My eyes have been very challenging lately and it appears I have some active autoimmune activity, so it is really hard to tell how much is rosacea and how much is autoimmune.  I’ve resigned myself to the fact that my eyes are just going to be red and irritated.  I manage the best I can with lubricant eye drops and, overall, I’m working on managing stress, exercising, and eating well.  I also started back on a good quality fish oil since there is some data that this might help with dry eyes.  I’m just a little sick of this eye business, so today I wanted to focus on something a little more fun and “sunny!”

I’ve had lots of time to try seven different sunscreens.  I have very oily skin along with sensitivity and rosacea.  Here is a list of what worked and didn’t work for me:

1.  Elta md UV Clear Broad Spectrum SPF 46:  While this niacinamide containing sunscreen with zinc oxide and octinoxate did not irritate me at all, left no white cast, and absorbed nicely, it left a shine and my skin seemed to look oily very fast.  I’ll be using this up on my neck and backs of hands.

2.  Laroche-Posay Anthelios 50 Mineral Sunscreen:  I love this sunscreen, especially for summer.  It’s a thin, milky consistency.  It has titanium dioxide and zinc oxide in it which I feel helps soothe the acne that comes along with my rosacea.  It sort of dries out any pimples that I have.  It does leave a bit of a white cast, but I use a tinted sunscreen like make up over top of it to give my skin some color, focusing on areas where the sun might hit my face naturally.  I do still seem to get oily with this one, but not quite as badly as with some of the others on this list.  This bottle is almost empty.  That’s my clue that it has worked for me!

3.  Replenix Ultimatte Perfection 50+ with zinc oxide:  This is a terrific, matte, colored sunscreen that I like to use all over my face in the summer and as a second layer over base sunscreen to add color in the winter.  I apply it just on my forehead, across my nose and cheeks, and a tiny bit on my chin.  This keeps my oily skin fairly matte which I like.  It’s almost time to order a new bottle of this.

4.  Purito Centella Green Level Unscented Sun SPF 50+:  This oil free sunscreen has no fragrance or essential oils which can be hard to tolerate with rosacea.  It has no white cast whatsoever and absorbs readily into the skin.  My skin seems to like it; however, I do still seem to get oily with it.  For winter, I have been using this and layering some of the Replenix product to give color and oil control where I need it, mostly in the T-Zone.  As far as plain sunscreens with no white cast, I like this Purito product better than the Elta md one.  I bought this off of Yesstyle.com and actually ordered two along with some other products so I could get free shipping.  I’ll likely use up both tubes. 

5.  DRMTLGY Tinted Moisturizer SPF 46:  I really want to love this zinc oxide and octinoxate product.  It goes on beautifully, makes my skin look youthful and dewy, and the tint is just the right amount.  However, I get very oily fast with this one.  Ugh!  I’ve been using this up on my neck which is really aged from photosensitivity and I also use this almost like a blush over other base sunscreens.  It gives a little glow to my cheeks that’s not heavy.

6.  Biore UV Oil Control Base:  This is the newest one I’m trying.  It smells like glue and I find if I use smaller amounts and rub it into a small area it blends better than if I apply larger amounts over a larger area.  I really like how this dries matte and stays matte for the longest out of all these sunscreens.  I am still shiny by the end of the day, but that’s just me.  I wish this was a little darker tint for my medium skin tone, but it’s been working fine for winter.  You might not like this one unless you are super oily like me.  Update January 24, 2021:  I've since quit using this product after a breakout after a few days of using this.

7.  Cetaphil Daily Facial Moisturizer with Sunscreen:  I really love the color of this tinted mineral sunscreen and it blends in really nicely and looks moisturizing.  It feels very soothing on my skin. I am not happy that it only has an SPF of 20, nor am I pleased that I get very oily quickly with this product.  I even feel like this made my skin break out some.  I do like this on my neck, however, in the winter I try not to use tinted sunscreens on the neck area because it comes off on my black down coat which just looks gross.  This will go in the drawer until summer again until it can be slathered on my neck. 

Because I'm so oily, I do not moisturize my skin before applying sunscreen.  The sunscreen seems to be moisturizing enough.  After I wash my face in the morning, I've been applying a rice toner and then a prescription of azelaic acid.  Then sunscreen is my next and final step. I’ve come to enjoy the routine of protecting my skin each morning and only wish I had started it decades ago.  I resisted wearing sunscreen for many years because of oily skin and acne.  Just because you have rosacea doesn’t mean you have to stick to a mineral sunscreen, although they do seem to be easily tolerated.  I think there are enough products on the market now for people who have challenging skin like me.    It just takes some trial and error to find the right one.  Even though it’s winter, don’t forget your sunscreen!  It’s imperative with rosacea, but not only that, it’s imperative for preventing age related sun damage and skin cancer. 

Most people know rosacea is a condition of the skin, but did you know it can affect the eyes as well?  My rosacea actually started as a rash around my eyes.    Over time, it spread to the rest of my face and even to my ears and down my neck.  Eventually, my eyelids started to swell and I would awaken in the morning with crusted over eyes. The eyeballs themselves were looking more and more red, bloodshot, and felt constantly irritated, dry, and scratchy.  By mid-afternoon, I was having blurry vision.   I’ve always had auto-immune related dry eyes, so I was used to some of these symptoms, but after my first rosacea flare, it felt like my eye issues just ramped up in severity.  This was more than my typical dry eye.

Yes, this is a picture of my very own eye.  Not pretty.  When my eye problems continued even after initial rosacea treatment, I made an appointment with my ophthalmologist.  He agreed this was rosacea involvement and after examining my eyes, he told me I had a condition called blepharitis as well.  Blepharitis is an inflammation of the eyelids and it goes along with rosacea.  Even now, I can’t really tell how much is dry eye and how much is rosacea.  The doctor assures me it doesn’t really matter anyway because it’s all connected.

Treatment for me included oral antibiotics (which was already prescribed from the dermatologist), antibiotic eye drops for a week, continued use of gel lubricating drops which I had been using prior to my appointment, and a morning and evening routine of ten-minute hot compresses to the eyes followed by eye scrubs with an over the counter product.  (From ophthalmologist instruction in the past, I had learned to thoroughly wash my eyes along with my entire face and then to use a washcloth with additional gentle cleanser to the eyes.  I’ve also used hot compresses in the past for my dry eye condition.)

After sticking to this routine for two weeks, I did see some improvement.  At first, the eye scrub product felt very abrasive to my eyelids, but I stuck with it and let the product do its work without applying too much pressure.  I have noticed some breakage of the eyelashes and even some eyelashes which have fallen out.  (This will be a follow up discussion with the eye doctor.)  I get up very early to go to work, so sticking to the ten-minute soaks in the morning was the most difficult part of the routine.  (Lately I’ve slacked off of this in the morning just due to the time constraint and I definitely have noticed some regression in my eyes.)  I am really enjoying the soaks at night.  It has become part of my routine to unwind at the end of the day and it does feel so soothing to my eyes.  I’ve made it a little more fun by using the time to listen to my favorite YouTube dermatologist videos during this time.  In the mornings, I was using the time to prepare for the day by listening to praise and worship songs.  I’m definitely getting back to this.

At a follow up visit with the ophthalmologist, a steroid eye drop was added into my routine, twice a day for a week and then down to once a day as needed.  Overall, I am glad I went to the ophthalmologist.  There was not any one thing that was a miracle worker, but all these things together have given a bit more improvement in my eyes.  The whites of my eyes are still quite red.  I asked the doctor about Lumify eye drops which I had seen in stores.  Unfortunately for me, although they whitened my eyes pretty immediately, the result did not last more than about an hour.  They’re expensive also.  I do believe the steroid eye drop has helped a bit with the discomfort during the day.  I’ve noticed I’m not thinking quite as often about how uncomfortable they feel. 

If you are in a rosacea flare and you think your eyes are possibly affected, I would encourage you to seek out an ophthalmologist.  Be prepared for some work on your part, but with some diligence which you can begin to view as self-care (you might actually enjoy it!), your eyes can improve!  This eye stuff has caused me to think a lot about eyes.  As a believer in Christ, it reminds me of Psalm 17:8, “Keep me as the apple of your eye; hide me in the shadow of your wings.”  To be the apple of someone’s eye is to be completely cherished!  I’ve also heard it explained before that this expression of being the apple of someone’s eye comes from the tiny reflection we can see of ourselves when we look in someone’s eye who is also looking at us.  So, when we ask God to keep us as the apple of His eye, we are yearning for God to keep his close eye on us!  It may seem like you are super focused on what you are going through right now, but take some time to think of the big picture and put things in perspective.  We are never outside of God’s eye and we are cherished by Him more than we can even comprehend. 
 

This rosacea journey has prompted the question of “what is true beauty?”  As women and for even very young ladies, we are taught through the world that our beauty is what others decide. People might say it is beautiful unblemished skin, perfect facial features, long, lustrous hair, and a toned body.  And when that doesn’t fit into our world, we feel ugly, unaccepted, and it even causes us to hide from others.  Why have we allowed society to determine our definition of beauty? 

Why do we try to hide our not-so-perfect features?  Why can’t we see beauty in the midst of acne, rosacea, hair loss, bodies that don’t function like they do for others, bodies that we wish were different?  Being forced to go without makeup during rosacea challenges, helped me to find my true beauty.  Beauty can be found in the things we don’t like so much about ourselves.  It’s in the imperfection that beauty shines through.  We are hard on ourselves, but if we were to ask others, they would say it’s our unique features that are so beautiful.  When we look at other women and think, “I wish I looked like her”, she might be thinking the same thing about the very thing in you that you don’t like so much! 

Rosacea actually gave me confidence to not feel like I have to cover up every blemish.  Why does society look at acne, for example, differently than it looks at any other medical condition?  Why must one feel like she must cover visible imperfections to feel accepted?  It’s actually really freeing to run to the store and not really even care what someone might think of that big cyst on your forehead!  By not constantly covering every single skin condition, we force society to think about its reaction to visible health conditions, and perhaps we might even change what society considers true beauty.

And yet, it isn’t Rosacea that tells me I’m beautiful.  It’s God, Himself!  He just used this journey to be a teaching moment for me.  He tells me in I Peter 3:3-4 that “your beauty should not come from outward adornment, such as elaborate hairstyles and the wearing of gold jewelry or fine clothes.  Rather, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God’s sight.”  This encourages me to dig into His Word so my heart can be changed by God and others can see that inner beauty shine outward.  He made you and me in HIS Image, too!  Celebrate today how God made you, ladies!  He does not make mistakes, and in Psalm 139, He tells us we are fearfully and wonderfully made!  I challenge you today to love how God made you, full of blemish and full of beauty all at the same time.  There is no one else like you, so embrace those attributes you have that are yours alone.  It defines your true beauty!

Image by <a href="https://pixabay.com/users/kinkate-3436326/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=1761648">kinkate</a> from <a href="https://pixabay.com/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=1761648">Pixabay</a>

After some initial treatment, I started to feel hopeful that Rosacea could possibly be managed and I wouldn’t suffer with this awful rash forever.  About one and a half months into my treatment, I went in for a scheduled major surgery and as a result, suffered a mild lupus flare along with an exacerbation of my rosacea including redness and small pustules.   I had suffered with cystic acne as a teenager and young adult and large cysts were starting to pop up after my surgery, which I had not had in a long time.

During my recovery, I was plagued with digestive issues and the surgeon recommended I stop the Doxycycline which I was taking for rosacea.  (I see now that my digestive problems were not from the Doxycycline, but from the surgery itself.  More healing time helped me.)  Stopping the antibiotic contributed further to my rosacea setback.  I noticed the biggest change in my eyes.  They were looking puffy again, even the eyelid margins felt swollen, and they were feeling very scratchy, irritated, and were much redder than before my surgery. 

A follow up appointment with the dermatologist confirmed that the anesthesia and drugs used during the surgery as well as the physical stress of the whole ordeal caused my rosacea to flare.  She put me back on a form of Doxycycline which is timed released and a lower dosage than my initial treatment.  She wanted to keep me on the lowest dose to keep my condition managed.  I also discussed my desire to use Tretinoin to see if it would help the acne portion of the rosacea and the fact that it also helps with anti-aging was a plus for me at fifty!  She said I could start the cream very slowly, once a week at first, but cautioned that it could worsen rosacea.

This combination along with the basic skincare I was using (see my earlier post) and the continued use of topical Soolantra began to settle my skin.  The Tretinoin seemed to help with the acne portion.  My eyes felt only slightly improved, and shortly after this, I consulted with an ophthalmologist (a future post coming soon!)  I do not like being on an antibiotic for any length of time.  An antibiotic kills off your good bacteria as well, so I’ve started taking a probiotic.  The dermatologist explained that there is not much treatment available for the eyes afflicted with rosacea and oral antibiotics is the targeted treatment for this. 

Tretinoin caused peeling of my skin, so for the first week, I only used it one night.  (Do not exfoliate this peeling skin, but rather use a good moisturizer and it will resolve.)  Then the second week, I increased to twice a week, and so on until I had worked up to every night.  At that point, I noticed that when I had to wear a mask in public due to Covid, my face felt like it was burning under the mask.  I decided to cut my Tretinoin use back.  When I returned to my dermatologist, her preference was to put me on Azelaic acid instead.  She said intermittent use of the Tretinoin would not give me the benefit of a nightly use of Azelaic acid.  My skin immediately loved the Azelaic acid, however, I began to notice some mild acne.  I’ve only recently started back on the Tretinoin once a week because I like how it makes my skin look.  Remember, I have oily skin, so dryer skin types with Rosacea may not tolerate Tretinoin.

As you can see, it takes working with your doctor to manage a stubborn condition such as this.  Life events can trigger Rosacea.  There will be backwards steps, but just as I learned as an EDS Mama, Hope Always!  And if you are right at the beginning of a Rosacea journey, know that you will get improvement with proper management. 
 
 

The very first thing one should do when faced with a skin condition is consult with their dermatologist. You cannot self-diagnose because what you see could be a million different things.  Even my dermatologist took some time to reach a diagnosis for me.   In my case, when my skin did not respond to the initial treatment of what the doctor thought was dermatitis, I underwent a skin biopsy which gave definitive answers.  I have no scar from the procedure at all and a diagnosis allowed me to get treatment right away for rosacea, so I would do it all over again. 

Immediately having a diagnosis, I stopped all my natural, botanical skincare products I was using.  This was hard for me because I always thought that natural was better, but as I learned about my condition, I realized even natural products could be exacerbating my condition.  I learned that essential oils and botanicals can irritate my sensitive skin.

Two things turned my skin around quickly:  Soolantra and antibiotics.  My dermatologist prescribed Soolantra, which is an ivermectin lotion.  People with rosacea have a higher than normal level of mites on the skin.  They don’t know if this is a cause or effect of rosacea.  Because my eyes were affected (they were swollen, red, and goopy in the mornings), my doctor prescribed two months of an antibiotic.  Within days of starting this regimen, I started to see major improvement.  (Stay tuned for another post on my eye involvement as I recently had to visit an ophthalmologist.)   I’ve always hated sunscreen, but my doctor advised that I also needed to start using it as the sun was making my rosacea worse.  I started watching YouTube videos by Dr. Dray, a dermatologist who is diligent about incorporating sunscreen into a daily beauty routine.  I actually look forward to applying my sunscreen every morning; it has become a part of self-care for me. 

These are the products I used for my own rosacea.  I wash morning and night with Cerave foaming face wash for oily skin.  I have oily skin along with rosacea and I was noticing that as my skin got oilier as the day went on, I would get more symptomatic with burning, itching, and redness.  CeraVe has parabens in it, which I have always tried to avoid, but I’ve started to change my thinking on skincare products as I’ve had to adapt to what works for my skin.  Things I avoid like the plague now include the sun, essential oils, fragrance, and botanicals.  Now I see that as soon as I add in a product with essential oils or botanicals, my skin reacts.  In the morning, after washing with the CeraVe foaming face wash, I apply my prescribed topical Soolantra.  After that, I apply sunscreen.  You can read down further for my initial sunscreen experience, but I am constantly trying new ones.  Soon, I will post a review of many different brands.  I have stopped using any make up on my skin especially with all the mask wearing.  Because my eyes have been affected, the only make up I really use is mascara.  On a very special occasion, I may use some eyeliner or eye shadow but I love how using no make-up makes it quick to get ready in the morning!  I have little eyes with fair eyelashes, so I feel like I need the mascara.  If I had big eyes with lush eyelashes, I would go sans mascara in a heartbeat!

At night time, currently I feel like I need an extra product to break down the sunscreen (although when I was first diagnosed, I did not use this product, just the CeraVe Foaming Face Wash.)  Even though I have oily skin, I am loving using Habo Lado Cleansing Oil first.  It breaks down the sunscreen and mascara and rinses cleanly away with plain water and it has no added fragrance.  After that, I use the Cerave Foaming Face Wash and follow with Cerave moisturizing lotion applied to damp skin.  The lotion says it is for Normal to Dry skin, but it just feels so soothing on my sensitive skin.  I love it.   I do not use any moisturizer in the morning because the Soolantra feels like it moisturizes well before my sunscreen application.  I did try Neutrogena moisturizer for Sensitive skin and although I liked the lightweight feel of it, it burned my skin when I applied it and I quit using it.  I also tried using Neutrogena Ultra Hydrating Gentle Cleanser in the morning and since it also stung my skin, I quit using it.  Some people, including Dr. Dray, do not wash their face in the morning, but I find I am oily when I wake up, so I continue to wash twice a day. 

Sunscreen has been a huge challenge for me with oily skin.  I’ve always hated it.  I do wish I had started using it earlier, however, because I have lots of sun damage on my neck which is photosensitive and the deep wrinkles remind me I have started too late.  I am still trying to find a sunscreen I like.  I first tried Cerave 50 SPF and it left me with a white cast, but did not seem to break me out.  I do find the zinc oxide is calming to my skin and even helps with the acne that comes along with rosacea for me.  Currently, I like LaRoche Posay Anthelios 50 sunscreen all over my face and neck as a base.  It has a liquid, milky texture which I like.   I learned from Dr. Dray to use tinted sunscreens as a makeup.  Currently I seem to be liking Replenix UltiMATTE Perfection 50+ Tinted Sunscreen which I layer over top of the LaRoche Posay sunscreen on my cheeks, nose, and forehead.   I am excited to try a Purito brand sunscreen soon which is supposed to be good for oily skin.  I will keep you posted. 

And that is it for starters!  The biggest piece of advice is to keep it simple!  Less is more!  Cleanse, moisturize, and apply sunscreen along with any topicals your doctor prescribes.  Take some time to test products.  If you try too much at once, you will not know what works and what irritates your skin. Be realistic.  Rosacea has no cure, so don't be surprised if it is not gone completely.  I would say, for me at this point, it is simmering beneath the surface.   And remember, I am no doctor so always, always, ask your doctor what is right for you. 

I identify as an EDS Mama and have for a long time.  I’ve always known I had to practice self-care and encouraged other moms with chronically ill children to do the same.  Unfortunately, I haven’t been very good at doing that myself.  As my daughter who has EDS grew into a phase of self-management, I thought that this would be my time to finally take care of myself.  I had neglected myself for many years so that I could take care of others.  No sympathy wanted, just matter of fact.

It was a nice thought that I would finally nurture myself a bit now that my child was older, but I had started a bad practice years ago that just continued by spilling over into caring for still other individuals.  Now don’t get me wrong, I’ve always worked on my own nutrition and tried to re-discover hobbies I once enjoyed.  But it was just enough self-care to keep me functioning.  I think what I’ve neglected most is my mental health. 

During the Covid-19 pandemic of 2020, I was very diligent in wearing masks and using hand sanitizer to protect myself since I have systemic lupus.  I often sent my husband to do the grocery shopping for our family.  After about a month of using the paper type masks for times I just had to wear one, I developed a rash around my eyes.  Preceding this, I had also totally changed my diet to plant based, no sugar, no gluten, very low inflammatory, so I wondered if the rash was a purging process in my body.  I had re-started a nutritional and skincare consulting business right before this and I was excited to have something just for me.  Eventually, under our governor’s orders, we were forced to work from home and I enjoyed a slower pace, finding time to take daily walks (mostly in the full sun of the afternoon).  The pandemic was a very stressful time for running businesses which were mostly shut down and there was so much that was new to learn and implement.  It was very taxing for many people, including for me.  Eventually our state re-opened which meant I transitioned back to the office setting.  I did not expect that this would be so difficult, but the stress of too many responsibilities on my plate beyond work was beginning to take a toll.  My personality has always been one to step up and get things done, to always put the needs and requests of others above my own. 

When the rash around my eyes did not go away, I finally made an appointment with a dermatologist.  Immediately upon entering my examining room, the doctor said she had seen multitudes of other patients all with the same “dermatitis” caused by hand sanitizer and facial masks.  She gave me a steroid cream and I went home to work on making a less irritating cloth mask.  The rash cleared up within days, however when I discontinued the steroid cream, the rash came back with a vengeance around my eyes and continued to spread down my face, neck, and ears.  My skin itched and burned all at the same time.  If I became overheated, I would feel a prickly sensation, more of the rash would come out, and the burning would begin.  It actually felt like my face was on fire at times.  My face and eyes appeared puffy and my eyes felt irritated, burned, and were goopy with drainage.  I had quit wearing all makeup because the doctor had said if the rash came back, I could be reacting to something else and I would need further testing.  I discontinued all the skincare and nutritional products I was currently using for fear this was an allergic reaction or worse, auto-immune triggered.

I was feeling very self-conscious now with how I looked because there was no hiding my condition.  I worried about how others would view me in the work setting and I started to avoid requests from friends to get together.  I was discouraged about my nutritional business.  Where does a person with lupus and skin like this fit into a skincare business when I can’t even use the products?  If I can be honest, I was depressed. 

I made a second appointment with the dermatologist and at this visit, the rash had changed on my cheeks which were now covered with small pustules.  I’ve had severe cystic acne in the past and I felt like acne was just never going to leave.  I agreed to a skin biopsy even though it might leave a scar because I needed to know what was causing this.  The doctor was puzzled as this was very unusual with the predominant eye involvement. 

I actually was not surprised when she called with the results to say I had rosacea and I also had eye involvement.  Both of my parents suffered with this and many people who have had acne in the past will go on to develop rosacea.  It is an inflammatory blood vessel condition with no cure.  I was scared because the skin around my eyes had actually started to change to a rough bumpy texture.  Would my skin be left with permanent changes? 

Although rosacea can have multiple triggers including genetic factors, I believe my largest triggers were the sun (my daily walks), stress, genetics, and exacerbation from mask wearing.  Hot drinks and spicy foods seem to have no bearing for me.  I have always been very sensitive to the sun with lupus and, mentally, I felt like I was at a breaking point of doing everything for everyone else.  I was stretched way too thin.  I also believe that lupus played a part in the inflammatory process.  Good nutrition and botanical skincare can be wonderful for the average person, but when the immune system goes overboard, these things can become triggers that just snowball. 

This rosacea really was an eye opener to not only me, but to my loved ones that I was not coping well.  The stress was written all over my face and it was begging attention.  I do believe God uses things like this to guide us and to teach us.  I'm thankful that I’ve developed a gentleness instead of judgement when I see someone without a mask during this pandemic.  I’m still searching for a mask which doesn’t irritate my skin.  Even a cloth one worn for extended periods causes my face to feel like it’s burning.   I’m learning to feel comfortable around others with no make-up and it feels good to just be me.

I have a heart for you, EDS Mama.  We need to be healthy.  We matter, too.  I hope that you will continue to join me as I share my Rosacea journey here which is part of growing old gracefully.  Why put off any longer taking care of yourself?