How it works:

  • Share your skin goals and snap selfies

  • Your dermatology provider prescribes your formula

  • Apply nightly for happy, healthy skin

How it works:

  • Share your skin goals and snap selfies

  • Your dermatology provider prescribes your formula

  • Apply nightly for happy, healthy skin

Everything you need to know about treating chronic rosacea

To minimize rosacea flare-ups, you’ll have to know what causes them in the first place.

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Curology Team
Sep 09, 2022 · 5 min read

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We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.
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If you’ve experienced rosacea, you probably know how stressful it can be. But thankfully, it’s also a very manageable skin condition, as long as you follow the proper treatment and do your best to avoid triggers. Here, we’ll show you how to help manage rosacea, so it doesn’t manage you! 

What is the main cause of rosacea?

Despite all the research on it, there’s still a lot of mystery surrounding rosacea. We know it’s a chronic inflammatory skin condition that may be caused by an overactive immune system, genetics, skin mites (Demodex folliculorum), intestinal bacteria (helicobacter pylori),¹ or a combination of any of these factors (or something else entirely!). Long story short, we still don’t fully understand the cause of rosacea.

Rosacea symptoms often include frequent flushing or persistent facial redness that can concentrate in the center of the face across the nose, cheeks, forehead, and chin. Some people also experience rosacea on their ears, neck, scalp, and chest. Other symptoms include dryness, papules and pustules, and dilated or visible blood vessels (telangiectasias). These typically occur in cycles, or flare-ups,² that can last days or weeks at a time, then disappear only to reappear. This is one of the things that can make rosacea so frustrating! 

It’s estimated that rosacea affects over 14 million people in the United States, but many people don't even know they have it—or they mistake it for acne. That’s because rosacea can cause acne-like lesions (papules and pustules). While it may look like acne, acne and rosacea are two very different conditions. And just because you’re experiencing redness doesn’t necessarily mean it’s rosacea.

What are potential rosacea triggers?

The first step in learning how to manage rosacea is to identify the triggers that set off symptoms for you—and then avoid them as best as possible. There’s a long list of potential culprits, but here are some of the more common ones:

  • Hot beverages and alcohol. Red wine, beer, bourbon, gin, vodka, and champagne may cause a rosacea flare-up.³ If you enjoy a drink with friends, just monitor how much and what triggers your rosacea. And pass on the hot drinks if you find that these are triggers for you. Try coffee over ice or a frappuccino. 

  • Spicy foods. Foods that pack heat—like peppers!—can bring on rosacea symptoms. Other foods like certain types of dairy, chocolate, and citrus can also cause flare-ups. 

  • Stress. Stress happens—it’s a part of life we all have to deal with. But there are plenty of ways to manage it, like deep breathing, meditation, and yoga. Finding your zen can help curb rosacea flare-ups.

  • Certain skincare ingredients. Many cleansers, creams, gels, and moisturizers are good for all skin types. But products that contain alcohol, witch hazel, or fragrance can cause irritation, which can trigger flare-ups. People who have rosacea often have sensitive skin, so it’s generally best to use gentle skincare products.

  • Heat and humidity, cold and wind, and the sun. You can’t change the weather, but you can adapt to it. Dress in layers, cover your face, try humidifiers, switch up your winter skincare routine, and use sun protection like broad-spectrum mineral sunscreen for sensitive skin with an SPF 30 or higher (like the Curology sunscreen!). 

  • Strenuous workouts. No, this isn’t an excuse to turn into a total couch potato. Regular exercise is part of maintaining a healthy lifestyle. But you might consider adapting your workout routine to something that works better with your skin. The National Rosacea Society has found that vigorous exercise can lead to flare-ups for some people.⁴

Does rosacea get worse with age?

Woman with red scars on face

Rosacea flare-ups tend to happen more frequently with age, especially if it’s not treated early. The silver lining? It's treatable! 

Remember, the best treatment for rosacea is the treatment that works best for you. Everyone’s skin is unique, and what works for one person might not work for another. That’s why it’s so important to work with a dermatology provider who’s knowledgeable about treating rosacea. 

Medications that help manage rosacea

Dermatology providers often use medications to treat rosacea. Proven ingredients include metronidazole, azelaic acid, and ivermectin, which can reduce papules, pustules, inflammation, and erythema (redness). Both azelaic acid and ivermectin are topical treatments available both over the counter and with a prescription, but not all strengths are indicated for rosacea. Topical metronidazole is only available with a prescription. Ivermectin and metronidazole are also available as prescription oral antibiotics.

Professional treatment is key

We wish we could tell you that rosacea can be cured. Sadly, we can’t—it is a chronic skin condition. That’s why professional rosacea treatment from a dermatologist is so important. To prepare for your initial visit, keep a journal of your rosacea symptoms to document important info like: 

  • What are your symptoms? 

  • Where are your symptoms—face, nose, chin, forehead? 

  • When did you first notice symptoms? 

  • What makes them worse? 

  • What are your triggers? 

  • How often do you experience symptoms?

After you begin treatment, add journal notes about the products you're using, what works for you, and what doesn’t. 

FAQs

What is the main cause of rosacea?

There’s still a lot of mystery surrounding rosacea. We know it’s a chronic inflammatory skin condition that may be caused by an overactive immune system, genetics, skin mites (Demodex folliculorum), intestinal bacteria (helicobacter pylori), or a combination of any of these factors (or something else entirely!).

What are potential rosacea triggers?

There’s a long list of potential culprits. Some of the most common ones are hot beverages and alcohol, spicy foods, stress, certain skincare ingredients, strenuous workouts, heat and humidity, cold and wind, and the sun.

What medications can help manage rosacea?

Proven ingredients include metronidazole, azelaic acid, and ivermectin, which can reduce papules, pustules, inflammation, and erythema (redness). Both azelaic acid and ivermectin are topical treatments available both over the counter and with a prescription, but not all strengths are indicated for rosacea. Topical metronidazole is only available with a prescription. Ivermectin and metronidazole are also available as prescription oral antibiotics.

Curology treats rosacea 

At Curology, we’re here to help your unique skin. Founded by dermatologists in 2014, we’re a full-service skincare brand that takes the time to understand your skin and your skincare goals. We believe in service first, which means being there when you have questions about the products you’re using or how you’re using them. 

Get your personalized skincare routine with Curology

Subject to consultation. 30-day trial. Just cover $4.95 in S&H.
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So, if you’re ready to get started, let one of our licensed dermatology providers guide your journey (because that’s what skincare is—a journey!). To become a member, simply answer a few questions and snap a few selfies. If Curology is right for you, we’ll create a personalized prescription formula using ingredients specifically proven to treat rosacea (including ivermectin, metronidazole, and azelaic acid), and you’ll also get other recommended skincare products. We can treat skin conditions other than rosacea as well, including acne and hyperpigmentation. Your first month is on us—just pay $4.95 (plus tax) to cover shipping and handling.*

P.S. We did the homework so you don’t have to:

  1.  American Academy of Dermatology. Rosacea: Who gets and causes. (n.d.).

  2. Gallo, R. L., et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. Journal of the American Academy of Dermatology. (2017, October 28).

  3. National Rosacea Society. Factors that may trigger rosacea flare-ups. (n.d.).

  4.  National Rosacea Society. Factors that may trigger rosacea flare-ups. Ibid.

* Subject to consultation. Subscription is required. Results may vary.

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Curology Team Avatar

Curology Team

Meredith Hartle, DO

Meredith Hartle, DO

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