One of my friends – we’ll call her “Eloise” – found herself with no alternative. At middle-age, she was suddenly faced with an outbreak of rosacea.

For those of you that aren’t familiar with rosacea, it’s a chronic skin condition that looks like large red cystic acne. Not a great look at any age, but certainly not when you’re beyond your teenage years.

Despite years of being my friend and enduring all my blathering on about food and gut health and prescription medications only “covering up’ the problem and not solving it, Eloise had to learn for herself how functional medicine can be the answer to some of life’s inconvenient problems when conventional approaches fail to address the underlying issues. In order to do this, Eloise had to become her own detective to solve her rosacea mystery. However, the upside for me as her friend, was that her own journey convinced her that what I do for work is not “voodoo,” as my father-in-law refers to it. Looking for the why behind the symptom makes a lot of sense.

Let’s read on …. Here’s Eloise’s story.

Eloise’s Rosacea Story

Eloise: Out of the blue, I began to develop what I thought was acne on my cheeks and neck that I never had before. While getting my yearly body scan at the dermatologist, I asked her to take a look and she told me it was Acne Rosacea. I asked her why someone would develop this out of nowhere. She told me that she had been seeing a lot of new rosacea patients as the Covid mask-wearing was causing a variety of skin ailments due to irritation and the warm, humid environment inside of the mask. I work at home, so I’m not in a mask for an excessive amount of time, but it seemed like a logical explanation. She prescribed me a couple of topical ointments and sent me on my way.

Me: So let’s evaluate this assessment… The doctor didn’t ask one question about her lifestyle, her diet, her medical history, other symptoms, new medications… nothing. The assumption here being “Oh you’re wearing a mask. That’s probably it.” Now I’m not criticizing (well, not in a mean way), this doctor – it’s just the way medicine is practiced these days. Not your run-of-the-mill, crappy medicine, but medicine from excellent, well-trained doctors. But what’s missing is the most important quotient: the why behind the symptom. Once a working diagnosis is reached then we choose from a list of approved medications that manage the symptom.

Eloise: I started using what she prescribed, but didn’t really notice any major improvement. In fact, it seemed to get worse. My skin had always been clear and pimple-free but now started to become inflamed and hyper-sensitive. The rosacea “pustules” (large, red pimples that don’t pop or go away) began to take over my cheeks and neck.

Me: Now who wouldn’t be upset about this. Sure, it’s not a fatal disease, but it’s a big drag and why is this going on? This is just NOT okay.

Eloise: I went back to see the doctor. This time she gave me a topical steroid cream. She also recommended an oral antibiotic, but I have an allergy to the one that worked for this condition, so I had to hold off.

Me: So — why use an antibiotic? It is often quite effective for rosacea but not because the skin is infected. It helps because it banishes a ton of bacteria from the gut. But this is only a temporary fix. The second you stop, the rosacea comes back. This is not a long term solution. There are definitely deeper issues.

Eloise: I had read that many people’s food sensitivities were linked to their rosacea flare ups. I asked her about it, but she told me there are no real links between diet and rosacea (except alcohol and spicy foods which cause the “flushing” most people associate with rosacea). I saw an allergist who told me the same thing.

Me: No real links, eh? A quick Google search that took me four seconds (would have been three, but I kept misspelling ‘rosacea;) turned up this: Diet and rosacea: the role of dietary change in the management of rosacea.

Eloise: When the 12th steroid cream was unsuccessful, and I was embarrassed to go out in public (thank god for that mask!), I started to do some research on my own.

I found myself on two different Rosacea Facebook Groups. I found an unbelievable amount of knowledge shared by people all over the world experiencing the same frustration — many who had been living with this condition for decades. Across the board, most posters complained that their dermatologist was unable to really solve their rosacea issues or even truly understand the cause.

Me: Love this!! She’s not just saying “Oh well, guess I’ll just live out the rest of my life like a pimply 14 year-old boy! But with better hair and a mortgage — which is fine if you are 14…or a boy…or like pimples.

Eloise: One cream commonly prescribed is called Ivermection 1% concentration. It is super expensive by prescription – sometimes hundreds of dollars even with insurance. Here’s the thing: Many rosacea patients try it and give up quickly because it often makes their skin worse before it gets better. Why? Because everyone has microscopic mites on their face called Demodex mites. People with Acne Rosacea have MANY TIMES more mites than the average person. So the Ivermectin cream is actually an anti-parasitic that kills the mites. When they die off they excrete really irritating substances to the skin — hence the flare up. Give it 12 weeks and your skin will clear, though you do need to go through a few cycles to get rid of the hatching eggs that are present. Once all the eggs are killed off you just need to use it a couple of times a week to maintain.

Me: Wow. I had never heard of this. Mind. Blown.

Eloise: I found that a product called Horse Paste which is Ivermectin for horses, a great cheap alternative to the prescription. It is double the strength of the ointment I was using and costs about $8.00 per tube. After one night of Horse Paste, my pustules had dramatically reduced in size and redness.

Here are some additional Tips and Tricks Eloise mentioned:

• Use a “barrier-cream”usually a zinc-based cream that rebuilds your skin barrier and protects from future flare-ups.
• Zinc-based diaper rash creams are great spot treatments for pustules – a brilliant trick!
• Silk masks: Yes! Paper masks: No!
• Mineral sunscreen: absolutely. Chemical sunscreen: a sure fire way to flare up.

Eloise: I learned that I had Ocular rosacea as well. I had recently developed the most intense burning sensation in my eyes that would last about 20 minutes. My eyes would get red, burn and tear the entire time and the eye drops didn’t help. In addition, my scalp had become dry and flaky which I had chalked up to the dry winter. What I learned was that the mites actually migrate from your face to your eyes and scalp and cause the “Ocular Rosacea.”

• Many posters recommend a foam made of tea tree oil terpines made for this specific use called Cliradex. I ordered it and after 3 or 4 days of use, my burning eyes went away.
• In addition, I ordered an Ivermectin liquid from a veterinary supply company (meant to be injected into animals as a anti-parastic), poured it into a spray bottle and sprayed it on my scalp. After a week, my itchy dry scalp went back to normal.

✚  Gut Skin Connection

Eloise: I learned about the connection between gut health and skin. Eating an anti-inflammatory diet, the benefits of probiotics and removing allergens. My doctors had never discussed this and most dermatological websites don’t address it. I also learned that rosacea is actually an auto-immune disease, and that it can’t just be treated with a cream. It is complex, confusing and different for everyone.

At that point, I came to Anita and she suggested an elimination diet to see if food was the culprit. I strictly followed that for about four weeks and my skin continued to improve – and somewhere along the way I did notice a connection between red wine vinegar and a flare-up. After four weeks, I began to re-introduce things back into my diet, and while I’m not yet convinced that food sensitivity is the total problem, what I eat definitely has an effect on my skin.

Currently I am starting a gut repair program with Anita because once I started to research the link between gut health and skin, I learned that most people with rosacea tend to have other GI problems, often auto-immune.

I have a long history of GI issues and an auto-immune disease – but it took me almost six months to actually make that connection. No other doctor I spoke with even considered the connection between my skin and my medical history until Anita pointed it out to me.

By no means is this issue solved for me. Everyone in my house is sick of the word “rosacea” — I’m sick of it too. I just want my skin to look like it did six months ago. But, this work in progress seems to be under control and I no longer cringe when I look in the mirror or have friends ask me what happened to my skin!

Most importantly, this experience was a wake-up call about how many doctors handle the unknown- they just throw medicine at it to stop the symptoms, but ignore the cause. I don’t want to be smearing horse paste on my face for the rest of my life — I want to figure out why I developed this at 47 and what I can do to make it go away permanently. I’m not there yet, but I feel confident that I’m getting close!

Me: Love this story — and many thanks to Eloise for sharing her journey and her wisdom. I hope this helps some of you out there as well!! There’s so much to do. Ask yourself WHY is this symptom happening? Don’t just mask it with medications that aren’t addressing the cause. Dig deeper. Don’t settle for mediocre health!!

Please Share the Health if you liked what you read!!!

For more information about my wellness programs and my practice, check out my website drsadaty.com. Hey Look!  You are already here…or give us a call 516.801.1313.

Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendations, please contact your doctor to be sure any changes you wish to consider are safe for you!