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The Truth About Rosacea and How to Treat It

We love makeup for so (so) many reasons, but there are certain skin issues that it can't even begin to fix. For those types of more serious concerns, we call in the big guns, consulting dermatologists and docs to help you understand what's going on, why it's wreaking havoc, and what you can do about it. In the second installment of this Birchbox Rx series, we give you our expert-endorsed prescription for rosacea.

When it comes to redness, there’s the post-spin-class crimson flush, the I-think-he-likes-me blush—and then there’s rosacea. More than 14 million people in the U.S. have the skin disorder, dealing with daily bouts of redness, bumps, and sensitive skin often caused or exacerbated by triggers like exercise, heat, and stress. Dr. Joshua Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York, explains what rosacea really is and shares his advice for treating it.

What Is Rosacea, Anyway?

“It’s an over-activity, an over-reactivity, and an oversensitivity of your skin to the environment,” says Dr. Zeichner. Essentially, your skin freaks out in response to stimuli that are largely harmless. More specifically, your immune system kicks into overdrive: the blood vessels become hyperactive, causing flushing and redness, and the nerves in the skin are excessively sensitive, causing some people to experience frequent burning or stinging.

Who Gets It?

People of every skin color get rosacea, but it’s most commonly diagnosed in those with fair skin—doctors believe that’s partly because the redness is easier to see on a lighter complexion. It often runs in families, and usually starts between the ages of 30 and 50. Symptoms can crop up earlier, however, so don’t shrug them off if you’re in your 20s.

What Does It Look Like?

There are four common profiles, or subtypes, for rosacea. The first is characterized by a red face—either a constant flush, or a blush that pops up due to environmental triggers like hot weather, spicy foods, alcohol, and even strong emotions. (Technically known as erythematotelangiectatic rosacea, it’s often referred to as the “flushing and blushing” type.) With the second subtype, papulopustular rosacea, symptoms include reddish bumps and pustules. If you have phymatous rosacea, skin thickening and enlargement of oil glands can lead to a larger, somewhat bulbous nose, says Dr. Zeichner. And people who suffer from ocular rosacea, experience irritated, red eyes.

How Do You Know If You Have It?

Rosacea can easily be mistaken for acne, an allergic reaction, or some other type of skin irritation. If you’re blushing unusually easily—especially if it's triggered by heat, spice, or booze—or if you’re dealing with persistent redness with or without bumps, you may have rosacea. Make an appointment with a dermatologist sooner rather than later, advises Dr. Zeichner: The condition often gets worse as time goes on—blood vessels stay dilated to create a permanent flush, or skin around the nose gets increasingly thicker. Getting treatment early can prevent the progression.

How Do You Treat It?

There’s no cure for rosacea, but there are three general types of derm-prescribed treatment options: topical medications, oral medications, and laser treatments. The topical medications are either antibiotics with anti-inflammatory properties or drugs that work by constricting blood vessels so the skin doesn’t look as red. A low-dose oral antiobotic can also be used to treat the inflammation. In some cases, a special pulsed-dye type of laser is used to help eliminate dilated blood vessels under the skin—and the redness that goes with them.

What Type of Skincare is Best?

It's important to supplement these prescriptions by taking good care of your skin. First, choose a daily moisturizer that soothes skin and keeps it hydrated. “Look for ingredients like ceramides and niacinamide, a form of vitamin B3 which has been shown to help reduce inflammation of the skin,” says Dr. Zeichner. We like Dr. Jart+ Ceramidin Liquid and Liz Earle Skin Repair Moisturiser™ Dry/Sensitive Skin. If your moisturizer doesn’t include SPF, add a sunscreen to your routine because UV light can make rosacea symptoms worse. Try Supergoop!® Skin Soothing Mineral Sunscreen with Olive Polyphenols SPF 40.

It doesn’t hurt to incorporate inflammation-reducing products like Caudalie Gentle Cleansing Milk and suki® concentrated clarifying toner into your regimen. For whatever flush remains, use a makeup primer with green pigments, like Smashbox Cosmetics Photo Finish Color Correcting Primer—Adjust to cancel out the red tones. Finally, avoid common triggers like sun exposure, hot showers, spicy food, alcohol, and stress! If your rosacea is acting up, take a lukewarm shower, swap that happy hour glass of wine for a relaxing mug of tea, and pass on the Sriracha.

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