Seeing red
On Rosie Green’s wish list? Rosaceafree skin – and she may just have it
Central heating? Bad. Mulled wine? V bad. Blow drying? Really, really bad. Hot baths? Ditto. Stress? Cataclysmic. All of the above abound at Christmas. And all trigger my nemesis rosacea, a skin condition that is to my dermis what Kim Jong-un is to the UN Security Council – a major irritant with a predisposition to go nuclear. So just at the time of year when I want to feel pretty and serene, I end up looking like the love child of a Ribena Berry and a macaque monkey.
If you’ve never had rosacea, I’m happy for you. If you’re one of the six million British people rosacea affects, you’ll know that it’s a chronic skin condition that often starts as cute blushing, but can progress on to excessive redness (stage one), red bumps, pimples and patches (stage two), enlargement of the nose (stage three) and eye irritation (stage four). It’s genetic. It’s not curable. And it hurts.
Physically, a rosacea flare-up stings, burns and, to quote fellow sufferer and actress Lena Dunham, makes your skin feel, “Like it had a slow sandpaper massage.” Mentally, it’s a downer. A survey by the National Rosacea Society in the US revealed that 90% of rosacea patients said their condition had lowered their confidence and self-esteem, and 41% reported that it had caused them to avoid public contact or cancel social engagements. I’m sure there are plenty of us who don’t need a stat to prove this true.
But this Christmas I want to suck down the eggnog, throw on my highest heels and not worry about flashing red. (FYI, a good tip when you feel a flush coming on is to run your wrists under cold water.) I certainly don’t want a repeat of last year where, at one much-anticipated party, killer cocktails and ferocious heating combined to make me look so wretchedly blotchy that I left, despondent, well before midnight. You see, my rosacea rumbles along, sometimes almost nothing, sometimes becoming everything – but last Christmas I went past stage one to stage two. As a beauty editor, this felt like a professional failure. It had been this bad a decade ago and I visited a private dermatologist for help in the form of antibiotics. In the intervening years, I’d managed it with soothing creams, sheet masks and facial oils (more on this later). I also had laser and intense pulsed light (IPL) treatments, which target and destroy the red capillaries in the skin. They worked brilliantly then, but haven’t been as effective since my rosacea got worse.
I’VE ALSO TRIED TARGETED ANTI-REDNESS PRODUCTS BY THE BUCKET LOAD,
and here’s the revelation: none of them really worked for me. So on the advice of a beauty editor friend, I went to see Dr Stefanie Williams, an in-demand dermatologist who heads up the Eudelo skin clinic in London and is a rosacea sufferer herself. Yet her skin is so porcelain and clear, she could be an extra in ITV’S Victoria. “Most women who come
“I end up LOOKING like the love child of a Ribena BERRY and a MACAQUE”
to me with rosacea feel devastated by it,” she says. “It often kicks in a bit later, from your late-thirties onwards, so they’re at the age where they’re starting to see wrinkles, and then they start seeing spots and redness as well. It’s hard.”
SO WHAT’S HER SECRET?
Dr Williams starts by putting my skin on a ‘diet’ with immediate effect. “Rosacea skin can feel dry, tight and sensitive, so sufferers plaster on heavy skincare to soothe it,” she explains. “But it’s actually the micro inflammation caused by the condition that makes it feel that way, rather than true dryness, and rich creams can make matters worse, causing more inflamed lesions.” Gulp. My balm cleansers, rich masks and fragrant oils? Banned.
I’m told to buy Avène Extremely Gentle Cleanser Lotion, La Roche-posay Toleriane Fluid (the plain version) and Skinceuticals Sheer Mineral UV Defense SPF 50. Effective? I’m sure. Indulgent and joyous? Not so much. After all those beautifully textured and divine-smelling creams and oils, it’s like eating rice cakes for lunch every day.
She also prescribes me two creams, Rozex (active ingredient: metronidazole) for the morning, and Finacea (active ingredient: azelaic acid) for the evening, as well as some oral antibiotics called Efracea. I take the private prescription to the chemist and it costs just shy of £100. I do all this diligently for three months. It doesn’t get better. It doesn’t get worse.
Dr Williams prescribes some stronger antibiotics (oxytetracycline), and swaps the Finacea for Ketrel, which is a retinoid (active ingredient: tretinoin) that works to normalise the skin and has the added bonus of smoothing out wrinkles and pigmentation. I expect a skin flare-up from the Ketrel – retinoids are known to be effective but harsh to start with, often causing redness and dryness before the magic kicks in – but I don’t get one. Combined with the antibiotics, it sees off the raised bumps within the month, and I’m thrilled.
But… I still have residual redness, so I know my journey is not over. Plus I know that once the antibiotics stop, the spots might return. So what’s the next stage? Now that my skin is pimple and papule free, Dr Williams advises laser treatment (she uses the DYE-VL ATF Vascular IPL) to nix the underlying redness left by all the flushing and spots. She says a common mistake is using laser (a single wavelength light) or IPL (a range of light wavelengths) on the skin while it’s still bumpy. This is because the laser/ipl won’t help the bumps, but will be attracted to them because they’re red, and thus will be diverted from reaching the underlying redness. Aha! Perhaps that’s why laser hasn’t worked so well for me recently. Dr Williams is hopeful the IPL, combined with my morning and night prescription creams, should keep my skin on an even keel. If it still won’t behave? She advocates a daily low dose of Roaccutane (the hardcore but effective acne drug). Thanks to the regime, my skin is now looking so great that I almost start believing it’s naturally perfect and I can start slathering on all my old unguents again. “I have the same problem,” Dr Williams smiles. “You have to resist.” For me, it seems clear skin is going to mean forgoing hot baths, red wine and heavy-duty face masks. Thoughts? It’s clear. It’s worth it.
“For me, clear SKIN is going to mean forgoing hot BATHS, red wine and face MASKS”