decided to show up like an ex holding a grudge, back in December resulting in redness and pustules on more occasions than I’ve ever previously experienced. 

A short timeline for you here:

Oct/Nov 18: Experiencing redness and facial burning, spots and blisters around nose and chin.

Nov 18: Diagnosed with rosacea but my main concern was POD.

Nov-Dec 18: Treatment with Metronidazole. Worked when I used it, POD flared up when I didn’t so I slowly faded out the use of it. 

Feb-Dec 19: Preeeetttyy chill skin.

Dec 19: Flare-up pushed me to start on Azelaic Azid that I have been using AM/PM until April.

April 20: Recently finished a course with antibiotics, I have been trying out Brimonidine.

NOW: Skin angry AF, giving it a break from all the above. 

When I started writing this blog, my skin was in the post-honeymoon phase, settled, happy and not even close to having a fight. I had come to terms with the condition - mainly because I, to an extent could manage it and because I thought I’d seen the worst of it. Which was not the case. Had there been a divorce lawyer involved he’d be clapping his hands, because this fight wasn’t gonna settle easy. 

I am currently experiencing the worst flare-up on its second week and have had to limit my skincare routine to a cleanser, niacinamide and a simple moisturiser. My current state is most likely due to the ‘come down’ from antibiotics, trying out brimonidine for the past 4 weeks AND falling asleep with make-up on (yeah, sometimes you don’t realise WHY your skin is freaking out until you reflect about your poor life-choices the past week).

I have previously tried metronidazole, been on long term treatment with Azelaic Azid, tried antibiotics and, latest, and alpha blocker - so - I have basically been through the whole doctor 101 rosacea-treatment pack, and can tell you what worked for me - and what didn’t.

Coming to terms with rosacea

Lol. As I said, I have been in denial for ages, and I am only now at the point (thanks to 5 days of burning cheeks) where I’ll compromise on many of the indulgences, why calling it ‘coming to terms’ is such a stretch. But, here we go:

My first advice is to accept it, figure out how it makes you feel and decide where you want to compromise. Compromising is a massive part of rosacea and if flare-ups affect your self-esteem and your presence you might want to adjust your lifestyle a lot. Secondly, I’d recommend you monitor flare-ups and adjust your lifestyle according to what’s affecting it. Rosacea is yet another pesky skin condition that you have to listen and learn from, exactly like you would with your heart and your best friends. 

It’s kinda like building a strong relationship - this one is gonna stick forever.

Ask yourself the following:

1. Why is it bothering me?
2. How is a flare-up affecting my perception of me and my presence?
3. What lifestyle choices am I willing to compromise on?

With rosacea, as much as so many other things, it is very much about your self-perception. Kinda like the law-of-attraction - if you feel great, you show it. And if rosacea brings you down, you should try to figure out how it can affect you less and how you can feel better. Because YOU deserve to always feel great.  

For me, I decided earlier that there are things I won’t compromise on (this will most likely change during this divorce, because damn, rosacea and I need a good settlement). I am a SUCKER for coffee, I want to be able to have a drink (or 5!) when I am going out and you are bloody not telling me that I can’t eat Indian or pick’n’mix once in a while. This means that I will have to accept that my skin will flare up and might affect me for the days after (so let me put it straight, eating a 400g bag of pick’n’mix the day before a wedding is NOT the way of dealing with it unless you want to look like Henry the Hoover just with rounder cheeks). It also means that I, by knowing my compromises, can try to identify what is less aggravating for my redness and try to balance my diet in other ways (wait for the bucket theory).

I have ‘decided’ that having rosy cheeks looks quite cute and that I am absolutely freaking fine with that part (the law of attraction, if you think you look cute, you can radiate this). What I am NOT fine with, is when the pustules flare-up on my cheeks and my skin burns so bad that I have laid with a cold cloth for 10 minutes (hey, a piece of good advice there lovers, avoid the sun!)

I have also decided that I want to avoid covering my skin with layers of makeup because this is my face. Well, and because I dislike wearing foundation because it makes my skin feel like it can’t breath. Thank God that I work at a skincare company where we celebrate inclusion, ‘being you’ in your best skin and having colleagues that are more than extraordinary in telling you that your skin’s looking great, mate!

My main learnings from dealing with rosacea are

1. My flare-ups and skin state is VERY affected by my lifestyle and sudden changes in my normal diet can cause my skin to freak out. My rosacea always seems to be triggered just before winter when the weather changes, but it is also very affected by my diet. I hadn’t been on treatment for rosacea for a year, until after a Susty Summit where I’d been indulging in doughnuts, gluten and had a drink.
2. My diet is the main factor on my redness whereas pustules are affected by what I use on my skin (both affect each other, but my lifestyle is being the devil in this).
3. That accepting the flare-ups is also making me able to deal with them without having to cover them up. Trial and error has by now provided me with quite a go-to strategy, and when I follow my normal habits, my skin is quite blessed. 

My top rosacea triggers (after the weather and aggravating skincare) and how my skin reacts

Sugar (especially pick’n’mix & doughnuts) > Redness, bloated face and pustules the day after

Alcohol (especially cocktails) > Redness and warm cheeks within 30 minutes, can cause pustules the day after

Wine (especially prosecco) > Redness during, pustules the day after

Spices (especially Korma and Garam Masala) > Redness

Gluten (especially from white bread) > Affects my gut and are often causing POD around my mouth

(Some) Make-up > Pustules, flares up my POD

By identifying the above factors I am able to manage parts of my flare-ups (or at least able to minimise the risk of having one) which is key in avoiding them. 

Do you know Talonted Lex? She’s the shizzle when it comes to rosacea and manning down the stigma about it. She also has some really helpful worksheets for rosacea triggers and journaling.

Read Part 2: how to adapt your skincare routine and diet!

Written by Karoline, BYBI Design Executive