Rosacea: Skincare and Treatments That Work! | Dr Sam Bunting 

Basic skincare tips for Rosacea that she mentioned in this video 👇👇 1. No double cleaning, keep it gentle, non foaming cleanser, non pore clogging cleanser. Touch your skin gently 2. Use barrier repair approach in moisturizing (nice occlusives, niacinamides, ceramides) 3. Use Sunscreen daily all year round (All mineral sunscreen with zinc oxide and Titanium Dioxide that give broad spectrum cover) 4. DON'T use toners, face masks, physical exfoliants, chemical sunscreens, facials

For 15 years I have been suffering from it and I always go back to doctors without benefit. I consider that this disease destroyed my life, distorted my appearance and destroyed my self-confidence... I know life is not fair.

Just wanted to add my two cents for what it’s worth, thank you for this video. Sorry for the long-winded post but hopefully this will help someone. If you truly want to tackle rosacea, you need to treat both externally and internally. Sure there are some who manage to get rid of it with a very simple solution like tea tree or azelaic acid, but if you’ve tried various things and are still suffering then read on. If you want to understand rosacea, learn about demodex mites, their life cycle, what kills them and what perpetuates them. If you’ve never heard of them then you have a lot of reading to do. These mites consume bacteria and fungi, which is released into the skin when they die because they have no anus to excrete them, causing inflammation in the skin. This is why antibiotics appear to work temporarily as they kill the bacteria but not what’s releasing the bacteria. The little buggers also eat elastin and collagen leading to premature aging. They can colonise anywhere on the body where there are hair follicles or sweat glands, inside the nose (rhinophyma), the eyelashes and meibomian glands (ocular rosacea and dry eye) and the scalp included (causing grey hair and hair loss)! They love and consume oil, whether it is the body’s sebum or oils in cosmetics/makeup. As far as I know they can’t consume coconut oil- it suffocates them (which is likely why it’s considered very comedogenic because the mites die and release their contents which show up on the skin as blemishes or pustules). I think Vaseline and castor oil may also do the same. Chances are if you have rosacea you will be colonised in other areas with these mites, even if it’s not causing symptoms. They reproduce at night on the surface of the skin whilst you are sleeping, then lay eggs in the follicles which can take a few days to a week to mature. They can live on the skin for 2-3 weeks before dying. They hate heat and sunlight, and enough exposure will kill them. Coincidence that pale Caucasian Northern Europeans suffer more? It’s the lack of sunlight as a contributing factor to allow them to overpopulate. Read these comments and notice how lots of people’s symptoms are worse in the winter. It becomes a vicious cycle because sunlight aggravates symptoms in the short term as the mites struggle and die, which leads to increased avoidance of sun. Similar situation with exercise and saunas. Safe sun exposure (never burning and only light tan) is very good for you and needed for optimum health. Certain oils will kill them eventually like tea tree, clove, neem, black cumin seed, peppermint or eucalyptus. Most microbes cannot survive extremes of pH either so acids like ACV or alkalis such as bicarbonate can also kill/disrupt their life cycle. Once you’ve understood these mites, then try to figure out WHY they have overpopulated and why your body’s immune system is reacting to them. Whether you mean to or not, you have created an environment for them to thrive. Internally, microbes love sugar and will feed off the sugar/carbs you consume. The sugars may also alter sebum/sweat composition making your body more attractive to them, as well as altering you gut biome to allow overgrowth of harmful microbes. This is why lots of people have great results with keto/low carb/intermittent fasting, as you starve the microbes of sugar, allow the gut to recover and repopulate with beneficial microbes. Remember that bacteria and fungi need sugar so you will deplete lots of unwanted microbes which can act as food for mites, and your body can finally repair/trigger autophagy as well. There is also a link between the adrenal-pituitary hormone axis and mites (and disease in general) - essentially you want to do everything that you can to keep your body sensitive to insulin and cortisol, and not allow these hormones to run at sky-high levels all the time, which stress and eating carbs all day long will do. Research how to improve cortisol and insulin sensitivity. The things you can do to help yourself- Externally: - stop using heavy creams/oils/makeup - use tea tree wipes for eyes for 2-3 months if eyes effected - soolantra (may be curative for a few, but recurrence rate is high- so I recommend using it in conjunction with other measures. Also- don’t suddenly stop it. Wean down to alternate days for a month then twice weekly for a month then stop, and aim to stop in the summer months - Dead Sea salt soap (they hate salt) - sulphur another option - Any of the oils listed above- be careful about toxicity and don’t apply copious amounts of essential oils direct to skin - Small amount of bicarbonate mixed with water for 1 minute to worst affected areas may work very well - ACV - may need to play around with dilutions, can be very harsh on some people whilst others tolerate it - Black cumin seed oil has worked wonders for some people - Red light therapy- this kills/disrupts demodex. Those gimmicky-looking masks actually work, the red light is crucial, yellow may help with lymphatic drainage but the other colours are less important. Red light therapy will also diminish broken blood vessels/capillaries significantly Internally: - raw garlic (at least short term or monthly) can help recover and maintenance - fermented foods- water kefir and goat milk kefir are great, do some research on the importance of fermented foods - black cumin seed oil internally - tea! Ah the power of tea. Research clove, cardamom, hibiscus, sage, dandelion and black tea- then decide on a combination and drink 3 times a day. This may only need to be short term but commit to it properly if doing - stop feeding them. Sorry to say but at least try keto/IF/low carb/a mixture of these for at least a month and see if it helps. Give your body a chance to rebalance it’s biome and hormones. If you continue with carbs and sugar, would strongly recommended avoiding all bread, oats, pasta and rice (all sweet stuff apart from dark choc has to stop as well). Longer term, a carb-concentration way of eating, where you only eat carbs with one meal of the day, is a good long term strategy for health and longevity in general - stop eating plant oils, stick to olive oil, coconut oil, ghee and grass fed butter - plenty of omega 3 foods - try to eat within a 6-10hour window, find what works for you - exercise - doesn’t need to be complicated, mixture of walking/yoga/aerobics/gardening/whatever sports you enjoy - find healthy ways to manage stress- some people exercise, meditate, read - find what works for you - spend time outdoors as much as you can I appreciate some people find quick and simple cures, and that’s wonderful as it saves you a lot of time and energy. But for those who are at their wits end, start incorporating some of the suggestions above (mixture of internal and external) and I’d be very surprised if you don’t start to see a positive result. Be patient- these microbes don’t die straight away, consistency is key! (A final musing- if you follow a ketogenic diet or have read up on it, you will likely have come across or even experienced a Keto rash, or prurigo pigmentosa as it’s formally known as. It’s currently a mysterious, itchy and inflamed rash which comes about with withdrawal or carbs/sugar. It’s itchy, it’s often worse at night, it behaves like severe rosacea, and it affects areas of the body where there are lots of hair follicles and sweat glands, and is usually worse after exercise/sweating. People who power through usually see resolution after a few weeks. Most people go back on high carbs and it quickly goes away. You decide the rest!)

People with acne are never told that they have to deal with acne for the rest of their life and acne is so much easier to handle whereaas people with Rosacea, Eczema and Psoriasis are told they will have to deal with it their whole life, I really wish more research was put into it, hopefully we will find a cure for it one day

I recently got diagnosed with rosacea and it’s been a struggle. It’s really been taken a toll on my confidence. This really helped a lot.. thanks

I have phymatous rosacea and have found remission through an effective skincare routine. Azelaic Acid an Tretinoin are the best actives for me. I totally agreed with everything Dr. Sam said. I will also say that there is disagreement amongst Derms as to whether double cleansing can or should be used OR whether it is harmful. There is not much data, if any, to support double cleansing. However, in my anecdotal experience, I use a lot of water-resistant sunscreen throughout the day and find that double cleansing is much more thorough and gentle at removing all over the sunscreen (having tried using a water-based cleanser for 60+ seconds). I use Avene’s XeraCalm oil cleanser as my first step, followed by Vanicream’s Gentle Facial Cleanser. This approach to cleansing has worked wonders for me. In rosacea solidarity, ❤️.

I started using the Nuface device this year as it was a Christmas present and have had to put a stop to it. It has really flared up my rosacea....I thought I'd share this as a warning for anyone who is interested but hasn't made the purchase as it is quite expensive.

🙏 🙏 🙏 needed this The sun is one of my biggest enemies 😭

thank you so much!! i sometimes get so disheartened when trying to find a routine that works bc everything seems to be irritating :( this really helped + youre so gorgeous!!

Thank you Dr. For being the first Dr. I have heard to explain the role the immune system plays in rosacea flares. People who do not have rosacea don't understand the physical pain that can accompany a flare. The temperature of my cheeks can register 2 degrees hotter than my forehead during a flare. Some days I have to apply my prescription Rhofade multiple times before the heat subsides.

For years, I thought I had acne. Once my derm diagnosed it, I researched and began using azelaic acid because I didn’t want to use ivermectin which I found gross. Azelaic acid completely cleared it up so I apply it once a day. My skin is clear for the first time in ages and is great for my confidence.

As a med student, I love your explanations of why each treatment works. Thank you 😊.

As a Mediterranean man with olive skin, always taken a lot of sun with no problem, and eating all sorts of food, I can say that the only effective treatment to my chronic type-2 rosacea (15 years now) is Azithromycin. Everything else (including creams, lotions, and skin-care cosmesis products) has been completely useless for me. Tried loads of them for many years, never seen any result. Azithromycin is on the other hand extremely effective already after a couple of days of the first cycle, and can have fairly long term effects: talking about 12-16 months with perfect smooth baby-skin (I have always had a very smooth, tender, slightly oily and naturally moisture skin), then the inflammation unfortunately slowly tends to come back, and another cycle is needed. But if I have a healthy life, I sleep enough and not stress too much, one cycle of azithromycin can last almost 2 years if lucky. I am saying that to make two main points: 1- I get a pretty heavy rosacea even though I am the opposite of a thick/dry/pale northerner-type of skin, and 2- Nothing has ever worked for me beside azithromycin -- no other antibiotics or lotion, or diet, or creams, or habit, or whatever. I take azithromycin, it goes away. Just my experience

Thank you so much for making this video this is a topic that I have been dealing with on and off for my whole life and just recently started having more flareups so getting to review this and hear what you have to say yes very very helpful thank you so much

Excellent deep dive on Rosacea. Thank you, Dr. Bunting.

Fantastic video ,thank you ❤️

Thank you for sharing this. The beginning of this video really resonated with me. The video is much better than one that's just product focused. I was surprised about the preference to avoid the double cleanse; I'm hesitant to think the gentle cleansers I use would remove this. I'm also wondering how is make-up removal handled, though I don't use this due to my skin situation.

Because of Rosacea I don't wear makeup anymore......and only put on sunblock on ....stress makes my rosacea flare ups🥰thx for sharing 🙏🏻👏👏👏

Thank you for these details.!

So what exactly causes it ? I love how doctors jump to products to treat it without finding out the actual cause

Thank you so much for this whole video. I love the way you explain in a larger picture with details. It's very understandable, educative and so helpful !!! :) I have type 2 of Rosacea and I would like to ask you what do you think about these two products from La Roche Posay? : 1. Rosaliac Micceral gel (I use it every night to remove makeup) and sunscreen Anthelios Ultra SPF50+ (I use it during all year as a protection and primer before makeup). I'm not sure if Micceral gel counts as cleanser and if sunscreen I use is rather mineral than chemical (couldn't find answers elsewhere). Thank you very much!

Thank you for this video, it was very informative. I've done my own research on

Thank you for the more indepth explanation of treatment, I can now go in and ask about oral treatment to go with it. She keeps telling me we may have to go that route but hasn't yet...I will push for it now. My face has gotten worse over the last 2 years...I have a red bump on the end of my nose that will flare up from time to time and frankly I feel like Rudolph. I now have another on the end of my nose which is even more difficult to cover with make up. My left cheek is starting to get very small bumps as well these all do not go away. My blood vessels are also broken. I keep getting new creams and the only thing they have ever done is control some and I only mean some of the redness. What do I do about bumps 😭. I feel discouraged and my self confidence is hurt. I just don't know what to do. I feel like I'm racing time before my nose is just bump filled..it's terrifying. The only thing I do is have coffee in the am..no drinking, no spicy foods etc. I'm trying to figure out how I can help myself.

Thanks for this information. I have seen dermatologists on three/four occasions and none of them provide this depth and quantity of information. Most of what I have learnt comes from the internet.

Thanks you! This was so informative, I finally understand my skin! After year of battling this on my own I finally went to a dermatologist last week and was blown away by the diagnosis. I would have never though this was what I have. I've been red in face since I was a child, even bullied. I had heard of it but just though it was about the blood vessels showing on skin, never about it looking like severe acne. Thank you again, everything makes sense now.

Thank you this was fantastic. xx the best and most clear breakdown of Rosacea and treatments.

I looking forward for the next video. Its my biggest consern, because i dont know, what i can do when it cames to anti aging. Thank you so much!

This is such a great video! There aren't that many in depth, informative, well presented videos about skin conditions like rosacea around, so this has been very valuable.

I believe the rosacea I have is the inflammatory type. I have been using Ivermectin cream 1% for about a week and my rosacea is virtually gone now. The brand name I use is Rosiver because this is what's available in Canada, but I know there are other brands out there. The cream is very expensive, but worth it in my opinion. Tried other things like cleansers and doxycycline, but they didn't work.

she’s so good at talking i was mesmerised

Thank you for this helpful advice, Dr Sam. It was a revelation.

Polyphenol in coffee may help mitigate symptoms. Started enjoying black iced coffee and began noticing a lessening of my rosacea symptoms. Provides relief if not cure.

Great information. Thank you! What about the best make up?

Perfect, in depth information that I needed. Thank you!

A sleeping rosacea problem: if my room is cool, that should be good, right? But what actually happens is that my nose becomes very red and rather swollen when my body gets warm under the blankets. You might think that I would need lighter bedding, but in fact, to moderate this effect, I am going to bed rather cold, and having difficulty getting to sleep because of the cold in the winter, but then heating up very much due to menopause. I'm already waking up too much at night, I can't be adjusting my bedding five times a night. Now I'm supposed to have no caffeine, no alcohol, no spicy food, and no sun in addition to no sleep. Under these conditions I am spending nearly the entire day trying to get the sunscreen off the lenses of my glasses. Feeling a bit testy.

I have type 2 and Metronidazole in combination with oral antibiotics worked really well on the spots and slightly lessened the redness. Didn't want to keep taking it because it's antibiotics so switched to Isotretinoin which worked really well. Still hardly any spots and stopped taking it 1.5 years ago. Redness will never go away I think.

I have rosacea and i believe im type 1 and 2. I have tried metro cream and spent tons of money on doctors and different prescription creams. For 10 years i have been researching and trying to figure this out. Just recently a friend of mine suggested i try Differin Gel . I bought the face cream and face wash at Walmart. All my red pimples disappeared. I have no more redness, and i have my face back. I no longer cover my face with make up to hide my red dots lol..I also stopped dying my hair around the same time. I wasn't sure if maybe that could be why. I believe in the cream. My face never felt so CLEAN! I still flush sometimes and have redness if i get nervous or upset. This is the first time i have written about this cream and i have been wanting to get it out there. It has Retinoids,so i guess its a vitamin A. Best of luck to everyone suffering from this skin disease. Its worth a try. I use it when i shower, and sometimes i use the cream when my face feels dry. A little goes a long way. I hope i can help someone. I just want to add, I stopped drinking red wine a few years ago, that helped with the rosey cheeks but the pimples were still there until i tried this cream. :)

i love this woman! i learned so much from her videos plus obsessed with her skincare

Really helpful, as always, thank you :-)

Thanks for this video! I’ve got Phymatous Rosacea which I’m currently treating with assistance from my dermatologist!

Not that often that I find a new RU-vid channel that I’m impressed by. This one hit a home run. Happy to subscribe.

Thank you for great videos. I have ETR rosacea and Azelaic Acid is the best treatment I have found for my skin. As you mentioned hyaluronic acid does not work well for my rosacea skin. But vit B with peptide (The Ordinary) is perfect to remove feeling of face skin tightness.

Thank you so much very helpful 👋🏻❤️simply cleanse moisturiser spf right

I learned so much!!! Thank you so much!

I do suffer cheek flares after double cleanse but I really need that first oil cleanse to break up my mineral SPF.

merci merci dr sam! this means the world to Mama( my mommy) xxx we both look forward to see you soon at the clinic.

Excellent and to the point. I would love to hear your thoughts on the use of LED Light Therapy. I understand it can have a positive effect on the skin.

Out of nowhere I have really bad rosacea on my forehead. Thank you for your video. It’s very helpful. The metronidazole is already making a difference. This treatment along your video, I’m feeling more positive already.

Please could you do a video on seborrheic dermatitis?! My GP originally diagnosed me with rosacea but I eventually got an appointment with a dermatologist, they said I have seborrheic dermatitis.

Would be good if you can talk about Rhinophyma rosacea. There is alotnof confusing informatiom out there and would be good to get a summery and outlook for individuals 😊

Most informative video on rosacea I’ve seen! So thorough and eye opening.

Thank you Dr Sam! This is hands down the most informative video in regards to Rosecea. I have had it since 2005. Accutane works the best for me.

Good morning dear Dr. Sam♡ Thank you for this informative video! I have a question about double cleansing: I do double cleanse so I can take off my make up properly (1st cleanse) and then cleanse my bare face again. Isn't it necessary to clean your face thoroughly in other to prevent impurities? Thank you! Enjoy your weekend🍀

You are so smart! How did you talk basically non stop without a glitch? Great info, thank you so much.

Isotretinoin years ago and IPL twice a year changed my life! No more redness, pimples or flushing!

thanks! I can't wait for the next video about rosacea and anti-aging treatments!

oh yes it feels so relatable the redness on cheeks and nose after having a glass of wine! thank you for the video, dr Sam 😊

Hi Dr. Sam, thanks for sharing this video. Hopefully, you can recommend few products too!

I have rosacea in my cheeks, forehead and chin. It has worsen when I turn 32. I also have large pores at my nose and cheeks and also blackhead. I always try to squeeze them or put some claymask to suck all that nastiness of.

Gosh how i wish my acne rosacea was as easy as you say it is to get under control. I have been suffering with this for about 4 years and that's how long I have been on isotretinoin but off Couse that has side effects, so now i am on Stelara. I have worked in the beauty industry all my working life and always taken care of my skin. This has truly challenged me. I stumbled onto your RU-vid channel and i have just purchased some Azelaic acid so i am hoping that this will help

what do you recommend most for rosacea, acne prone skin with broken capillaries? Cetaphill gentle cleanser and lotion OR Cerave hydrating cleanser and lotion?

i got rosacea when i was 9 and i’m now 14 and still have it and i didn’t know what it was for a really long time

Thank you!

Since I was 15 years old, I have been suffering from acne on my cheeks. I went to several dermatologists, and doing many procedures, and tried many skin creams. My lifestyle is very healthy! At the beginning of the year, I went to a dermatologist, and he told me that it was rosacea and not acne!! He gave me antibiotics because my skin was inflamed and i change my skin care routine for rosacea, after that, my skin improved very much, and the redness decreased a lot. Thank you for the information on this video .

Such a useful video!!!! ❤️❤️❤️

Adding pictures of these different types of Rosacea as your describing them would be super helpful!

Ty u Dr. Sam ❤ I have rosacea & have decided to use bakuchiol in place of retinol during the summer months along w/a mineral sunscreen. For your next video do you have any recommendations for Bakuchiol - I've been looking at 'Herbivore' as the 'Inkey List' is hard to source at this time.

thank you. I struggle with type 2. I'm trying to get a handle on it before it completely takes over my life.

Thanks for the video😍

Me and my son both have rosacea and it has always affected my confidence growing up so I really hope it doesn’t do the same to him

Would you be able to make a video on RSS or steroid withdrawal syndrome, apparently it can last a long time and can look like rosacea, eczema, dermatitus

Thanks, this is really informative! I’ve always had rosy cheeks (cue “Why are you blushing?”) but it’s gotten significantly worse this past year, with sensitivities to alcohol, spicy food, exercise, winter weather, skincare products that I’ve used for years, etc. Next on the agenda - a derm appointment. Also - side note - I’m really digging your hair color. :)

Fantastic video! I went to a dermatologist here and in 3 minutes she said I had rosacea (redness and broken vessels). She’s prescribed a face gel for super dry skin (not my case) and sunscreen for rosacea. I now know what to properly use on my skin. Thanks doc! Also taking it easy on my red wine 😭

So excited for next week's video! I have got my rosacea under control and would really like to try antiaging

I have type 2 I think . Thank you for such an informative video. I have been using retinol and this has flared the redness and the stinging 😢.

Thank you for posting so much valuable information about Rosacea! Recently diagnosed with mild rosacea and my derm prescribed Noritate (Metronidazole). This along with Protopic has completely brought my skin back to normal. I am hesitant to use these medications more than is absolutely necessary and definitely want to try azelaic acid after watching your videos! I would love if you could do a video on why you’ve moved away from prescribing Metronidazole?

No mention of brimonidine?

Extremely useful! I’ve recently started to use Ivermectin and It has significantly changed my skin

Thank you for the video🙏 Can LED face masks help with rosacea?

Thanks! Love to learn as much as I can about it. It’s taken 10 years for me to control it. Doctors are just not interested. I avoid fragrance, essential oils and most actives. Sometimes products with these things work great and sometimes products without all those things still cause a reaction 😂

I object to not double cleansing, if I don’t fully remove my makeup it get gunky on my face and causes so much extra flakey skin. I recommend DHC oil cleanse and then a gentle foaming cleanser. I also think my six week facial and micro derm also helps with buildup since many OTC exfoliating products bother me. (I have had more recent success with glycolic acid from IT Works)

In frustration I realized that blood vessels needed repair and began applying cold compress to my skin. Not a cure, but does aid in repairing blood vessels. Sulfur soap helps outside cleansing, magnesium diet and cold compress helps beneath skin.

I think I've always had rosacea and didn't know it. I've always been red cheeked and easily flush. I've gotten worse as I get older. The flush can carry down to my neck and chest. I still haven't officially been diagnosed but in the last year, I've developed the broken capillaries on the cheeks and little postules that aren't acne because they last maybe a half day. Because of this irritation I've now developed hyperpigmentation. Unfortunately, I live in a very hot and humid environment. I think this is what has driven it into overdrive after living here for 12 years. 😩 Of course also my age... Luckily I've been using a tinted mineral sunscreen since I've been 26. I naturally gravitated towards that since it helped somewhat hide the redness and I don't like foundation

Can Rozex be used along with Brightly serum?

what is your opinion on led masks and Rosacea ?

What other cleansers do you recommend besides Flawless Cleanser?

I’d love to know more about laser treatments for rosacea, especially for the redness.

Hello Can you have a recommandation for a high UVA mineral protection ?

Great vid

What are your thoughts on Korean Skincare? A lot of K-beauty is focused on the skin barrier and clean ingredients with no fragrance.

I have type 1 and went to the dermatologist for the first time. He perscribed Metronidozole and said it can be used along with my Ordinary brand retinol and azelaic acid (and then cerve night moisturizer).. but would the azelaic acid with metro be too much? If not, what order should I apply things in?

Pretty much everything you said makes sense to me, but I am curious about something. I wear makeup at least 2-3 times a week, and have been double cleansing for over two years, and it drastically improved my skin. I use a cleansing balm and then a hydrating gel cleanser. Both are really hydrating and gentle and my skin feels great after I use them, doesn’t flare up at all, but there is some redness that is still there at all times. Is there any other makeup removing method that you recommend?

Could you please list products that you use?? Nothing works sadly!! CeraVe, Cetaphil, Vanicream.

Hi Dr. Sam! What do you recommend for makeup removal since you do not recommend a double cleanse? I find it difficult to remove sunscreen and makeup if I don't double cleanse.

yes and I can't do some yoga poses ;) like the head down one!! started at 40. Worst part is around 2am every night wake up with skin burning at the cheeks and have to get up to put more moisturizer on. My face hates to be against the pillow as it heats up my cheeks.

Hi Dr Sam I had a question do you recommend the Avene extremely gentle cleansing lotion ? I don't think you have ever spoken about that one. It's the one with the anti fungal Ingrediant. I heard that Ingrediant can cause itching and cause irritation ? Wanted to no if it was ok for rosacea or should I stick to the tolerance cleansing lotion instead ? Thank you

Hi Dr Sam I always had sensitive and eczema prone skin, but during perimenopause developed type one rosacea. I had it fairly well controlled until last year when it went a bit haywire - perhaps stress related? It's finally starting to calm down, but I didn't go to my GP during the lockdown's etc because it didn't really seem to be important enough to bother an already besieged healthcare system for. I'm already on a repeat prescription for low dose clonidine - helps a lot with flushing and treated it with azelaic acid and extremely gentle skincare. I also find antihistamines can help, which I take for hayfever anyway. I had to back off from the tretinoin I had been using successfully for more than a year, as my skin was just too sensitive. I scaled down to retinaldehyde when tolerated and am still there for the moment. It seems to be calming down again and once it's back to MY normal, I'll resume the tretinoin slowly. Spf has been a real challenge - mineral spf's are mostly really drying on my very dry/eczema prone skin and many chemical spf's sting/burn. After a LOT of trial and error, the paula's choice calm mineral spf30 normal/dry over a moisturiser is working well enough. It's still a bit drying, but less so than many others. I'm the palest of the pale Scottish skin so tinted spf's are normally orange, but white cast isn't really an issue for me. Best wishes.

How long do you typically have to be on antibiotics, like Metronidazole? Is it a permanent thing? Also, are there any negative impacts to having rosacea, aside from looking flushed?

What do you think of the new research suggesting topical tretinoin may be an effective treatment for rosacea?

Analogy of kettle vs oven response makes so much sense. Wondering if there is analogy between rosacea and autoimmune diseases (I have 4).