The physical and psychological impact

Reading Time: 6 minutes

I used to feel terribly indulgent and guilty for getting so upset about the skin on my face. I don’t consider myself to be a vain person, but vanity kept stepping forward to steal the limelight – I was not comfortable with this. On reflection, perhaps it wasn’t vanity at all, but more embarrassment and exhaustion at trying to hide something that is almost impossible to hide…my face!

I was lucky enough to have escaped the teenage years relatively unscathed in terms of skin complaints, only to be metaphorically kicked in the shins when I entered my thirties and was diagnosed with Rosacea. I want to be honest from the start – I was hoping to use images of me for this feature, to show the full extent of the rosacea, but due to social stigma and embarrassment I have decided not to. I’m genuinely hoping there will be a time where this won’t be the case – if only I were as brave as the wonderful Lex, (who is busy kicking rosacea’s butt over on Instagram).

I am now 41 and have suffered with this skin issue for the best part of 10 years. During that time I have seen various GP’s, two dermatologists, tried various (steroid based) creams, taken antibiotics, adjusted my diet and reduced my alcohol consumption amongst many other things in an attempt to combat this condition.


Rosacea is considered a common skin disease and according to research it affects 1 in 10 people in the UK and is more common in women aged between 30 and 50. Rosacea causes enflamed looking redness on the cheeks, nose, chin and forehead. Some people (including me) also get blister like bumps (pustules) on the face that can be sore and itchy, whilst others may suffer with burning/sore eyes (ocular rosacea).

Medical professionals still don’t know what causes rosacea but there are are a number of possible explanations including;

  • Abnormalities in facial blood vessels: Skin specialists (dermatologists) suggest that abnormalities in the blood vessels of the face cause the flushing, persistent redness, and visible blood vessels. What causes the inflammation of the blood vessels is still a mystery.
  • Light skin colour: A much higher percentage of people with fair skin develop rosacea compared with other people.
  • Demodex folliculorum (microscopic mite): Demodex folliculorum lives on human skin and usually causes no problems. However, patients with rosacea have much higher numbers of these mites than others do. It is unclear whether the mites cause the rosacea, or whether the rosacea causes the overpopulation of the mites.
  • H. pylori bacteria: H. pylori, a bacteria found in the gut, stimulates the production of bradykinin, a small polypeptide known to cause blood vessels to dilate. Experts suggest that this bacterium may play a role in the development of rosacea.
  • Family history (inheritance, genes): Many patients with rosacea have a close relative with the condition (Source – Christian Nordqvist – Medical News Today)

There are may factors that are considered to aggravate or act as a trigger for a ‘flare up’ of rosacea. These include:

Caffeine, alcohol, spicy food, wind, dairy products, sunlight, hot baths and extreme temperatures to name but a few. (As someone who enjoys coffee, considers curry a favourite food and loves a tipple over the weekend whilst soaking in a hot bath – this was not good news!)

I have however stopped having hot baths, reduced my alcohol and caffeine consumption and I try to eat milder curries and (sadly) it has only made a marginal difference to my skin.


The first thing that I alway read when I am researching treatments for rosacea is that ‘there is no cure’ but various treatments can be used to control symptoms…great! I have found that keeping a diary of what I eat and what I am doing over a period of a few months can be helpful to look for patterns of when a flare up can occur. This can also be useful to show your GP if you go to seek treatment…

Topical treatments

Such as metronidazole cream or gel, azelaic acid cream or gel and ivermectin cream) may be offered. They usually need to be applied twice a day for 6-8 weeks.

Oral antibiotics

Such as tetracycline, oxytetracycline, doxycycline and erythromycin) may also be offered. These are usually taken for 4-6 weeks but sometimes a low dosage may be prescribed for a longer period.

Laser and intense Pulsed Light (IPL) treatment

Redness and visible blood vessels can also sometimes be successfully improved with this treatment. (Source –

All of the above can be discussed with your GP and the trialled. Some will have a positive effect and some will not. On the whole, I have found that the antibiotics and topical treatments make very little difference to my skin, although I do know others who have said that they have seen great improvements – the key is to be willing and persistent and hopefully you will find out what works for your skin!

– Not me, but the very brave and wonderful @TalontedLex

The Psychological Impact

Not only is rosacea a long term condition but it is also generally poorly understood. What I wasn’t prepared for was the damage that such a visually obvious skin condition can have on one’s self-esteem. I was a teacher for many years and I could feel students’ eyes focusing on my skin, some even went so far as to say ‘Miss, why is your face always so red? I would explain what rosacea was to them, in an attempt to avoid embarrassment all round – then inevitably go home and have a little cry. Not the worst thing that could happen I know, but after ten years of feeling like your head is a beacon, it gets a little wearing.

Understanding now that this chronic condition is not going to magically go away, and that my focus on lotions and potions and adjusting some of my lifestyle choices over the last decade have perhaps been misguided, I am now concentrating on how to combat the psychological damage that a facial skin complaint can cause.

Here are a few thoughts:

  1. Avoid stress. Not always achievable I know, but baby steps and and all that! Not only does stress cause a flare up but it can also have a hugely negative impact on our sense of self-worth. Try regular exercise (yoga perhaps) or practice breathing techniques. Others I know swear by meditation, but I personally have struggled with this. Try different types of calming exercise and eventually you’ll find something that works for you.
  2. Get the knowledge! Inform yourself as best as possible about what rosacea is and how it effects you. That way if you see someone looking you can avoid awkward conversations by just telling them what it is. I found this reduced my embarrassment on the whole. Also the more you know, the better prepared you can be – this can help combat feelings of despair when the next flare up occurs.
  3. Talk! To a partner, doctor, friend – whoever you are comfortable with. I have found that talking about my frustration about my skin has helped profoundly. Family and friends will be kind and offer a plethora of ‘oh it’s not that bad’s’ – they mean well, so take it all in. Medical professionals can potentially offer counselling or support groups to help come to terms with this chronic condition. If you feel that you are becoming anxious or depressed as a result of your rosacea PLEASE speak to your GP…If you feel you need any support, please get out there and ask for it. It makes all the difference. Brush aside the embarrassment or the guilt or the ‘I’m wasting the doctors time’. You are WORTHY!
  4. There are also a number of online support groups for rosacea sufferers. Give it a try – knowing that I am not alone and that millions of people struggle with this condition also, has had a profoundly positive effect on my ability to cope on a daily basis!
  5. If you do have a treatment plan, stick with it – knowing that you are doing everything you can to kick rosacea’s ass will make you feel empowered and focused. Psychologically, this is gold!


An update!

Since I first starting writing this feature, over the last two weeks, I have found a product that seems to be having a positive effect! Hip Hip Hurray!!! I am almost too nervous to write it down incase it breaks the spell and the red fiery sore skin returns. A few weeks ago I read an article about a women suffering with Rosacea as a result of an allergic reaction to hair dye (I’ve been dying my hair for 20 years and had never thought of this!). She searched for a product to help her skin and was really desperate as she was getting married imminently. She came across a product called ‘Kalme’ and was thrilled with the results, claiming that the redness and soreness of her skin cleared up really quickly.

So, I immediately ordered myself some ‘Kalme Day Cream SPF30‘ – after two weeks my skin is markedly better…like better than it’s been in 10 years! I did find that my face was still rather dry though, so after doing further research, I went on to purchase the ‘Kalme Night Cream’, which gives extra overnight moisturisation.


My skin isn’t perfect, but for the first time in a decade I felt like I could potentially leave the house without having to plaster concealer all over my mug. This moment was actually quite an emotional one for me, having spent so much time feeling self-conscious about my skin. It’s still early days and I have read reviews from people that say the Kalme products didn’t work for them. But, if like me, you have tried many products and medications over a number of years and nothing has worked, trying another one is no big deal and it could so be worth it!

I’d love to hear from any fellow sufferers – how have you managed roseacea yourself? If you’ve been lucky enough to find something that really works, please let us know. You can always comment anonymously if you prefer.

And sending much love to all fellow rosacea sufferers today.

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  • I was first diagnosed with rosacea about 4 years ago, and about 1 year after I first moved from the countryside to living in London. Like you, I went from having minimal skin issues to this horrible, painful condition that sucked at my confidence. I also suffer from ocular rosacea. I also tried all the steroid creams and antibiotics and they did very little to help, so I started to do my own research and to try and narrow down what my triggers were.Spice, alcohol and anything diet related doesn’t seem to be an issue, but sun and extreme changes in temperature, as well as stress, and I think also London pollution play a part for me. I still get flare ups but in the last few months have found a skin routine that really helps me:

    1. Lush’s Ultrabland cleanser twice a day.
    2. A green tinted moisturiser in the morning before makeup with an SPF – I use Eucerin.
    3. The Ordinary’s Natural Moisturising Factors at night. It has hyaluronic acid, which I was told to avoid, but it isn’t causing any problems.
    4. No face scrubs or toners on any kind. No exfoliating on my face at all, beyond using a flannel to wash my cleanser off.
    5. I also have to avoid eye make-up removers (even the ones aimed at sensitive eyes) and eye creams and gels because I’ll regret it if I do use any – burning and stinging immediately. I use a mascara I can rub off gently with water and Ultrabland is fine on my eyes.
    6. Trying to mitigate my stress levels is a huge one, but not always totally possible.

    So, all that said, thanks so much for writing this, and don’t feel bad about not posting photos at all. It’s a brave step to write this and help this condition be better understood. Much love. Xx

    • Thanks so much Laura! Feeling really emotional reading your comment. I don’t think I had admitted to myself until relatively recently the psychological damage that this condition has had on me and others who suffer…it feels good to share!

      Really glad to hear that you have been able to spot your triggers and manage them reasonably effectively.

      I have never had ocular rosacea, which must be really difficult to deal with – I hope this is improving for you.

      Thanks for sharing your skin care routine also!

      Love Cx

  • I have mild rosacea now but it was a lot worse about 4 years ago. I’m very fair skinned and like you didn’t have massively bad skin in my teens. I went through a bad spell of rosacea completely out the blue and it really knocked my confidence, I went from having slightly flushed cheeks bones permanently, to the tiny but red and painful spots you described and it was awful. Everyday I’d wake up and I’d have more of these super painful little spots that would make my skin looks sore and dry etc. I went to the doctors and they gave me a steroid cream which along with using eucerin moisturiser that was specifically for rosacea cleared it up. It does occasionally come back so thank you for the recommendation of the products above. It is amazing what a difference to your self esteem your skin makes and when it’s bad you really notice the difference it makes waking up each morning and finding more bad skin etc. I don’t really mind my permaflushed cheeks now as long as I don’t get the spots to accompany it but I do sometimes long to not have people think I’m hot (not in the way you want them too haha) when I’m not wearing make-up. I use mac face and body foundation and have since I was about 16 as I find it really light and doesn’t irritate my skin, it’s great to quickly cover up the redness. Xxx

    • Thanks for sharing Lily and so pleased to hear that you have found a good solution to your flare-ups.

      The red spots that ooze (soz, tmi) are the worst bit for me. They make my face feel like it’s on fire!
      They haven’t been back for a few weeks, so fingers crossed the little blighters stay away long term!

      Rosacea sufferers of the world unite!!

      Feeling the love and strength today Cx

  • My Mum suffers terribly and most boyfriends have asked me what was wrong. Unfortunately she too likes all the triggers and I’ve tried to encourage her over the years to try various topical lotions and potions but she just accepts it. I now suffer from it after having a terrible reaction to an antihistamine. And what do you think I did? Kept taking the antihistamine until I realised what was causing my red face. It look liked like I had severe sunburn with raised bumps. I was so desperate I even rubbed my babies nappies on my face! Unfortunately the damage was done and I now have small thread veins on my cheeks and react to heat and alcohol immediately. Currently sitting in the car looking like I’ve been on a sun bed! I will look into this cream for my Mum though.

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