rosacea anyone?

[TheSweep]

I have rosacea and was wondering if anyone here as has it. What impact has shaving had on your skin?

I shave every day because if I skip a day the shave is rougher on my skin. I don't put meds on my face because they never seem to help. I have gotten to the point where my face doesn't hurt like it used to but is still reddish most of the time.

 

[AFG]

I have it. I use a gel type med that is only marginally effective. For the most part its use sun screen and stay out of the wind. During the winter months mine mostly subsides but is a more of a problem during the summer. It never completely goes away. There was one glycerin soap that seemed to make it worse but other than that I have not had any shave related problems and I shave daily.

 

[col conk]

I have it also.
Shaving with better products has helped -less irritations.
I dont apply alcohol based AS's to my face. Witch hazel and moisturising creams only.
Ive used Flagyl based cream(metrogel) works on the acne but does nothing for redness.
Ive found that a good moisturizing regiment and hydrocortizone cream for bad flare ups is the only think that works for me.

 

[RazorPete]

I have rosacea and was wondering if anyone here as has it. What impact has shaving had on your skin?

I shave every day because if I skip a day the shave is rougher on my skin. I don't put meds on my face because they never seem to help. I have gotten to the point where my face doesn't hurt like it used to but is still reddish most of the time.

Rosacea is really common and I treat it very frequently in my dermatology clinic. Here is a bit of info on rosacea, lumped into another general post in this forum on acne.
http://badgerandblade.com/vb/showpost.php?p=1811960&postcount=32

but if you have any further questions specifically about rosacea, please let me know, I am glad to try to help out - its something I know quite well.
Pete

 

[TheSweep]

Rosacea is really common and I treat it very frequently in my dermatology clinic. Here is a bit of info on rosacea, lumped into another general post in this forum on acne.
http://badgerandblade.com/vb/showpost.php?p=1811960&postcount=32

but if you have any further questions specifically about rosacea, please let me know, I am glad to try to help out - its something I know quite well.
Pete

Thanks for all the suggestions everyone. I am the only person I know in real life with rosacea.

Metro gel never seemed to do a thing for me. And I can't avoid all the triggers (how is a person never to get really hot/cold or drink booze?) I use a LOT of Aveno lotion, after every shower and after every shave. It is a life saver.

I have flare ups now and then, work is rough during the summer because I work outdoors on roof tops.

I have never noticed aftershaves bothering my skin, but where I shave never seems as red to begin with. Should I never use alcohol based stuff?

 

[Strikermike]

I have it also. It really is only on my nose. As I understand it if you have dry skin you should use metrocream rather than the gel. I also use a soap called rosaderm. If I would remember to use these products on a daily basis you wouldn't know I had it. They work well for me when I keep up the regimen.

 

[RazorPete]

Thanks for all the suggestions everyone. I am the only person I know in real life with rosacea.

Metro gel never seemed to do a thing for me. And I can't avoid all the triggers (how is a person never to get really hot/cold or drink booze?) I use a LOT of Aveno lotion, after every shower and after every shave. It is a life saver.

I have flare ups now and then, work is rough during the summer because I work outdoors on roof tops.

I have never noticed aftershaves bothering my skin, but where I shave never seems as red to begin with. Should I never use alcohol based stuff?

when you get flare ups, what do you notice, red bumps that last for a while, or generalized flat read areas. And where do you mainly get it, nose, cheeks, around the mouth? All of these can be clues as to whether your shave materials might be worsening your rosacea. Ie, if you only get it on your nose, and you do not shave your nose, its likely that your rosacea is not worsened by your shave regimen. Do you get eye irritation too? IF so, it could be related to your rosacea and you might want to see an ophthalmologist too. Drinking alcohol does not have to be absolute, but cutting down can even be helpful. Also, moderation in eating really spicy hot foods can also help. Certain meds that dilate blood vessels, like those meds that advertise on TV ad nauseum, where people are sitting in bathtubs and they talk about having an erection lasting over four hours. I have seen those meds exacerbate rosacea in many patients. Certain other blood pressure meds or heart meds can do the same thing. Its a good idea to mention this to your general doctor, the one who prescribes meds to you.

As far as other things to help rosacea, what you want to avoid is anything that causes prolonged redness on your skin. What happens with repeated redness is that you get premanent dilation of the blood vessels on your face, which are disfiguring. Also, if your rosacea repeatedly flares on your face, you can get rhinophyma, aka a WC Fields nose, which can be disfiguring too. To avoid these complications later in life, its worthwhile being proactive now.

My usual advice is to use a strong sunscreen before you leave the house for the day, spf 30 or above with UVA as well as UVB protection. Wearing a hat with a wide brim can also be helpful. Even short bursts of sun can sometimes exacerbate rosacea and produce redness that lasts for hours. This is especially important because of your work. You can consider roof work an occupational hazard for your rosacea.

As far as shaving, anything that would cause redness or irritiation in a non-rosacea person could do the same for you, and worsen your rosacea. Instead of an alcohol splash, it might be worthwhile using something rather bland and soothing after shaving just as a trial for a few weeks to see if that makes a difference. Thayers with aloe vera or a light treatment with an alum block would be a nice alternative to stronger alcohol containing preparations as an after shave. After this, your sunscreen can also double as an aftershave balm.

Its too bad metrogel does not work for you. One thing you can try is to use some retinol containing preparations that you can get over the counter, there are a lot of them. I know it sounds paradoxical, but regular applications of retinol, or its prescription cousin tretinoin, can at first cause irritation and redness but if used consistently, they often can stabilize rosacea and ultimately reduce the redness. These retinols or other meds should only be used at night time, as they are photosensitizing.

Finally if you are doing all of these things and still the rosacea is acting up, there is oral tetracycline, or its chemical relatives doxycycline or minocycline. These meds generally are very effective, although they are only available by prescription. In particular doxycycline is particularly convenient and can be used on a once a day basis. Often even low doses of tetracyclines, much lower than that needed for acne vulgaris, are sufficient to control acne rosacea.

Anyway, I hope this is helpful for you and other folks here who might have this very common problem.

Good luck

Pete

 

[TheSweep]

when you get flare ups, what do you notice, red bumps that last for a while, or generalized flat read areas. And where do you mainly get it, nose, cheeks, around the mouth? All of these can be clues as to whether your shave materials might be worsening your rosacea. Ie, if you only get it on your nose, and you do not shave your nose, its likely that your rosacea is not worsened by your shave regimen. Do you get eye irritation too? IF so, it could be related to your rosacea and you might want to see an ophthalmologist too. Drinking alcohol does not have to be absolute, but cutting down can even be helpful. Also, moderation in eating really spicy hot foods can also help. Certain meds that dilate blood vessels, like those meds that advertise on TV ad nauseum, where people are sitting in bathtubs and they talk about having an erection lasting over four hours. I have seen those meds exacerbate rosacea in many patients. Certain other blood pressure meds or heart meds can do the same thing. Its a good idea to mention this to your general doctor, the one who prescribes meds to you.

As far as other things to help rosacea, what you want to avoid is anything that causes prolonged redness on your skin. What happens with repeated redness is that you get premanent dilation of the blood vessels on your face, which are disfiguring. Also, if your rosacea repeatedly flares on your face, you can get rhinophyma, aka a WC Fields nose, which can be disfiguring too. To avoid these complications later in life, its worthwhile being proactive now.

My usual advice is to use a strong sunscreen before you leave the house for the day, spf 30 or above with UVA as well as UVB protection. Wearing a hat with a wide brim can also be helpful. Even short bursts of sun can sometimes exacerbate rosacea and produce redness that lasts for hours. This is especially important because of your work. You can consider roof work an occupational hazard for your rosacea.

As far as shaving, anything that would cause redness or irritiation in a non-rosacea person could do the same for you, and worsen your rosacea. Instead of an alcohol splash, it might be worthwhile using something rather bland and soothing after shaving just as a trial for a few weeks to see if that makes a difference. Thayers with aloe vera or a light treatment with an alum block would be a nice alternative to stronger alcohol containing preparations as an after shave. After this, your sunscreen can also double as an aftershave balm.

Its too bad metrogel does not work for you. One thing you can try is to use some retinol containing preparations that you can get over the counter, there are a lot of them. I know it sounds paradoxical, but regular applications of retinol, or its prescription cousin tretinoin, can at first cause irritation and redness but if used consistently, they often can stabilize rosacea and ultimately reduce the redness. These retinols or other meds should only be used at night time, as they are photosensitizing.

Finally if you are doing all of these things and still the rosacea is acting up, there is oral tetracycline, or its chemical relatives doxycycline or minocycline. These meds generally are very effective, although they are only available by prescription. In particular doxycycline is particularly convenient and can be used on a once a day basis. Often even low doses of tetracyclines, much lower than that needed for acne vulgaris, are sufficient to control acne rosacea.

Anyway, I hope this is helpful for you and other folks here who might have this very common problem.

Good luck

Pete

I am so glade I brought this up, you have been so much more helpful then the last time (4or5 years ago) I went to the doc. He was like "stop drinking and here is some gel. bye"

I don't have acne with it, just patches of redness. They are high up on my cheeks, round my nose, a little bit on my neck and the middle of my forehead. It is almost a line where I stop shaving is where I am red. Other then the round spots of it on my neck that never have hurt, just are a bit red sometimes. So that is good news, I just shaving isn't making it worse, woo hoo!

I don't take any meds so that can't be a factor.

I always have a hat on when I am outside, my uniform for work includes a hat too. I need to be better about sunscreen, I tend to only use it when it is really sunny and I know I will be in the sun a lot.

You have scared me into being more proactive though, I never knew it could scar me for life. I have had this since I was a teenager. What kind of products have retinol? I have heard that word before but I am not sure where to get it. Do the pills have bad side effects? Are they costly?

Thank you so much!

 

[RazorPete]

I am so glade I brought this up, you have been so much more helpful then the last time (4or5 years ago) I went to the doc. He was like "stop drinking and here is some gel. bye"

I don't have acne with it, just patches of redness. They are high up on my cheeks, round my nose, a little bit on my neck and the middle of my forehead. It is almost a line where I stop shaving is where I am red. Other then the round spots of it on my neck that never have hurt, just are a bit red sometimes. So that is good news, I just shaving isn't making it worse, woo hoo!

I don't take any meds so that can't be a factor.

I always have a hat on when I am outside, my uniform for work includes a hat too. I need to be better about sunscreen, I tend to only use it when it is really sunny and I know I will be in the sun a lot.

You have scared me into being more proactive though, I never knew it could scar me for life. I have had this since I was a teenager. What kind of products have retinol? I have heard that word before but I am not sure where to get it. Do the pills have bad side effects? Are they costly?

Thank you so much!

The fact that you have had this as a teenager and that you never get red papules but only patches of redness makes me wonder if you really do have rosacea, especially if your dermatologist only saw you fleetingly and did not spend time getting the history that you are relating to me here. Anyway, just consider me a skeptical person, especially when I have not examined someone's skin myself. I would say there is an outside chance that you may just have dry sensitive skin, sub-clinical eczema if you will, that just gets red easily.

If you have hay fever or asthma, or anyone in your family has allergies or eczema, or if you notice that the problem is worse in the winter when its colder out, and it gets worse when you skin gets dry, that would make it more likely that you dont have rosacea but rather mild eczema. Anyway, sunscreen would definitely help either problem, but if you have eczema, then adding a mild and bland moisturizer would help. You can just use a moisturizing sunscreen and solve both problems.

As far as the retinol, while there is a chance it could help rosacea, it probably would make eczema worse, so please do be careful with it. One brand of retinol containing cream is called neutrogena healthy skin anti-wrinkle cream. Its pretty inexpensive compared to the other more upscale products and works just fine.

I think its important also to point out that both eczema and rosacea are chronic conditions, which dont have a cure. So the best expectation is that these conditions can become improved with therapy, but they will likely come back if you stop treating them.

Anyway, sorry not to be more definitive here but really the diagnosis needs to be nailed down before the most optimal therapy can be laid out. So I hope you understand the limitations we are faced with here. So you can try treating with sunscreen and moisturizing for eczema, and if that does not work you can try sunscreen and retinol approach for rosacea. I think the bottom line is that if neither works, you should take a visit to your doctor, hopefully a dermatologist who is willing to spend a bit of time with you especially on the medical history, to verify the diagnosis and prescribe prescription products like tetracyclines if they can verify you have rosaea.

Cheers,

Pete

 

[njpaddy]

Have it too. Forehead, cheeks and under eyes. It's actually been better since I started with a DE as I pay more attention to my face. It gets an aftershave splash of WH (w/alcohol) and Nivea Sensitive ASB. Face is red when I get done (mostly from the hot/warm water and WH), but most of it fades quickly. I don't seem to get the crusty patches that I used to. For after showers when I don't shave I like the Neutrogena Triple Protect Face Lotion. The rosacea isn't going away, but it's not getting worse and my face feels soft.

 

[RazorPete]

Have it too. Forehead, cheeks and under eyes. It's actually been better since I started with a DE as I pay more attention to my face. It gets an aftershave splash of WH (w/alcohol) and Nivea Sensitive ASB. Face is red when I get done (mostly from the hot/warm water and WH), but most of it fades quickly. I don't seem to get the crusty patches that I used to. For after showers when I don't shave I like the Neutrogena Triple Protect Face Lotion. The rosacea isn't going away, but it's not getting worse and my face feels soft.

There should be no crusting with rosacea. This kind of crusting and the location where you are describing your involvement sounds much more like seborrheic dermatitis. That is treated pretty well by using over the counter selsun blue or nizoral shampoo as a facial wash on a regular basis. Try it and see if it helps. You can get a sample size of one of these shampoos in the travel section of the drug store for very cheap.

 

[Geordon]

Anyway, I hope this is helpful for you and other folks here who might have this very common problem.

Good luck

Pete

I don't have a dog in this fight, so to speak, but I wanted to make sure to say THANK YOU! Pete, I really appreciate the fact that you are so willing to give freely of your experience and knowledge specific to skin and it's many issues.

Three cheers for RazorPete!

 

[Mr. Beaver]

I have rosacea, and use a lotion of sulfur and sodium sulfacetimide. Not sure if it's the same as metrogel, but it works for me.

 

[Jim B.]

If you have hay fever or asthma, or anyone in your family has allergies or eczema, or if you notice that the problem is worse in the winter when its colder out, and it gets worse when you skin gets dry, that would make it more likely that you dont have rosacea but rather mild eczema. Anyway, sunscreen would definitely help either problem, but if you have eczema, then adding a mild and bland moisturizer would help. You can just use a moisturizing sunscreen and solve both problems.

Pete

That's me all over. Thanks Pete for reminding me about using a moisturizing sunscreen.

Thank god for cortisone cream when it gets really bad. I really suffered and still have scars from severe eczema when I was a kid 50 years ago before there was cortisone cream.

 

[BCatl]

I also appreciate Pete giving of his time and expertise on the subject.

I am also pretty sure that I have it, though I have not been to a dermatologist for confirmation. I first started noticing red splotches on my forehead about 10 years ago. Upon closer observation I noticed these were tiny bunched blood vessels. I also have them on my cheeks too.

I can't ever remember getting acne, but I do get flare-ups of redness occassionally, usually after I have applied some kind of chemical to my face. Most of the time, my face is not too red in these areas.

I am blonde/blue, typical light complextion. I wear a 30 to 50 SPF, and a hat whenever I can during summer, not as careful during winter.

If I have problems with a flare-up, I will usually put calamine lotion on. I know this stuff is supposed to be drying, but it has a very calming and stabilizing effect on my skin, and seems to tame my problem down quickly.

No problems with my nose yet, but I had one uncle who had a terrible problem with his nose, which I would certainly like to prevent ever happening to me. What I am doing seems to work very well for me for now, if indeed it's roseacea.

 

[RazorPete]

I have rosacea, and use a lotion of sulfur and sodium sulfacetimide. Not sure if it's the same as metrogel, but it works for me.

thats another helpful therapy for rosacea.

BTW, thanks for the good wishes, I appreciate knowing I am helping out. Eventually when I get closer to retiring, I plan to write a book on practical skin care for non-medical folks, the straight stuff without all the "trying to sell you something" hype that typically accompanies skin care books. Some of these blurbs I write are just practice sections for such a book. I would like to include a chapter on wet shaving in the book but plan to just be a contributing member here for a few years first and soak in all I can. This forum is definitely an educational experience! Thanks to all of you!

 

[BCatl]

Please don't retire, we need all hands on deck! (Just kidding, a little).

I have had at least 5 health plans over 10 years. My internal medicine doctor du jour is so rushed, I never have thought to mention my skin though I should (I have some other health problems that keep him busy).

In my state, we don't have to have a referral to a dermatologist by law (at least that is my understanding). However, getting into a dermatolgist's office is another thing. Between my schedule, and the derma. office schedule, I always find an excuse to put it off.

I started protecting my skin from sun after seeing my mother go through skin cancer on her face that involved plastic surgery after removal of the cancer.

 

[RazorPete]

In case anyone is interested, this is the definitive book on acne and rosacea, written by Gerd Plewig and Al Kligman. Dr. Kligman, who made huge contributions to the field of acne research, died unfortunately about a month ago. He will be fondly remembered.

 

[col conk]

In case anyone is interested, this is the definitive book on acne and rosacea, written by Gerd Plewig and Al Kligman. Dr. Kligman, who made huge contributions to the field of acne research, died unfortunately about a month ago. He will be fondly remembered.

Pete
Thanks for all the information!

Does that book come in an abridged verson.

 

[BentonClay]

My Dad, 75, has it. He forgot to bring his shaving kit this visit. My wife found him a disposable Bic and he started shaving - no water, just scraping his face in front of the hallway mirror. Ouch! Time to educate him about wet shaving...