Perimenopause can affect every organ system in your body, and your skin is certainly not an exception. Between hormonal acne, skin discoloration, changes in hair growth and distribution, and rosacea, all is fair game when it comes to perimenopause. Let’s focus on perimenopause rosacea for a not-so-hot minute to see why it can happen and how to treat it. 

What is rosacea?

Rosacea is a surprisingly common inflammatory skin condition characterized by redness, visible blood vessels, and small red bumps. Sometimes, the bumps contain fluid. Typically, rosacea develops around the center of the face, covering the cheeks and nose. Often, people assume rosacea is acne or ruddiness. However, it is crucial to treat rosacea at its earliest sign as it can cause skin thickening and scarring if left untreated. 

Anyone can develop rosacea, but it is most common in women in middle age. Also, it is more likely to occur in people with lighter skin, a history of smoking and sun damage, and family members with rosacea.  

Look for these signs when you are identifying if you have rosacea perimenopause:

• Redness on your cheeks and nose. 
• Swollen red bumps that look like acne
• Enlarged nose from swelling and skin thickening (although this is more common in men than women)
• Eye complications, such as periorbital swelling, and dry, irritated, red eyes (also known as ocular rosacea)

Can perimenopause cause rosacea?

Any chance you were convinced as a teen that your acne would pass once you were an adult? Yea, us too. Unfortunately, that is not the case. Acne can affect people at really any point in their life, although it is most often linked to stress and hormones. And just when you think you should be over hormonal skin issues once you are in your 40s to 60s, your skin can take a turn for the worst. It’s regrettable, we know. However, there is good news, so sit tight!

Perimenopause can certainly cause rosacea. Remember, perimenopause is a time of significant physical changes driven by fluctuating estrogen and progesterone levels. Our skin is often a window into those hormonal changes, so when our hormones are all over the map, our skin becomes easily irritated and prone to inflammation. And, let’s not forget that perimenopause can also be a stressful time in a woman’s life that is often met with anxiety. Furthermore, hot flashes can cause vasodilation near the skin’s surface, which increases redness and can cause a rosacea flare-up. 

What aggravates perimenopause rosacea?

The cause of rosacea is largely unknown, but certain triggers make it worse and cause flare-ups, including: 

• Spicy foods
• Hot beverages
• Alcohol, especially red wine
• Extreme hot or cold temperatures
• Exposure to the elements (wind, sun, snow, etc.)
• Exercise (because it causes vasodilation in your skin)
• Cosmetic and skincare products
• Medications that cause vasodilation, such as blood pressure medications
• Emotions

How to treat perimenopause rosacea

There is no cure for rosacea. However, early interventions aimed at controlling and minimizing its effects can manage and mask this skin condition. If you notice rosacea or acne-like symptoms, such as redness, swelling, and red bumps on your cheeks and nose, make sure to meet with a dermatologist (a medical doctor who specializes in the skin).  

The American Academy of Dermatology recommends the following options for treating rosacea:

Managing your triggers: Find out what triggers a rosacea flare-up and figure out ways to avoid them, if possible. 

SPF is vital: Protect your skin from the sun all year round with sunscreen, a hat, and avoid the sun when it is strongest each day. Use an SPF product that is at least 30 SPF or higher. If you have trouble using a sunscreen that does not irritate your skin, look for products that contain zinc oxide or titanium dioxide. 

Good Skin Care Practices and Products: Perimenopause rosacea is not due to poor hygiene. However, it is important to provide gentle skincare to minimize irritation and inflammation. Use a mild cleanser on your fingertips to clean your skin and rinse with lukewarm water. Avoid washcloths, toners, and astringents, as they can worsen the redness. Your dermatologist can make a good recommendation for skincare products if you find other products sting or aggravate your skin.   

Paula’s Choice CALM Redness Relief Moisturizer 

This moisturizer is designed to provide refreshing hydration to lessen signs of aging while calming the appearance of redness and sensitivity.

Laser and light-based therapies: These types of therapies can have long-lasting effects, although they rarely are covered by insurance and often require multiple sessions. Not everyone is a candidate for this type of treatment, so it is essential for a dermatologist to verify this is a safe option. 

Prescription Medications: Brimonidine gel and oxymetazoline hydrochloride gel are FDA-approved to treat rosacea. These medications have only a few temporary side effects. These medications reduce redness for 12 hours after use. 

Perimenopause rosacea is not due to poor hygiene. However, it is important to provide gentle skincare to minimize irritation and inflammation.

Unlike teenage acne, which tends to improve with age (for at least a few years), rosacea can worsen even after menopause if left untreated. This is because the skin can thicken and scar over time, which makes it harder to treat. Therefore, seeing your doctor as early as possible can help minimize longterm changes in your skin. (And, using green in your makeup can oppose the red tones to neutralize your skin color 🙂 )  

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.