March 2006
Dear Paula,
I’ve been using your cleansing and moisturizing products for a few years and they work extremely well on my sensitive, rosacea-prone skin. Unfortunately, nothing I’ve tried (including your suggestion of a BHA product) has helped with the redness from occasional flushing episodes. I use MetroLotion and apply sunscreen with SPF 15 as a moisturizer every morning. Short of using makeup (not an option for me, although I am in awe of all the women who put time and effort into making themselves so beautiful every day), do you have any suggestions for concealing, or reducing, the appearance of flushing on my cheeks and forehead? Is there a medical procedure I should consider, or can I find relief with over-the-counter products?

Robert, via email

Dear Robert,
It seems like you have practiced due diligence and experimented with various gentle over-the-counter options, which is great. Reducing facial redness from rosacea is, as you know, not an easy task. The redness begins in the blood vessels well beneath the surface. Unless you’re familiar with what triggers your rosacea flare-ups, finding the right product to minimize the redness can prove fruitless. Identifying what causes your bouts of redness is critical to managing the episodes, so do pay attention and take notes on your circumstances during a flushing episode. Did the climate change? Did you ingest something (such as wine, cheese, or something spicy) that caused it? What about cologne, a new laundry detergent, or exercise? Once you have a better idea of triggers, avoiding them (as much as possible) will likely result in fewer instances of reddened skin.

Regarding medical procedures versus over-the-counter products, there is no question that medical treatments are preferred for rosacea. Over-the-counter products have their place as part of a comprehensive skin-care plan, but to really address the most bothersome, persistent side-effects of rosacea (redness and broken capillaries), nonablative laser treatments are the current state-of-the-art therapy. There are several studies documenting successful clearance of rosacea symptoms following treatment with Intense Pulsed Light (IPL) devices, a good indication that such treatments can be worthwhile for you (Sources: Dermatologic Surgery, October 2005, pages 1285–1289; and Journal of the American Academy of Dermatology, October 2004, pages 592–599).