Beauty journalist Lisa Barrett on rosacea in menopause

Often when we are entering menopause, it’s not always the most talked about symptoms such as hot flushes and mood swings that first appear. Before I’d even heard much of the menopause, I remember hitting 50-years-old and almost overnight, my typically normal skin had taken on a dry, papery texture from head to toe – along with an intense itching that I wasn’t used to.

Apart from dry skin being a common side effect of menopause, there are other more challenging skin conditions that you might be experiencing. Among my midlife friends, rosacea is a skin concern that crops up time and again and being that April is Rosacea Awareness Month, I figured it was the perfect time to get the low-down on it – and I knew exactly who to call upon for the most reliable information.

Perimenopausal herself, Kate Kerr is an award-winning facialist and skin expert who has suffered from acne in her teens and rosacea in her 30s, so she understands exactly what it can be like to lack skin confidence as we age. And as she now specialises in treating rosacea, I asked Kate whether she could shine a light on this common skin condition and give us some practical tips and advice on how best to manage it during menopause.

What is rosacea?

Rosacea is a common skin condition characterised by facial flushing, skin hyper-sensitivity, persistent redness, broken capillaries and pimples. In more advanced rosacea, symptoms can extend to tissue distortion and it can even affect the eyes. It predominantly affects the nose, cheeks, forehead, and chin.

Is rosacea more common in perimenopause and menopause?

Kate explains that even though we may think that our rosacea has only developed since peri or menopause, we could have had it way before then but just not severely enough to cause us any concern.  She says, “Menopause is the second time in a woman’s life when hormones go awry. Problems might arise not just because our bodies are producing less oestrogen and progesterone, often it’s the imbalance between the hormones that can upset skin the most – particularly with rosacea.

Rosacea is an oily skin condition and when you have an imbalance of androgens (sex hormones) combined with hot flushes, the heat in the skin can exacerbate oil production, causing more inflammation, leading to breakouts. Add to this the fact that we have less collagen in menopause which makes the skin thinner and less able to camouflage the redness caused by broken capillaries, they will naturally appear more visible.

With the capillaries nearer the surface of the skin, they lack protection from the outside elements such as fluctuations of temperature and so are more susceptible to damage. Menopausal skin is also less hydrated which impairs the skin’s protective barrier and can lead to irritation and inflammation.”

Kate reassures me that it’s not all bad news for rosacea sufferers and there are simple lifestyle changes and skincare solutions which can help manage rosacea prone skin.

Common rosacea triggers

Anything that is consistently making the skin flush means you have a higher chance of capillary damage and the more the capillaries dilate and constrict, the more they will weaken, so try to avoid the following:

  • Alcohol has the double whammy of dilating blood vessels and affecting the imbalance of hormones which can wreak havoc on the skin.
  • Spicy food often contains the heat-producing compound capsaicin, which makes hot flushes worse.
  • Caffeine can increase blood-flow to the skin and make you feel flushed so consider swapping your morning coffee for a healthy herbal tea.
  • Steam rooms, saunas, and cold plunge pools promote extremes of temperature which is one of the most common ways to cause a rosacea flare-up.

Rosacea and wellbeing

It is understandable that a severe rosacea breakout might make you feel insecure about your looks, so the following feel-good, skin-loving tools are beneficial for a healthy mind and complexion:

  • Exercise has been shown to increase collagen production for a plumper complexion, and can also improve sleep, which encourages the skin to self-repair. Avoid over exertion to prevent the face from reddening too much and try brisk walking, gentle weight-training, Pilates and yoga which are all great for menopause health.
  • Mindful habits such as daily meditation, journaling and listening to calming music can help soothe an over-active nervous system which might trigger skin flare-ups.


Rosacea myths debunked

Myth: Rosacea needs to be treated like dry skin.

Truth: As Kate explained, rosacea stems from an overactive oily skin rather than dry skin, so getting a handle on it by choosing the right skincare regime will help.

Myth: White skins, particularly Celtic are more prone to rosacea.

Truth: While it’s true that rosacea can look more dramatic on paler skins, it doesn’t mean black or brown skin doesn’t also suffer, it’s just that it often goes undiagnosed. Kate says that black skins show rosacea with sebaceous hyperplasia (enlarged and clogged, bumpy pores). Lighter brown skin may look quite pretty and have what looks like a light flush across the cheeks, but it is actually capillary damage.

Myth: Having rosacea means you have sensitive skin.

Truth: Kate says, “People with rosacea have skin that has become sensitised – it is not in itself sensitive – and it can still be strengthened and improved back to its former health.”

Skincare tips to combat rosacea

Kate recommends:

  • If you want to try a clinic facial, look for one that includes LED light therapy which I love for my clients. It is a safe, non-invasive, effective treatment for rosacea, using specific wavelengths of light to reduce inflammation and redness.
  • Vitamin C should be added to your daily skincare regime – it’s good for strengthening capillaries.
  • Invest in a sulphur-based mask which as well as being anti-inflammatory, also helps with oil flow. Sulphur supresses sebum production and has an anti-inflammatory, antibacterial effect as well.
  • Go for water-based rather than oil-based serums as you want to avoid anything heavy and oily.
  • Retinol will help to strengthen skin and thicken the collagen, providing cushioning and protection of the blood vessels underneath. Retinol also activates angiogenesis which produces new, healthy blood vessels and clears out old, damaged vessels. Start off with a 0.5% formulation and build up.
  • Contrary to popular belief, not all acids in skincare are bad for rosacea. When cleansing, look for salicylic acid which helps to control oil. It’s anti-inflammatory and exfoliates the debris in the pores. Azelaic Acid boosts skin turnover to unclog pores and reduce inflammation. Glycolic Acid is one to avoid as it is more active and can be irritating on irritated skin.
  • Never, ever go without sun protection. Wear it daily, even when the weather is rainy and cloudy.


Rosacea-friendly skincare

Here are my top product choices designed for optimal performance on rosacea-prone skin:

  • A high-quality sunscreen is essential! Alpha-H Daily Essential Moisturiser SPF50+ is good. This formula is super lightweight and is rich in vitamin E, known for its skin soothing and anti-inflammatory properties.
  • The delicate eye area needs hydrating and comforting. Bloom Effects Black Tulip Eye Cream contains azelaic acid, niacinamide, aloe and chamomile, all known to be beneficial for rosacea.
  • To help control excessive oil, reduce inflammation and redness, add a little Sunday Riley B3 Nice 10% Niacinamide Serum every other day to help control excess oil and reduce inflammation and redness.


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We understand there’s a lot of information out there on the menopause. You can read through the NICE guidance on menopause management, as well as the NHS overview on the menopause.