Her battle with rosacea
Lipowski Milan/ShutterstockKristin Chenoweth is a super famous, super talented Grammy- and Tony-award winning actress and singer and her face has graced the covers of magazines, billboards, and everything in between. But what most people don't know about the bubbly blonde bombshell with the petite stature and powerhouse voice is that she's spent the better part of her adult years battling a pesky skin condition known as rosacea. "It's a red, itchy, apparent, slightly embarrassing thing, it's usually on the face, and people who have it just hate it," Chenoweth told RD. "It doesn't matter if you're on camera or not—who wants to have another 'thing' to deal with?"
Finding rosacea meds that work
fizkes/ShutterstockUntil she was about 25, Chenoweth had never dealt with skin problems, so when she started experiencing bumpy, itchy redness on her face, she treated it with over-the-counter meds. "I tried all the wrong things, of course Cortisone, oils, you name it—anything over the counter I tried it." When she finally saw a dermatologist several years later, she received an instant diagnosis: rosacea. Since then she's tried almost every remedy out there to keep her inflammation at bay, recently settling on a solution that just gained FDA approval, RHOFADE, for which Chenoweth is now the celebrity ambassador. "My redness has gone way down along with the bumps, itchiness, and this has been week four. I use it right after my moisturizer and it keeps my redness in check all day long."
But RHOFADE is not her only defense against rosacea. "I've never been a big drinker, but I try to avoid alcohol as well as caffeine and extreme temperatures." While the list of potential rosacea triggers are endless, we sat down with Chenoweth's celebrity dermatologist, Dendy Engelman, MD, as well as dermatologist Sejal Shah, MD, to find out the top red-causing contenders.
Rosacea trigger: sun exposure
Timofeyev Alexander/ShutterstockFor most skin problems, a little vitamin D can work wonders. Unfortunately this is not the case with rosacea. In fact, a survey of 1,066 rosacea patients found that 89 percent listed sun exposure their number one rosacea trigger. "Sun exposure can cause redness and blood vessel dilation, and can heat up the skin and body overall," says Dr. Engelman. "For this reason, especially, I advise all of my patients—not only rosacea patients!—to wear sunscreen all the time and to avoid direct sunlight between 10 a.m. and 2 p.m., when the sun is at its strongest." These are the sunscreens dermatologists use on themselves.
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Rosacea trigger: emotional stressSyda Productions/ShutterstockSeventy-nine of rosacea patients listed stress as a trigger for their rosacea. "During times of emotional stress, parts of the nervous system are activated and chemicals know neuropeptides and neurotransmitters are released," explains Dr. Shah, Board Certified Dermatologist and RealSelf contributor. "There are different types of neuropeptides and neurotransmitters and they can have a range of effects. In people with rosacea they are thought to increase inflammation and dilate blood vessels," she says. If emotional stress is a trigger for you, strategies for stress management can help control flare-ups. These 15-second strategies can help lower stress ASAP.
Rosacea trigger: hot environments
Keisuke_N/ShutterstockAs if anyone with rosacea needed scientific proof of the connection between heat and flare-ups, one study published in the Journal of the American Academy of Dermatology showed that the skin of individuals with rosacea is significantly more sensitive to heat. "High humidity seems to also make problematic skin break out more, so it is a trigger for people with pustules," adds Dr. Engelman. "Try to maintain a moderate temperature year-round, even when you're inside." She recommends keeping heaters on low and avoiding heat-inducing activities like saunas.
Rosacea trigger: cold or windy temperatures
Lena Pan/ShutterstockIn the same survey, 57 percent of rosacea patients listed wind as a trigger for their redness. And, as anyone who's been skiing knows, the combination of wind and cold weather can make even a non-rosacea sufferer red in the face. "These more extreme temperatures compromise the skin's protective barrier and lead to dry, irritated skin," says Dr. Engelman. She recommends avoiding exposure to very cold or windy weather when possible or, at the very least, covering up with protective wear whenever you do head outside. Here's how to layer clothing to stay warm in cold temperatures.
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Rosacea trigger: alcohol consumption
PhotoMediaGroup/Shutterstock"There is an undeniable correlation between alcohol and rosacea," says Dr. Engelman. "Alcohol causes a widening of the blood vessels which could contribute to redness and flushing if you have the condition and magnify those effects." What's interesting is that according to the study, "red wine has been identified as a rosacea trigger for those who already have the disease, but it's not significantly associated with developing rosacea in the first place." Dr. Engelman says this can be possible because red wine contains flavonoids, which are anti-inflammatory. "Although red wine contains histamines and resveratrol, the latter is an antioxidant that can contribute to flushing."
Rosacea trigger: hot or spicy foods
hsunny/ShutterstockFor those who can't get enough of Sriracha or who carry hot sauce in their bags a la Queen Bey, know this: Spicy foods are not gentle on the skin, especially if you have rosacea. "Hot foods dilate blood vessels, making the face appear even redder, so it's best to avoid liquids and foods that are spicy or very hot temperature or at least reduce how much you consume per day," says Dr. Shah. If you do have something warm, she suggests following it with something cold (for example a cold glass of water) or splashing cool water on your face to constrict the vessels.
Rosacea trigger: histamine- and niacin-rich foods
Oksana Shufrych/ShutterstockHistamine and niacin cause blood vessels to dilate, so eating foods rich in either one may contribute to a rosacea flare-up. Such foods include fermented alcoholic beverages and foods, cured meats, sour foods, dried fruits, citrus, aged cheeses, nuts, and certain vegetables. Dr. Shah suggests take an antihistamine or aspirin about two hours before a meal to counter the effects of histamine and niacin.
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Zuurbiero/ShutterstockUp until this point, the best way to treat rosacea or prevent an episode was to manage the triggers, but the new medication is changing that. "I'm really excited about RHOFADE, which will soon be available as a prescription from your dermatologist," says Dr. Engelman. "It's the first and only alpha1A adrenoceptor agonist approved for persistent facial erythema associated with rosacea in adults and contains the same active ingredient, oxymetazoline hydrochloride, that's used in Afrin to treat redness."
Dr. Engelman's other recommendations for managing symptoms include using a tinted moisturizer with SPF. "Not only will it neutralize the appearance of redness, but it will also reduce the flaring that comes from sun exposure." Cetaphil Redness Relieving Daily Facial Moisturizer with SPF 20 is another great option Dr. Engelman recommends to patients because it's a mineral-based sunscreen that provides UVA/UVB protection without irritating sensitive skin. Additionally, since those with rosacea have sensitive skin, she emphasizes patting, not rubbing, off your makeup, as the friction can increase the redness. "I like Cover FX for foundation, my go-to is the Custom Cover Drops, because it's free of talc, mineral-oil, gluten, fragrance, and parabens while providing great coverage; it's safe for all skin types, and it was even tested and formulated for rosacea patients," she says.
If all else fails, laser treatments are very effective at minimizing persistent facial redness. Do, however, make sure to choose a board-certified specialist who is well-versed in laser medicine.