Rosacea

Rosacea

Fight Flushing and Blushing

Elizabeth has fair, almost translucent skin that turns a glowing pink whenever she's hot, angry, embarrassed or somewhat tipsy.

But now, barely into her thirties, the pink is changing to red, the red is coming more often and small bumps, pimples and tiny broken blood vessels are appearing around Elizabeth's nose.

Elizabeth's doctor says that all the flushing she experienced was actually a prelude to rosacea, a skin condition in which blood vessels in the face tend to widen, engorge with blood and can turn your face red as a fire truck.

No one knows what really causes rosacea, although doctors have noticed that fair-skinned women of Irish or Celtic ancestry are genetically predisposed, says Karen S. Harkaway, M.D., clinical instructor of dermatology at the University of Pennsylvania School of Medicine and a dermatologist at Pennsylvania Hospital, both in Philadelphia.

What triggers the flush to begin with? "The big five are spicy foods, alcohol, emotional stress, heat and humidity," says Mary Lupo, M.D., associate clinical professor of dermatology at Tulane University School of Medicine in New Orleans.

Unfortunately, rosacea is a chronic condition that comes and goes, says Deborah S. Sarnoff, M.D., assistant clinical professor of dermatology at New York University in New York City. Doctors frequently treat rosacea with prescription antibiotics such as tetracycline, or Metrogel, a topical medication originally developed for parasitic infections.

STOP FLUSHING COLD

Sometimes medications don't work, says Dr. Sarnoff. So here's what you can do when the flush hits.

Apply a cold compress. Soak a cloth or paper towel in ice-cold water and apply it to the flushed areas of your face, says Dr. Harkaway. The cold will constrict the dilated blood vessels and halt the inflammatory process.

Use tinted makeup. If you're prone to frequent flare-ups, use a green-tinted under-foundation cover, available at beauty supply stores, for everyday wear, says Dr. Harkaway. The green combines with any red in your face and neutralizes it completely.

PREVENT FUTURE FLARE-UPS

Fortunately, keeping rosacea under control is frequently as simple as treating your skin gently and avoiding anything that's known to trigger a flush, doctors agree. Here's what women doctors suggest.

Find a gentle cleanser. Use a liquid facial cleanser that contains sodium lauryl sulfate or disodium lauryl sulfosuccinate, such as Skincare System's Gentle Purifying Cleanser, says Dr. Lupo. Both ingredients will clean your skin gently and without any stimulation that might cause flushing.

Soothe your skin with chamomile. Since chamomile is known to soothe rosacea-prone skin, Dr. Lupo suggests using cleansers, soaps and moisturizers containing chamomile, an herb related to the ragweed family. One caution though: If you are allergic to ragweed, you should avoid these cleansers.

Avoid abrasives. Any type of abrasion can cause a flush, says Dr. Lupo. So leave abrasive products such as scrubs, buff puffs or cleansing powders to others.

Keep wrinkle creams to a minimum. If you have rosacea and want to use an anti-aging cream that contains alpha hydroxy acids to prevent wrinkles, proceed cautiously, says Dr. Lupo. Read product labels carefully and only buy creams that keep the percentage of acid under 2.5 percent, she says. If package directions urge you to use the cream twice a day, don't push your luck. Use it once a day, tops. If there is any redness at all, discontinue using the product.

Gently apply a cucumber moisturizer. After you cleanse your skin (and also if you apply an alpha hydroxy acid preparation), smooth on moisturizers that contain cucumber extracts, says Dr. Lupo. Although no one knows why, cucumber lotions soothe rosacea-prone skin.

Select cosmetics for sensitive skin. Since the chemicals used in most cosmetics will irritate rosacea-prone skin, use only cosmetics that are labeled "for sensitive skin," says Dr. Lupo. Although not chemical-free, they usually have fewer and less-irritating chemicals than regular makeup.

Stay in the shade. "Stay out of the sun, period," says Dr. Lupo. "The sun will set off a flare-up"--and no cover-up or sunscreen will prevent it.

Use only a titanium dioxide sunscreen. Even in the shade, you're exposed to indirect sunlight, so use a sunscreen whenever you go outside, says Dr. Lupo. Avoid all the chemical sunscreens and stick to a sunscreen that lists titanium dioxide as its major ingredient. It's less irritating to rosacea-prone skin.

Stay cool. Since heat is a major cause of flare-ups, dress in layers of light clothes that you can peel off to keep your body cool, no matter where you are, says Dr. Lupo. And take tepid (not hot) baths and showers.

Avoid wool. If you have rosacea, says Dr. Lupo, you're better off avoiding wool--it tends to keep you too warm and seems to cause redness and rashes in those who have rosacea.

Choose cool food. Spicy food is known to make those with rosacea flush, so Dr. Lupo recommends that women with rosacea avoid it as much as possible. Avoid foods prepared with chili peppers, Tabasco sauce, horseradish and the like.