What’s the Relationship Between Rosacea and Menopause?

Rosacea is a chronic skin condition that typically affects the face, neck, or chest. Doctors characterize it as a rash, pimples, redness, and broken blood vessels.

Hot flashes — a common occurrence during menopause — can cause the same areas of the body to flush and feel warm to the touch.

Not only can this rush of warmth set off a full-body sweat, but it may also trigger a rosacea flare-up. Because of this, it is often necessary to treat the symptoms of both menopause and rosacea concurrently.

Hot flashes associated with menopause may cause rosacea to flare up, but doctors do not know the root cause of the condition. Rosacea symptoms may linger even after the hot flashes relating to menopause subside.

The following factors may play a role:

• the way your body processes the protein cathelicidin
• hypersensitivity to skin mites that live near hair follicles
• changes in the blood vessels under your skin
• having an overactive immune system
• your genetics

You may be more likely to develop rosacea if you have:

• fair skin
• a history of cystic or nodular acne
• a family history of rosacea
• Irish, English, Scottish, Scandinavian, or Eastern European ancestry

The first sign of rosacea, or prerosacea, is typically blushing or flushing of the face. You may notice persistent redness around your nose. Over time, this inflammation may spread to the rest of the face and neck.

Rosacea typically presents in four unique ways:

• Subtype 1, or vascular rosacea: The blood vessels under the face swell, causing the skin to become swollen and feel warm to the touch.
• Subtype 2, or papulopustular rosacea: Pimples and pustules form across the face and neck.
• Subtype 3, or rhinophyma: The nose of the skin thickens, and the oil glands on and around the nose become enlarged.
• Subtype 4, or ocular rosacea: The skin around the eyes or the eyeballs themselves become red, causing the eyes to sting, burn, and water. It may feel as though there’s something in the eye.

Many people experience a combination of these symptoms.

In darker skin tones specifically, rosacea may also present as dusty, brown discoloration and yellowish-brown hard bumps around the mouth and eyes.

Different types of dermatitis, shingles, and other skin rashes can appear as warm, red, and inflamed lesions on the skin. Therefore, it is important to speak with a dermatologist or other healthcare professional.

They can help determine the underlying cause of your symptoms and advise you on any next steps.

The hormone estrogen helps maintain your skin’s structure and aids in hydration. By stimulating the production of collagen, elastin, and hyaluronic acid, estrogen helps your skin stay plump and firm.

The hormone progesterone helps regulate the production of sebum, which moisturizes and protects your skin.

During menopause, these hormones decrease, leaving your skin without these vital nutrients.

As a result, the skin may become dry and irritated. Health experts believe this may trigger more intense rosacea symptoms than people have previously experienced.

At this time, there is no cure for rosacea. Your individual treatment plan depends on how severe your symptoms are and what areas they affect.

A clinician may recommend a combination of medication and surgery. They may also help develop an appropriate skin care routine.

Medication

In less severe cases, medications can help control the symptoms of rosacea.

This can include:

• oral retinoids, such as isotretinoin (Accutane), which prevent skin glands from producing oil
• topical medications for treating inflammation — these medications can include tretinoin (Retin-A) and azelaic acid (Azelex)
• topical and oral antibiotics to treat inflammation and redness, such as metronidazole, sulfacetamide, tetracycline, erythromycin, and minocycline

Medical procedures

Different medical procedures may be useful for treating more severe causes of rosacea.

These can include:

• dermabrasion to remove the top layers of the skin
• laser resurfacing to reduce the size of enlarged blood vessels
• cryosurgery to freeze and remove unwanted tissue

Rosacea flare-ups can last anywhere from a few minutes to a few weeks. It varies from person to person and even situation to situation.

The best way to control flare-ups is to know what’s causing them. Keeping a record of your specific triggers — such as stress, certain foods or drinks, and sun exposure — can help you identify any patterns and adjust accordingly.

Apply sunscreen daily to all exposed areas, including your face, ears, neck, and chest, to help protect the skin against harmful UVA and UVB rays. Make sure your sunscreen has an SPF of 30 or higher, and reapply at least once every other hour.

Use facial cleansers and other products that could irritate your skin sparingly. If possible, switch to fragrance-free detergents and soaps to minimize flare-ups.

Common skin care elements that may irritate the skin include:

• alcohol
• witch hazel
• camphor
• fragrance
• glycolic acid
• lactic acid
• salicylic acid
• benzoyl peroxide
• menthol
• peppermint
• eucalyptus
• sodium lauryl sulfate

Certain dietary changes may also help ease rosacea symptoms. Consume the following foods and beverages sparingly if you find they trigger hot flashes or other symptoms:

• alcohol, especially wine and liquor
• spicy foods, such as hot peppers, chili, and salsa
• foods that contain cinnamaldehyde, such as tomatoes, citrus, cinnamon, and chocolate
• hot drinks, like coffee and tea

Anxiety around your face and skin changes, along with other menopause symptoms, can feel overwhelming.

If your symptoms are causing you mental or physical distress, it is important to consult with a doctor or other healthcare professional. They can help you develop a treatment plan that suits your individual needs.

If you have concerns about changes in your skin, take a log of your symptoms with you to your appointment. The following information can help your clinician make a diagnosis:

• whether you are experiencing any itching, burning, or pain
• where on your body you first experienced symptoms
• whether your symptoms have spread to other areas of the body
• when you first noticed your symptoms
• if you suspect that something triggered your symptoms
• any treatment methods you have tried

Your clinician may request a skin sample or blood test to help rule out other skin conditions.

Certain symptoms should prompt immediate medical attention:

• a rash that spreads quickly or appears all over the body
• a rash that leaks green or yellow pus or feels hot to the touch
• a rash accompanied by a fever of 100.4°F (38°C) or higher

The underlying cause of rosacea is still unknown, but the condition is treatable. There are a variety of options available to help reduce inflammation and improve your quality of life.

Treating the symptoms of menopause, such as hot flashes, may also soothe inflammation and other rosacea symptoms.

Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.