Treatment Options

Helping Yourself

Keep a diary:

One of the best ways to help prevent rosacea flare-ups is to avoid potential triggers. Keeping a written record of your flare-ups ? when they occur, what you eat and drink, what the weather conditions are, and other information ? can help you and your doctor to determine your triggers. The National Rosacea Society (www.rosacea.org) provides printable diary forms that you can fill out to help you keep track of relevant information.

Avoid foods and beverages that may trigger flare-ups:

Generally, individuals with rosacea should avoid hot spices such as cayenne, black pepper, chili, and curry. For many individuals, monosodium glutamate ? an ingredient often used in processed and Oriental foods ? causes facial flushing that may aggravate rosacea. Limiting intake of hot beverages, caffeine, and alcohol also lessens or prevents flare ups for many rosacea patients. Certain fruits and vegetables, dairy products, and marinated meats are other common foods that may trigger rosacea. You may want to avoid eating foods that you think may affect your rosacea.

Pay attention to facial cleansing and make-up:

• Choose cosmetics and cleansers that do not contain alcohol, fragrances, or preservatives
• Wash your face with a gentle soap or facial cleanser and lukewarm water
• Try not to wash your face too often ? no more than twice a day, if possible
• Pat your face dry with a soft towel or let it air-dry
• Let your face dry completely before applying medication or make up
• Use an electric razor instead of a straight razor blade
• Avoid hot water, hot tubs, and saunas
• Avoid powder make-up
• Avoid scrubbing facial skin with rough cloths, sponges, and cleansers

Protect your face from the sun and extreme weather:

• Avoid outdoor activities as much as possible during peak sun hours (from about 10 AM to 2 PM) and in very cold weather.
• If you must be outside, always use a sunscreen of at least 15 SPF (sun-protecting factor), even on cold or cloudy days. Consider using a sunscreen that is sold for children because children?s products tend to be milder, possibly helping to reduce irritation. In addition, make sure your sunscreen protects against both UVA and UVB rays.
• Wear a hat with a wide brim to shade your face from the sun.
• In cold weather, cover your cheeks with a scarf to decrease skin dryness.

Try to avoid medications that can cause flushing:

Some medications can cause flushing, which may increase the redness and irritation of rosacea. If possible, avoid the use of topical steroids such as betamethasone, fluocinolone, and hydrocortisone.

Other common drugs that may cause or worsen flushing include:

• calcitonin (for osteoporosis)
• calcium channel blockers, such as nifedipine and verapamil (for high blood pressure)
• dipyridamole (for preventing blood clots)
• hydralazine (for high blood pressure)
• morphine (for pain)
• minoxidil (oral for the heart, topical for hair loss)
• niacin (for high cholesterol and found in multiple vitamins)
• nitroglycerine (for the heart)
• raloxifene (for osteoporosis)
• sildenafil (for erectile dysfunction)
• tamoxifen (for breast cancer)

Many other drugs, including some that are given to treat cancer and others used to prevent rejection of transplanted organs, may cause facial flushing. If you notice a worsening of your rosacea when you take certain medications, discuss the benefits and risks of changing to a different drug with your doctor.

Avoid extreme exertion:

• Discuss a new exercise program with your doctor before you begin it
• Choose low intensity workouts
• Exercise for short periods ? 15 to 30 minutes at a time
• If you exercise outside, exercise in the morning or evening when temperatures are cooler

Try to avoid extreme temperatures (especially during flare-ups):

Since heat and cold can both cause flare-ups, try to stay in a well-ventilated, temperature-controlled room during extreme weather. When the weather is very hot and humid, limit the time you spend outdoors, sip cool drinks, or chew on ice chips to keep cool. In the winter, minimize exposure to cold and wind by staying indoors as much as possible. Try to avoid overheating while exercising by having a damp towel and cool drinks readily available.

Take care of your eyes:

• As much as possible, avoid rubbing your eyes, and always wash your hands before touching your eyes.
• For dry eyes, artificial tears may be used several times a day to replace moisture. Humidifying the air of the home may also help relieve dry eyes.
• You also need to keep your eyes and eyelids clean. A cotton swab dipped in an over-the-counter eyelid cleanser or in baby shampoo that has been diluted with an equal amount of water may be used to clean the eyelids and eyelashes. Rinse thoroughly with lukewarm water.
• Covering the eyes with a compress ? a clean cloth that has been dipped in warm (but not hot) water ? for a few minutes several times a day may help to loosen scaly skin and open clogged tear ducts.
• To treat eye infections or inflammation that occasionally may be associated with rosacea, your doctor may prescribe antibiotic, anti-inflammatory, or antiviral eye drops or ointments.

Try stress-management techniques:

• Practice deep breathing exercises
• Stretch muscles as a whole-body stress reliever
• Read or make time for another quiet, relaxing activity

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Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.