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.