No, I don’t have a sunburn. Opening up about rosacea

Thanks to the Act on Red campaign for sponsoring this post and helping me finally find the courage to talk about my rosacea.

Before and after treatment. Smile much? Sheesh.
(Update: Note that the second picture benefits from some light makeup and good lighting. These are pictures I happened to find but were not taken as before/after pics as such. I’ll always probably have some background rosiness.)

I’ve pretty much always had bad skin. Ever since I was a kid, I mean. I graduated from teenaged acne, to adult acne, to a persistent rosiness that started to set in more often, lasting longer and longer. That rosiness had a name, of course, I’d just never heard of it. It’s probably fair to say that I’ve had rosacea since my early twenties.

But I was a few weeks into my first pregnancy when it really started to get out of control. Huge red, fluid-filled bumps erupted on my chin. They were sore to the touch and like the biggest, baddest pimples you ever had. Except they weren’t really like pimples exactly. They didn’t ever come to a head that could be squeezed and if you tried, they wouldn’t pop like a pimple at all. Rather, they’d just ooze fluid and scab over, just as plump as ever.

These new pregnancy zits were the worst, I thought. Thank goodness I worked nights in a dimly-lit bar.

Then, just as suddenly as they started, they were gone. During my second and third trimester of that pregnancy, my skin was as good as it ever has been. All fresh and glowy. I could be pregnant forever.

I wasn’t pregnant forever, though, and the bright-red cherry on top of my postpartum hormones, engorged breasts, hair loss, weight gain and sleep deprivation was the return of those special “pregnancy zits.”

Somehow, as my hormones gradually settled down after that first year of breastfeeding, my skin cleared up. Kinda sorta. I was still prone to breakouts, they just weren’t as bad. But the clear skin that remained was redder than ever before.

My second pregnancy followed a similar pattern, but this time I made sure to see a dermatologist a few months postpartum. By this time,  I wasn’t surprised to get a diagnosis of rosacea. And those pregnancy zits were actually something called pustules that can happen with certain kinds of inflammatory rosacea. Lucky me.

I started using a topical cream prescribed by my doctor and it worked like a charm. Woohoo! Clear skin at last. Why had I waited so long?

And then I stopped using it. Why? Because clearly it worked. Because my skin was fine. You don’t keep putting zit cream on when you have no zits, right? I didn’t know this was different.

What followed was the worst rosacea breakout of my life. It was extremely painful and humiliating and treating it meant I had to prematurely wean my sixteen-month-old daughter. I wrote about having to stop breastfeeding, but I’ve never wrote or talked about why. People could clearly see a giant, angry red swelling that started on one side of my nose and spread right over the top to the very tip. I just pretended it wasn’t there. There was nothing to say.

The medication I was taking (oral antibiotics as well as a topical treatment) worked to keep pustules away and inflammation down, but my skin remained a bright, angry red where they had been. What’s more, I still wanted to have one more baby. This meant I had to go off of the strong medication I was on and switch to a much more mild topical cream. But was I going to let rosacea dictate whether or not I could have another baby? Hell no.

Same story again. I swear, if I could bottle those second trimester pregnancy hormones and take them every day, my skin would be perfect.

Except this time the breakouts were even worse after giving birth and the angry, tender redness that followed lasted longer and longer, never seeming to quite fade away altogether. I used a topical cream and waited them out. I talked to my family doctor and said I wouldn’t go on the antibiotics until I was done breastfeeding; not if I didn’t have to. (Note these are super-strong antibiotics that you can’t take while breastfeeding but most other kinds of antibiotics are fine to take while you’re nursing. Motherisk is a great resource for finding what is safe to take while pregnant and breastfeeding.)

I slathered on topical cream with the first sign of a breakout and watched closely to make sure that while many of these were inevitably large and unsightly, they didn’t threaten to take over half my face again.

I somehow got through it and as soon as I weaned that baby booked myself an appointment with a dermatologist. Now, finally, I’m receiving proper treatment for my rosacea, the breakouts have all but stopped and my skin is getting a chance to heal.

I’ve also wised up and have learned to minimize flushing by wearing sunscreen on my face every single day, no matter what. (I use a very good tinted sunscreen that serves double duty as a light foundation.) I also wear hats if I’m going to be in the sun, avoid heat in general and never ever use a skin care product that isn’t approved by someone in my dermatologist’s office. Too many well-meaning people who have NO IDEA what rosacea is or how to treat it will suggest all kinds of products that just make your skin worse.

Other triggers that I refuse to accommodate are exercise (because I still need to be healthy!), coffee, wine and deliciously spicy food. Really, everything is a flushing trigger and I still need to enjoy life. (It’s a myth that alcohol abuse causes rosacea, by the way. But if you do have it, then some kinds of hot or alcoholic drinks may trigger flushing.)

I really do wish that I’d been seeing a dermatologist about my skin well before I ever had babies. I don’t know what took me so long. Of course, rosacea isn’t a pregnancy-related condition (even if pregnancy can aggravate it), it can affect both men and women and it’s chronic which means you’ll never, ever outgrow it. Keeping my rosacea under control makes a world of difference for my overall well-being.

I encourage anyone who thinks they may be suffering from rosacea to visit the Act on Red website to learn more. A recent study of people with rosacea found that 40% of respondents experience redness on a daily basis. Persistent redness (70%), flushing (68%) and visible blood vessels (53%) are the three most common symptoms of rosacea. Heat (39%) followed by sun exposure (21%) are the most common triggers while 89% of respondents say that spicy foods trigger their rosacea. And 65% of respondents think about their rosacea at least once a day. Does that sound like you?

This post was brought to you by Act On Red, however the images and opinions are my own. For more information please visit www.actonred.ca.