Saturday, 23 July 2011

Perfume And Rosacea: A List Of Trigger Factors To Make You See Red

I am not blessed with good skin. Since the age of 15 or so, I have suffered from some sort of dermatological disturbance or other. For many years the doctors just called it acne: "teenage acne" first, then, as I approached my 40s and it became untenable to construe 36 as the new 16, my condition was promptly renamed "adult acne". I wondered how long these skin eruptions would persist - would my dispiriting ailment ever be relabelled "geriatric acne"? As the years passed with no remission in sight, it seemed a very real possibility.

On turning 50, I entered a brief phase of "menopausal acne", before a new hospital consultant pronounced my condition to be...drum roll..."perioral dermatitis". I quite liked this name, because "dermatitis" sounded reassuringly non-specific, even when qualified by its location ("around the mouth"). This was clearly not something I could have brought upon myself by eating lots of sticky buns and chocolate. But as it turned out I didn't suffer from perioral dermatitis for long, because at my next six monthly consultation, a new consultant took over, who was adamant that I was in fact suffering from rosacea.

Rosacea - it has a pleasing ring to it, possibly because it sounds a bit like "rose", but appearances are deceptive. Rosacea is in fact a ruddy nuisance. Your skin is prone to angry red patches, topped off with painful lumps and bumps that rise and fall with the precision choreography of a pus-propelled Mexican wave.

The first line treatment is antibiotics - both oral and topical - but in my reading around the subject, I was shocked to come across a long list of possible trigger factors compiled from patient histories. Here are the ones that sounded most relevant to my own lifestyle and diet


•Cheese (except cottage cheese)
•Soy sauce
•Yeast extract
•Broad-leaf beans and pods, including lima, navy or pea
•Citrus fruits, including tomatoes, bananas, red plums, raisins or figs
•Spicy and thermally hot foods


•Hot baths
•Simple overheating
•Excessively warm environments


•Strong winds


•Alcohol, especially red wine, beer, bourbon, gin, vodka or champagne
•Hot drinks, including hot cider, hot chocolate, coffee or tea

Medical conditions

•Frequent flushing

Emotional influences


Physical exertion

•"Lift and load" jobs

Skin care products

•Some cosmetics and hair sprays, especially those containing alcohol, witch hazel or fragrances
•Hydro-alcoholic or acetone substances
•Any substance that causes redness or stinging

Hello? That is my life right there that the Rosacea Organisation has described. Indeed it is pretty much the life of any middle-aged working woman. Well, speaking for myself it is, give or take the lima and navy beans. What are navy beans, anyway? Oh, and I am not a fan of Bourbon. But otherwise that is me to a "T".

So I am supposed to avoid sun...and cold...and wind? And humidity? That would also include rain, I take it, which tends to be jolly humid. That means I can only venture out on a mild, dry cloudy day, and must remain confined to barracks during all other types of weather. Which will doubtless increase my stress levels (another trigger), and prompt me to seek refuge from the stress of multiple weather constraints in a nice relaxing bath with a glass of wine (a double whammy of triggers!).

Though I must say that it has been no hardship at all to avoid exercise - gentle Pilates once a week (when I am in the country) can't surely do me any harm. I don't have a "lift and load" type job either, unless you count mauling my briefcase and luggage in and out of the boot of the car on work trips. And as a concession I have given up witch hazel spot zapping sticks, along with facial toners containing astringent, alcohol-based formulae (which is most of them!).

Even so, there were enough prohibitions on that list to put the wind up me good and proper (it's that wind trigger again!), so at my last hospital appointment I levelled with the consultant.

"Okay, so what's the deal with all these supposed triggers in the leaflet I've been given? If I followed that list to the letter I would end up like those poor kids you see on the Discovery Channel who live in a bubble - you know, where their parents can't hug them or their skin would fall off? What is a person really supposed to do?"

"Ah", replied the consultant. "I shouldn't worry in your case. You have some redness, but your rosacea manifests itself for the most part as papules and pustules rather than spontaneous flushing."

Hearing my face linked to such distasteful terms as "papules and pustules", I blushed deeply. But at the same time I was relieved that I could crank up the radiator and enjoy a G & T or two. And most importantly, I could carry on wearing perfume on a daily basis...

For in my case the trigger list proved to be a red herring more or less. And for everything else, there's Revlon ColorStay. Yes, for a foundation with light but forgiving coverage, it simply cannot be beaten.

Picture of rosacea sufferer from, photo of girl with "face mask" from, photo of windswept woman from, cartoon of man lifting load from, cartoon of spotty face from, photo of mugs from, phot of Revlon ColorStay from


Ines said...

Honestly, what in the world is rosacea? I thought for some time I might be suffering from it as my cheeks always seem ruddy to me (although not as bad as some people seem to have it) but in the end I think I don't have it. Although red wine does tend to exacerbate the condition so far I have to apply cooling things (glass usually) to fight the effect.
Windy environment doesn't help but moderate summer heat is ok.
And I won't go into my skin regimen, I'm not sure you could handle it. ;) But I like the effect it has. :)

Vanessa said...

Hi Ines,

To give you the best overview of the condition, I recommend googling some images of rosacea sufferers. Some of the people you will see also have acne, others just generalised redness. The pictures of really severe cases are hard to stomach and I even had to look away at certain points. Also, bulbous noses seem to be a symptom as well, which I am fortunate to have been spared!

Anonymous said...

So, as well as sharing Beau's lines, we share rosacea. I have the generalized flushing kind (which it seems, according to your consultant, is the kind not to have). I haven't removed the triggers from my life (except I never mix coffee and alcohol unless wishing to do a full-faced Rudolph imitation), do avoid scented facial products and hot water, and try to get my face cooled as soon as I can when it flushes. So in the end I have an even overall mild ruddiness which can probably only be changed with expensive laser treatment.
And yes, I probably should wear foundation, and, more importantly, non-chemical sunscreen every day.
By the way, those skin care products you identify as rosacea sufferers needing to avoid aren't good for anyone's face.
Perfume wearing, on the other hand, is perfectly fine, unless you're taking little nips from your flacon or using it to dry those zits.

-- Lindaloo

Vanessa said...

Hi Lindaloo,

Are you by any chance my undisclosed Siamese twin, I am starting to wonder? The Beau's lines alone (now back on one and a half thumbs!) were pretty telling for starters...

A "mild ruddiness" can sometimes be passed off as a wholesome, outdoorsy sort of complexion - if you don't feel the need to cover it up my guess is that it probably looks fairly natural anyway. Well, not that rosacea is "unnatural", but like the complexion of a non-sufferer, I mean.

Now I never thought of using perfume as a witch hazel substitute, haha, though I did try targeted blobs of toothpaste once - there was no discernible improvement to the spots and you look jolly foolish with it on.

Cymbaline said...

I swear, getting older is not for the faint of heart! I'll be 53 next month and have been through the adult acne phase and am now 'hot flashing' on a regular basis with a side serving of rosacea on my right cheek (face!). It was interesting to read your list of 'triggers' and they all certainly apply to my life as well. The 'flashing'/rosecea connection especially. Now that I think about it, they both started about the same time. Then again, it could be the stress/drinking combo!

: D Your posts are always educational-with or without perfume. Merci beaucoup!

Vanessa said...

Hi Cymbaline,

We are of a very similar age - I am 52 and also experience hot flushes on a regular basis - as I type, indeed! LOL re "side serving of rosacea"...given that the key to beauty is said to be symmetry of facial features, your lopsided affliction is doubly unfortunate.

: - (

From my reading, and what the hospital told me, hormonal changes may actually precipitate rosacea in women of our age - something to do with a major malfunction of the blood vessels.

"The hot flashes sometimes associated with menopause may bring on a flare-up or even the initial onset of rosacea."

Cymbaline said...

In spite of that darn list I intend to tempt fate by having a G & T before dinner and a lovely red wine with. All Hail! to us over 50's!

And to celebrate our two day in a row (woohoo!) streak of fair weather here in the PNW, I'm wearing Carnal Flower-it only works on me in really warm temps.

Vanessa said...

Hi Cymbaline,

Spookily, I am enjoying a G & T as well, so we can tempt fate together! : - )

Suzy said...

I have had rosacea for 15 years. No prescription creams or antibiotics helped. What healed my skin was two things they tell you not to do - I use oils to cleanse and moisturize and I regularly exfoliate with a mild enzyme not mechanical scrub. And I never use chemical sunscreens only mineral ones. The redness and bumps disappeared within a week and have never returned EXCEPT with windburn in the winter.

Vanessa said...

Hi Suzy,

Thanks for stopping by to report your own tactics for dealing with rosacea. In my reading I did also clock the fact that some people recommended cleansing with oils, but wasn't sure what brand/types of products they were using specifically. I would be interested to know more about your regime for sure, also the exfoliation product with a mild enzyme. That said, my bumps have been around for 35+ years so may be more entrenched, hormonally speaking. Roaccutane has even been mooted but I see that as a very "big gun" to be used if all else fails.

Anonymous said...

I am sorry you have to suffer such pesky skin problems and I really hope it'll get better with antibiotics (and sacrificing those lima beans!), but as long as it yields such hilarious posts I feel you are making the very best out of it. I love your writing so much! :D

Vanessa said...

Hi Olfactoria,

Yes, I am definitely giving the lima beans a wide berth, or - as the lovely German phrase goes, so often heard on traffic bulletins - "weitraeumig umfahren".

And they do say that bad news makes better copy than good, so from that perspective there may be some truth in what you say!

Undina said...

First - my sympathy, Vanessa. It is funny the way you described it but I know that it's not fun at all.
Second - I'm horrified: I still had some of my hopes about my skin problems... ;)

Vanessa said...

Hi Undina,

Your sympathy is much appreciated, and sorry to learn that you have some skin problems of your own. Do I infer you are surprised that these can persist till relatively late in life? It was an eye opener to me, I must say!

Undina said...

On my last visit to a dermatologist when I said that I needed to do something about my acne since it feels stupid to have those and crow feet at the same time, I wasn't completely serious... Deep inside I still thought that problems will end by the time real signs of aging show up... I'm calling my doctor tomorrow!

Vanessa said...

Hi Undina,

Oh dear, you are definitely in the same boat as me - apparently only a very small percentage of people who suffer with teenage acne find it is still hanging around in middle age. The doctors were intent on renaming mine, however, as rosacea at the bumpier end of the symptom spectrum. If only their cures were as varied as their terminology!

Sam said...

Hi Vanessa,

I'm 42 and started about 10 months ago with Rosacea. I couldn't believe it, at my age too. It even affected my eyelids. I was told I was of an age for rosacea with the modern day pressures of life and work ie, stress! My body was rebelling it seems! I tried everything and it just wouldnt settle down. Eventually I was given a two month low dose course of antibiotics, and also used Liz Earle Cleanse and Polish and Clinique's Liquid Facial Soap. It's worked wonders and my skin is back to normal, as normal can be! Hope this helps :)

Vanessa said...

Hi Sam,

Thanks for dropping by and sorry I didn't spot your interesting comment earlier. Those cleanser tips sound very promising - have made a note. It was apt that you should mention your eyelids - not that I have redness there, but I have noticed my eyes being more bloodshot lately, which may be related to "ocular rosacea" apparently. These things are sent to try us all right!