Rosacea Flare Ups - What to do to regain control

By Travis Hayden, MPAS, RPA-C 

with updates by Lesley Loss, MD

Rosacea is a chronic and relapsing condition. Despite the best available medical treatments, avoiding aggravating environmental and lifestyle factors, and a patient’s compliance to their daily skin care regimen, an occasional flare-up will occur. When it does, many patients are left feeling frustrated and once again facing the embarrassment of rosacea's conspicuous and bothersome symptoms.

Having a plan of action for coping with a rosacea flare-up is helpful and often necessary.  I often recommend to my patients this 4 step approach to handling their rosacea flare-ups:

Step 1 - The first step is to note any recent changes in treatment and lifestyle routines that may have contributed to the flare-up of symptoms. Take control of the situation immediately. Identify and correct any actions that may have led to the flare-up, including not taking medication or exposure to aggravating factors such as sun, wind, alcohol, heated beverages or spicy foods. Dealing directly with frustration and anxiety is also important. Emotional stress can trigger further aggravation. Eat right, get enough rest and practice relaxation and being more compassionate to yourself.

Step 2 - The second step is to continue with your recommended soothing daily facial care routine. It is important for patients to not detour from their recommended skin care plan to try “new” things that they think may help but in actuality may just further worsen the flare-up. Be sure that you are using a gentle soap or water-based cleanser that is not grainy or abrasive and should be spread with your fingertips rather than using a rough washcloth or pulling at the skin. Rinse with lukewarm water and use a thick cotton towel to blot the face dry. It is ok to take advantage of less irritating mineral makeup to hide the symptoms of a rosacea flare-up. 

Step 3 – Application of topical medication(s) may follow when the face is dry. After the medication(s) is absorbed, follow it with camouflaging mineral makeup as needed. There are several green-tinted foundations and even moisturizers available to help counter the red appearance, and they can be used under other skin-tone foundations. Moreover, flesh-tone or green-tinted concealer sticks may be used by both men and women to hide symptoms in specific areas. 

Step 4 – Systemic medications may be necessary to put out a flare-up if the above three steps are not controlling things. Patients should contact their provider’s office at this point so that they may have a discussion as to which medication(s) would be the right choice for them to take during a persisting flare-up. 

The physical and emotional turmoil suffered by many of the estimated 14 million Americans with rosacea has been well documented. National Rosacea Society (www.rosacea.org ) encourages those who suffer from this conspicuous and often life-disruptive facial disorder to seek medical help before it reaches advanced stages. Fortunately, medical therapy is now available that can effectively control the symptoms of this chronic and often progressive disorder. Allowing patients to remain in control of their rosacea and its flare-ups can dramatically improve the quality of people's lives by restoring their personal appearance.

While prescription systemic and topical agents are often a mainstay in therapy, two non medication based treatments we commonly recommend include Candela Vbeam Perfecta pulsed dye laser and Neocutis Pêche.