What's been working for me
It's hard to know if this post will even be helpful, because I do sooooo many things, and our skin and our rosacea is so individual. (I have Type I and II.) But, since I have had some sustained success over the last few months, I figured I would give it a shot. I started 200 mg daily of minocycline (I did not want to bury the lede), which I do think has been a big part, but I also think my skincare and a couple other internal things have been doing some heavy lifting.
My skincare routine:
AM (if showering):
* Cetaphil Gentle Skin Cleanser
* Sulfur-sulfacetamide 5-10% face wash (I use it as a mask in the shower, after the Cetaphil)
AM (if not showering):
No wash, just jumping in with the following:
Skin flooding application of the following topicals (applying to very damp skin in layers, not allowing the previous layer to fully dry down):
* Curel Hydrating Water Essence
* 15% Azelaic Acid foam
* .75% metronidazole cream
* Curel Anti-Wrinkle Hydrating Serum
* Curel Moisture Facial Milk
* Curel Intensive Moisture Facial Cream
* Freeman's Moisturizing Gel Mask with glacier water and pink peony (I use this in a largish dollop--maybe canned chickpea size--as a topper.)
* Either MD Solar Sciences Mineral Creme in SPF 50 or Supergoop Zincscreen in SPF 40
PM:
* Bioderma Sensibio Micellar Water (I put it in an automatic foaming dispenser and rub the foam into my skin with my fingertips, doing a gentle massage all over to break my sunscreen, etc. I make sure to be thorough around my lashes and eyebrows, because I am pretty sure I have Demodex. If my face feels very dirty due to sweat, or the rare makeup day, I do this twice.)
* Kirkland Signature baby wipe to gently swipe away any residue (it honestly was fine when I just used a tissue, I never suffered any breakouts from residue, but I like not having lint on my face)
* The Ordinary Squalane Oil
* .1% Tazarotene
Internally:
* 100 mg (twice daily) of minocycline (I actually usually end up taking 100 mg a day, because I often forget to take my second dose to allow enough timing in between my supplements, but this dose is working great, and I am going to just drop to 100 mg on purpose, and then ask my doctor about switching over to 40 mg extended release doxycycline)
* 40 mg (twice daily) of famotidine (apparently there is a large link between GERD and rosacea. I was diagnosed with silent reflux by an ENT 3 years ago, and the 40 mg pills are a prescription dose. I get Asian Glow when drinking, and do take a pill prior to drinking to minimize it, so not putting together the two sooner is perhaps an indication of faltering intelligence. 🫠)
* 15 mg of zinc M-W-F (I honestly don't know if this helps, but posts on here--and subsequent research--is why I started taking it; I chose the dose to avoid zinc poisoning.)
* Sports Research 12mg Astaxanthan (I don't know if this is helping with my rosacea, but since it is the "King of Antioxidants" and rosacea is an inflammatory condition, I just assume it does.)
* Lots of other unrelated (I think) supplements, but happy to provide a more extensive list, if asked.
Hair:
I switched over to Paul Mitchell Tea Tree Special shampoo and conditioner. I believe I have Demodex on my scalp, too, and I think that has been the cause of my decades-long scalp acne. I no longer get scalp acne.
Notes:
I am allergic to aloe, sensitive (to a lesser degree than my aloe allergy) to centella asiatica-madecassoside, and niacinamide and hyaluronic acid (sodium hyaluronate) both trigger the fuck out of my rosacea (the amount of niacinamide in the Cetaphil Gentle Skin Cleanser doesn't seem to bother me, perhaps because of limited contact and the fact that I rinse it off). I know I look like a Curel shill, but all of the products in my routine have been selectively chosen after YEEEEARS of trial, error, and ingredient elimination. (I am 41.)
General flushing triggers are wind, cold, heat, capsaicin, caffeine, nightshades. I will never give up coffee, peppers, tomatoes, or gardening, but lately I am flushing sooooooo much less, even in the face of general triggers.
I know my routines and medication/supplements are extensive, and I don't know how helpful it is, but I figured if it could help anyone that it was worth posting.