Acne Rosacea...HELP!

[DLgal]

Okay, I am at the end of my rope with my face. I have acne rosacea and perioral dermatitis (diagnosed by a dermatologist). I have been suffering for YEARS with this. It is mostly around my nose and chin...pus or clear fluid filled, painful, itchy bumps that burst, crust over, and then leave red marks that last for months, sometimes years. My face is so red and blotchy. I just turned 40 and it seems to be getting worse (yay perimenopause).

So far, everything I have tried has not helped. This is what I have done so far:

-Oral antibiotics (I had an allergic reaction to them, so that route is out)
- Rx Metrogel/Metrocream (did not help at all...made it worse, in fact)
-OTC Prosacea (a sulfur based gel). Did not help.
-CeraVe cream cleanser and moisturizer cream to "rebuild the moisture barrier in my skin." Has just made my rosacea worse.
-Eucerin Redness Relief line of cleansers and moisturizers (no change)
-Simple brand cleansers and moisturizers
-Dove sensitive beauty bar
-No moisturizers at all
-Salicylic acid products
-Apple cider vinegar
-Tea tree oil
-Coconut oil

Do I need to go back to a dermatologist? I just didn't get anywhere with the last one, even though I got a diagnosis and a treatment plan, it didn't end up helping any, so I don't want to go back to that one at least.

I have seen some VERY pricey products that are supposed to help, but I am wary to waste more money on this.

Does anyone have any suggestions or did anything else not mentioned actually help you? Right now, my biggest issue is the painful bumps that burst and look and feel terrible. Also, the red splotchy skin.

I am not above cosmetic "treatments" like peels or lasers, if they will actually work. Just not sure if those would be options.

 

[old lady]

I had rosacea myself and that Metrogel worked for me. I would back to the doctor and tell him what is going on or get another one.

 

[Disneypeach]

I have rosacea too ...meds from dermatologist didn't work well but my internist also has rosacea and suggested using Aveeno Calming lotion and cleanser which HAS helped. YMMV tho

 

[DLgal]

I have rosacea too ...meds from dermatologist didn't work well but my internist also has rosacea and suggested using Aveeno Calming lotion and cleanser which HAS helped. YMMV tho

Yeah, tried that too. It feels good using it, but it doesn't actually make a visible difference.

I feel like it is so hormonally driven for me...I have times during the month where the bumps completely go away and my face looks clear for like a few days, then it just gets progressively worse as my cycle advances.

 

[DLgal]

I had rosacea myself and that Metrogel worked for me. I would back to the doctor and tell him what is going on or get another one.

I was given the Metro Cream first. Had a followup 3 months later and the doctor switched it to the Metrogel, because he said the cream wasn't strong enough. The gel didn't help either, but I just didn't really like that doctor's bedside manner overall. He didn't seem concerned about the self esteem issues this causes. He was all business, and kind of brusque. He basically said "well, the oral antibiotics are the best course of treatment, but if you had an allergic reaction to them, that's not going to help you." He didn't have any other ideas.

The gel basically dried out my face so bad that it turned white (like, white patches of dry, cracked skin).

I should probably start looking for another dermatologist.

 

[Christine]

Yeah, tried that too. It feels good using it, but it doesn't actually make a visible difference.

I feel like it is so hormonally driven for me...I have times during the month where the bumps completely go away and my face looks clear for like a few days, then it just gets progressively worse as my cycle advances.

Have you tried oral contraceptives? Or if you are on them, have you tried stopping them? Either way, something needs to change your hormonal picture.

 

[DLgal]

Have you tried oral contraceptives? Or if you are on them, have you tried stopping them? Either way, something needs to change your hormonal picture.

I can't take hormones at all. Last time I took oral contraceptives (to try to manage hormonal migraines), I developed a blood clot. I don't need them because my husband had a vasectomy, and my doctor has said there is more risk than reward at this point with taking hormones. She flagged my file with a huge red sticker that says "NO HORMONES."

So, even if my hormones are out of whack (which they seem to be, again...I am going through perimenopause and my doctor thinks I will go through an early menopause as well...I have other medical indicators that this is my current situation), I can't take any hormone therapy due to the blood clot risk.

 

[Wishing on a star]

Ohhhhh, I feel for you and hate that you are going thru this!!!

I would see another dermatologist, and perhaps someone about the perimenopause/hormones.
Does developing a blood clot have to mean that one is not on any hormone therapy at all??? Hhhhhmmmm???
There are different options out there. And, some Dr.s are just anti-HRT.
I don't know anything about your skin situation, but I have been on HRT for a long, long, time, necessary for other reasons.

The migraines are interesting as well.
Along with the reaction to the antibiotics. (I am allergic to several antibiotics)

It seems that something is going on... Maybe even other factors, such as sensitivities, etc...
I just wonder if there might be some 'kicker' here that a really good specialist can figure out????

I know what it is like to have complex issues, and it can really suck.
I hope you get some improvement.

 

[FairestOfThemAll37]

Obviously your medical team knows best. Just to clarify, is it that you can’t take any hormones or any estrogen hormones? If it’s the latter (which is common for those at risk of stroke or clots), there are progesterone only options that can regulate hormones without the added estrogen.

I’d go back to the dermatologist and see what they offer after you go through what you’ve tried. Diagnostic medicine is not an exact science and acne and most skin concerns can have all sorts of different treatments and triggers and lots of skin conditions can look like another.

There is a bit of a hive mind over there and they love certain products, but there’s a sub over on reddit called skincareaddiction. There’s some pretty good resources on products and routines.

Cerave is well loved over there (and talk of a damaged moisture barrier is very r/SCA-esque) because it’s cheap and has minimal ingredients. You’ll definitely want to do a minimal cleanse and moisturize and then slowly add in any additional products. Lactic and Glycolic acids are good place to start for AHAs. Sometimes any acids will cause problems with rosacea and sometimes it can ease the inflammation. Tretinoin (Retin-A) is clinically proven for acne and anti-aging, but is sometimes not recommend for rosacea patients. Tret requires an Rx (assuming you’re in the US) so you’d want to ask your dermatologist about that. Epiduo is now available over the counter, but would ask deem due to rosacea.

A lot of acne and anti-aging treatments can cause really dry flaky skin so hydration can help to offset that. hyaluronic acid is good for dehydration, but you’ll want to layer it under a moisturizer.

A lot of people have issues with the surfectants in foaming cleansers so you could always try oil cleansing. It was a game changer for me.

I hope some of this was helpful. I realize it’s all more trial and error and more money on products. Skin is a very fickle thing.

 

[4kids4karen]

I have the same issue with the same type bumps on the end/tip of my nose and chin. What I found that works is using the right moisturizer.

I use:

Rejuvenique Oil Intensive By MONAT (This is a vegan product)

Belief Aqua Bomb Sleeping Mask (Belief products are amazing)

Also, recently switched all my make-up to Thrive Causemetics (Vegan Products) and have fewer breakouts.


I have other products but these are my favorites. I have also been using the Hana Cure Mask that I love.

I use to get professional facials every month that didn't help the issue. Metro Gel I thinks helps some but I rarely use it now that I have the condition mostly under control.

I have never heard of this being a hormone issue like someone said. I had a hysterectomy but the rosacea was there before and after. I only have one ovary left and I am not on hormones. Would not want to go on hormones either. My step dad has the same rosacea and I am sure it is not a hormone issue with him either.

 

[smokeyblue]

A course of prednisone. That was the only thing that got me back to a baseline that was workable.

 

[StitchesGr8Fan]

I couldhave written this. I’m in the exact same boat. I’ve found that my diet plays a huge role. I just discovered aspartame causes me to flare up.

 

[disykat]

When I went gluten free/dairy free for 6/7 weeks as part of an elimination diet for stomach issues my rosacea got significantly better. It was about five weeks in I really noticed a significant difference. I added dairy back in at 6 weeks, followed by gluten at 7 weeks. When I added the gluten back the rosacea returned - but it had only been a week since I added dairy back so I'm not totally sure if it was gluten or dairy or both that was the issue. I'll definitely try eliminating or reducing both again if I have a flare.

 

[Christine]

I have never heard of this being a hormone issue like someone said. I had a hysterectomy but the rosacea was there before and after. I only have one ovary left and I am not on hormones. Would not want to go on hormones either. My step dad has the same rosacea and I am sure it is not a hormone issue with him either.

I brought up the use of hormones because the OP herself thought that her hormone levels were causing it to some degree in the way that it comes and goes.

 

[DLgal]

Update:

I may have found a solution! I read up on AHAs and Retinol and have been using both, alternating each night. I tried a skin care brand called Olehendricksen and OMG...game changer! I bought a trial set called three little miracles and my skin looks amazing! I also got Neutrogena Ageless Intensives Night Serum (a retinol recommended for rosacea). I had one day of scaling/peeling but I just exfoliated it off (was the spot on my chin where my acne was the worst). It has been 2 weeks now and I am sold on Olehendricksen! Just placed an order for the full sized Night Transformation Gel and some more moisturizer. My skin is smooth, the redness has mostly disappeared, and my acne dark spots have faded significantly. I look 20 years younger.

To answer some questions, I got the blood clots after taking Yaz, which is mostly progesterone. I had taken POPs for a couple years long ago and constantly had headaches and felt nauseous on them. It seems my body is very sensitive to hormones (which seems to be a common issue for women with migraine and IBS, which are both thought to have a strong hormone connection). My doctor said "no synthetic estrogen or progesterone" in the future.

I do have an appointment with an allergy doctor soon because I have been dealing with constant hives and I want to get to the bottom of it, in case I am allergic to something unknowingly.

Also, I have gone gluten and dairy free (did the low FODMAP thing) in an effort to alleviate IBS issues, just last year. Neither helped with my skin OR my IBS. I was less bloated, but that's all. My IBS actually got worse. I did it for 12 weeks.