Guest Post by Makeup & Medicine : The Lowdown on Rosacea

Today’s post is a guest post written by Caecile who has a Youtube channel called Makeup & Medicine. I met Caecile on Instagram and we bounded over the fact that we are both 30-something women suffering from rosacea (that’s why the blog is called « A Girl With Pink Cheeks »). As a doctor, she has a good knowledge of rosacea and this post is all about explaining what it is exactly. If you want to know more, head to her channel for a video about this or makeup tutorials ;)

The Lowdown on Rosacea

Let me introduce myself: My name is Caecilie Johansen, I’m a medical doctor, living in Copenhagen Denmark. And just like Isabelle, writing this blog, I have rosacea too. Rosacea is a common chronic inflammatory skin condition affecting the face. It is characterised by flushing, redness, pimples, pustules, and dilated blood vessels also called telangiectasia. People with rosacea often have irritated and highly sensitive skin, reactive to skincare products and makeup. Before we break down the four subtypes of rosacea, let’s have a look at whom it affects.

Who’s the lucky bunch?

If you are fair-skinned woman in your thirties and your mother has it – then bingo! And oh, that’s me :-/ It’s more common in women than in men, and most frequently observed in fair-skinned individuals, especially of Northern European and Celtic origin. It affects one to ten percent of this population. So look around in your class or your work place, then at least one is suffering form rosacea. Typically rosacea appears at the age of 30 to 50 and is associated with familial predisposition. So if your mother has it, then you are likely to get it too, but the genetic basis of rosacea remains unclear – that’s doctor-lingo for “We haven’t figured it out juuust yet”.

You are not alone (WARNING: following section contains gross details)

You might think that I would refer to a support group for rosacea patients. But no. Let me warn you, this coming section is not for the faint hearted: The mite Demodex Folliculorum is considered to play a role in the pathogenesis of rosacea. Demodex mites live in the hair follicles – in everyone – yes, in your hair follicles too! However people with rosacea have a significantly higher density of these charming bastards in their skin. The theory is, that the presence of these mites stimulate inflammatory reactions in the skin, hence the abovementioned symptoms. So when you feel your nose itch at night, then it’s just a little Demodex crawling from one hair follicle to another.

Demodex-folliculorum på hår

The four subtypes

Rosacea is divided into four subtypes:

  • Erythematotelangiectatic (persistent redness and telangiectasias)
  • Papulopustular (a.k.a. acne rosacea)
  • Phymatous (thickened skin, typically of the nose, in Danish also know as ‘strawberry nose’)
  • Ocular rosacea (eye irritation, blepharitis and other eye symptoms)

I’m going to focus on the first two and most common subtypes.

Oh the joys of erythematotelangiectatic rosacea

This tongue twister is the subtype I suffer from – in a mild form. I’m predisposed to rosacea because my mother has is (this subtype as well) and my oldest big brother has the ocular subtype. People with erythematotelangiectatic rosacea experience persistent redness of the central face (cheeks, nose and around the nostrils) and flushing. Flushing is typically triggered by heat, physical activity, alcohol consumption, sun exposure, emotional stress and spicy food.


So after my 10 kilometres morning bike ride in the rising sun, I’m all flushed, radiating like a red light bulb. After three sips of alcohol I have purple-pink cheeks all the wrong places. If I get nervous when I have to speak in public, I feel the redness blooming in my face like unwelcome red weed.

Acne Rosacea

Papules and pustules = lumps and bumps characterize this subtype. It can be misdiagnosed as regular acne, however unlike regular acne, comedones (clogged pores) do not occur in rosacea. My rosacea started out as this acne form. It appeared out of the blue in the middle of my pregnancy with my first son. I consulted a dermalogical prossor, Robert Gniadecki, who hypothesized that the sudden onset could be caused by the hormonal changes in my body. The lumps and bumps gradually faded away after 10 days, and I received no treatment.


Treatment options 

  • Medical treatment: Especially aimed at moderate to severe rosacea, prescription creams such as metronidazole, azelaic acid, and doxycycline are recommended. The ocular rosacea is treated with cyclosporine 0.5% ophthalmic emulsion. See some impressive before/after photos here:
  • Laser treatment: The visible blood vessels and the underlying redness can be treated with laser or intense pulsed light therapy, however it often requires several sessions and later touch-ups as the skin condition continues to develop.
  • Cosmetic options: Products with green or yellow undertones can counteract the visible redness. However, I don’t use green or yellow primers, I prefer to use a medium to full coverage foundations and reapply the foundation in the areas needed.
  • General skincare options: I personally prefer perfume and paraben free skincare products. They feel gentler on my sensitive skin. As recommended by the National Rosacea Society: « Non-soap cleansers may be the best option – they contain less than 10 percent soap, rinse off easily, and have a neutral pH that is closer to the natural pH of the skin. Washing with lukewarm water and blotting the face dry with a thick cotton towel may also minimize irritation ».

I hope you found this blog post informative. Watch my video on the topic and stay tuned for my next tutorial: My Rosacea Foundation Routine. Read our next blog post about the skincare and makeup products Isabelle and I personally use for our rosacea pink cheeks.


Caecilie Johansen




6 thoughts on “Guest Post by Makeup & Medicine : The Lowdown on Rosacea

  1. stashmatters says:

    Ahhh that hair follicle image! But very informative post.
    Luckily I don’t suffer from it but I know a few people who do. My face only flushes when I drink red wine! :P I do get hives though – it’s difficult to pin down what triggers them.

    Liked by 1 person

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