Chemical Peels with Rosacea? Yes.

Do you have adult acne? I thought I did too.

I discovered a few years ago, when I started getting acne in my 40s, that it wasn’t acne at all. It was rosacea, type 2, referred to in the medical world as P&P or papulopustular rosacea. Sounds pretty, eh? "Most people classify rosacea into four types," says Sandra Marchese Johnson, MD. “Papulopustular rosacea or inflammatory rosacea’s key symptom is chronic red [patches] on the face, as well as an outbreak of red bumps and pimples. These bumps, known as pustules and papules, are different from actual acne and require a different treatment." [1]

This is a picture with a rosacea flare on my face: red, inflamed bumps that look like pimples somewhat, rough, tight skin. This is not an easy picture to post, but I think it's important for people to understand that rosacea skin SHOULD be treated with peeling agents. It's really the only thing I've found that keeps my skin clear, and I've used metro gel, azeliac acid, steroids, antibiotics, and more. 

Here's my skin now: click both to enlarge.

My keys to successful chemical peels with rosacea are …

1.      Dr. Steven Wallace in Manhattan says, “get the rosacea under control before doing anything else,” [2] and I totally agree. Find triggers and avoid them! This is a time-consuming process, but well worth it. I won’t bore you with how to do that, but post a comment if you’re interested and I’ll reply on the method that worked for me.

2. Use a gentle chemical peel agent on a regular basis, such as 5% glycolic acid in combination with 2% salicylic acid; alternate these on an interval that works with skin type and problems. BHA is also a great anti-inflammatory agent, so this will help! I use one of these every night, although I substitute the glycolic acid with retin-a about 3 times a week.

3. Do not proceed with a scheduled chemical peel if flaring; wait until flare is completely gone. My medium chemical peel of choice is TCA at about 25%, and I try to do this at least three times a year.

4. Stop the daily exfoliants 3-10 days before the scheduled chemical peel, depending upon skin condition

5. Clean up diet, which will help flares and contribute to better skin overall

6. Get a copper-based healing moisturizer to use post-peel only; don’t use this regularly because too much copper is bad for the skin but great for healing

7. Find a good zinc-based sunscreen to use every day, not just after the peels

I've linked the products I've found to work best with my skin.


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