Lupus and Skin: Welcome to Rosacea - another inflammatory condition

It's not chocolate or coffee, per se - it's caffeine! 

Okay, hold up. Let me provide some context. 

Earlier this year, I was trying to determine if a food or beverage was causing the persistent, but not entirely constant, redness across my cheeks and nose. It had been present for about 6 months, and then escalated to include a breakout/rash. That rarely happens these days (thank you, old age, and vitamin c face oil), so I knew something was up. I did a mini elimination diet, which you can read about here, which was helpful, but not entirely conclusive. I also considered the possibility that it was a lupus rash, but the redness seemed to be influenced by what I ate or drank...at least most of the time.

So I headed to the dermatologist. The day of the appointment, I looked my absolute worst - I'd skipped my calm relief serum, avoided the temptation to dot concealer on the brightest spots, and hid my brush so I wouldn't dust with mineral powder, as I had been doing since the redness arrived. Plus, my face looked particularly red that morning, for reasons I couldn't explain - but I was happy that at least my symptoms hadn't subsided for the doc visit. Sometimes that happens! 

He took a look at my skin, and while he narrowed it down to a couple of possibilities, was fairly confident it was rosacea, which, when left untreated, can also include an acne-like rash. Here's a great article about the symptoms of rosacea. 

My doctor explained that rosacea is an inflammatory condition of the blood vessels, usually on the face. So anything that causes a rush of blood to the face - like caffeine, spicy food, exercise, hot drinks, or extreme heat or cold - is going to cause the rosacea to flare. That's why the chai tea I had had the afternoon before the appointment had left my face flushed. I had deliberately chosen tea over coffee, but it was the caffeine I needed to avoid! 

You can read about the treatment options for rosacea here, but here's what I was prescribed: 

1) Minocycline - Oral antibiotic: Because the acne rash had formed, we had to move beyond a topical, and go straight to an oral medication. When I say it worked within a week, I mean it. It took it twice a day for one week, and the acne was gone, and the redness vastly improved. I was happy.  Like, no-concealer-or-face-powder happy. I continued the medication until the followup appointment (4 weeks), and doc and I were  very pleased with the results. 

2) Metronidazole - Topical antibiotic gel: This is for maintenance and upkeep, by decreasing inflammation in the blood vessels on my cheeks and nose. It's working beautifully, has caused zero side effects, and is easy to put on underneath my moisturizer or my nighttime facial oil. 

3) Avoid foods, beverages, or routines that cause a flush to the face.  Now that I know what I'm looking for, I can see that the spicy pepperoni from pizza exacerbates my redness, or that my face likes a splash of cool water more than my steaming hot shower. But I'm still adjusting to ALL of the things that cause my face to flush - sleeping on my stomach, even for just a few minutes; my beloved heating pad; the sun; hot wings. But I'm surviving. And I still drink my herbal tea every morning. I just wait until it it cools off a little. 

Pretty sure it was the increase in caffeine over the last school year that brought on the chronic condition, as well as my predisposition to inflammation. But I am thrilled at quickly we got it under control and that I know how to maintain healthy skin going forward. 

One more thought - I think gluten and dairy may cause my rosacea to flare, as well  - which makes sense from an inflammatory perspective because they are naturally inflammatory foods. But I'm curious if any other Rosacea-ites out there agree. Let me know via email or in the comments!