Rosacea: Why Me? Why Anybody? - Sydney, Australia

I was diagnosed with Rosacea recently, and it is horrible. I have tried many types of treatment, and am still actively seeking a suitable and efficacious treatment for it. This review is intended to allow me to share my experiences with searching for a good treatment option, possibly help others by sharing this information, and possibly be helped by others' information.

My face has a skin problem. It has an extensive history. This present recount will outline, as succinctly and accurately as possible , the symptoms and history of my face.
For the impatient reader, I will roughly describe the problem here before I go into how it came to be. It is important to note that my skin has not always been problematic. This problem is characterised by extreme but localised flare-ups of the rawest, deepest red and swelling on both my cheeks. It is accompanied by sensations of burning and stinging, as well as a feeling that my cheeks are somehow foreign to the rest of my face. The symptoms occur spontaneously and typically last for hours. At its worst, they do not subside for days. The initial occurrence of these symptoms is sudden, and as yet, unexplainable. Symptoms generally improve gradually over several months, but leaves behind splotches of redness, slight swelling and different skin texture in the affected areas. These splotches are, as yet, still unexplainable also. Gradually, the splotches fade from red to dark purple and/or brown over the course of years. However, another flare-up will once again start the aggravating cycle and thus bring the same symptoms all over again.
Now for the patient reader, I will outline as best I can how this all came to be . One day when I was 14 (in 2009), my face broke out with huge (about 1 cm in diameter) boil-like pimples on both my cheeks . I have no idea (or no recollection) of what caused this break out .
My mother bought me some acne medication from the pharmacist . As I recall, it was OXY 10. Although the product may have changed in the years since I used it, here is some information on the product taken from a pharmacists’ website :
Ingredients
Contains 10% Benzoyl Peroxide
Directions
…Initially apply cream to a small affected area once a day for the first two days. If no discomfort or reaction occurs, apply up to twice a day.
CAUTION: …If excess swelling, irritation, redness or peeling occurs, discontinue use. If these persist, consult a physician. Avoid excessive exposure to sunlight and other sources of ultraviolet (UV) light. Avoid prolonged use of this medication without consulting a physician…
Initially, this product seemed to work for me . However, I did not exactly follow the directions of use. I did not do a test patch and applied it extremely liberally , all over my cheeks, possibly for 2 or 3 days.
Some days later , I had a shower and experienced intense itching on my face. I felt my face, and was surprised to find that it was smooth. I thought immediately that the acne medication worked, and I was now pimple free (as I could not feel any pimples). I then liberally scratched the itch on my face.
When I got out of the shower and looked in the mirror, I saw that my face had turned bright red and had swollen immensely. I had no idea what had happened, but I reasoned that the acne medication was probably responsible. I also had no idea what the problem actually could be.
The redness and swelling at the time was characterised by a few noteworthy features. My face would look red raw and angry, puffy and swollen. Small white pimples also appeared on top of the red skin . The affected areas felt foreign and heavy, and a stinging and/or burning sensation would accompany .
In the following weeks, I may or may not have seen my General Practitioner (GP; hereon referred to as “Dr J” ) about it . However, Dr J probably did not give me a conclusive diagnosis that would lead to efficient and effective treatment at the time.
Eventually, the redness and swelling subsided over a few months. At the time, I was using oil-based moisturisers heavily , and so as the symptoms subsided, fresh acne and whiteheads appeared. However, these pimples were not of the kind described before . Rather, they were smaller pimples, quite probably caused by a build-up of oil and dirt in my pores.
What emerged after the redness and swelling subsided were a few differences between the affected and unaffected areas of skin. Splotches of redness/pinkness surfaced, which bore close resemblance to acne scars (I therefore concluded that they were left behind by the huge boil-like pimples that instigated this whole saga). Most of the surface area of my face was covered in these splotches, such that my whole face appeared red/pink unless one looked closely. The affected skin was also a different texture, and seemed to produce more oils than other areas. The affected areas were also slightly raised and puffy, and had enlarged pores (or pocked acne scars).
The subsidence of the flare-ups and its symptoms did not, unfortunately, mean its eradication. Over the next few immediate months and even years , I would randomly and spontaneously experience flare-ups, albeit not as extreme as initial flare-ups and absent the small white pimples. The affected skin was still a different texture, and the red/pink splotches still remained .
Over the next year after the initial flare-up, I had perhaps one or two more bad breakouts that resulted in the aforementioned boil-like pimples . I foolishly used OXY 10 to medicate myself, and once again experienced the same reaction. However, at that time, I was constantly flaring up anyway (albeit to lesser degrees of severity) so my reaction to OXY 10 made little difference. I finally decided that it was for the best that I dispose of OXY 10 and never use it again.
Despite disposing of OXY 10 , flare-ups would keep happening over the next few years. They happened both seemingly randomly and for a variety of reasons . Curiously, occurrences of flare-ups would be negatively correlated with sleep. That is, if I did not get enough sleep the previous night, a flare-up would occur the next day.
Over the years I became skilled at recognising what did and did not cause flare-ups , and my skin also began to gradually heal. The red splotches remained, however. I had always thought these to be acne scars , and treated them as such .
Gradually , things began to improve. Flare-ups would occur much less often , and the red splotches faded . Eventually, flare-ups caused by a lack of sleep the previous night were resolved if I slept for long enough the next evening. Furthermore, these flare-ups were not as painful and the redness and swelling would not be as extreme as before. By the end of last year (2013), flare-ups rarely occurred , and the splotches had faded considerably, such that they were no longer red/pink but rather a dark purple or brown colour. They were also less noticeable, and one could hardly notice them in most lighting situations except for under close inspection.
This year (2014) in April, an extreme flare-up (like those that happened back in 2009) occurred again. I experienced the same symptoms that I had not experienced for a number of years: extremely raw localised redness and swelling; burning and stinging pain; spontaneous occurrence and long-lasting stubbornness. Before this recent flare-up, I had been using an exfoliator every day for a number of consecutive weeks . This led me to think that over-exfoliation and sun exposure had caused my all-to-familiar symptoms.
When the flare-ups occurred, I stopped exfoliating and used a regular face-wash . To treat, I used a variety of moisturisers , gels and ointments . I used SPF 50+ sunscreen and tried to avoid excessive sunlight. I drank plenty of water throughout the day, and had plenty of sleep throughout the nights. None of this helped. However, about 4-6 weeks after the initial aggravation, I was able to find immediate yet temporary relief by splashing cold water onto my face.
I saw Dr J, this time making the consultation explicitly about my face. I told Dr J that I thought I had over-exfoliated and become over-sensitive to the sun, which made me sunburn easily. Dr J explained that this was not the case for a variety of reasons . Dr J thought I was having a reaction or rash to the many products I was using to treat my symptoms and advised me to stop using so many products and stick to just one . She also prescribed me a topical corticosteroid cream .
Following this consultation, I used only one moisturiser and applied corticosteroid cream twice a day on the affected areas. I noticed a significant improvement, and it worked extremely well in the first few days, such that the redness and swelling had significantly subsided and I did not experience any extreme flare-ups. However, by about day 5 of using the corticosteroid, its effectiveness waned. I continued use until day 6, and a week after my consultation, I did not apply anything. On this day , my face flared up again.
In the next few days I restarted use of the corticosteroid, in the hopes that it might work again like it had the previous week. Symptoms actually became worse. The redness, swelling and pain would return with such intensity that I felt like my face was burning itself off .
I then saw Dr J and explained what had happened. I explained that I had followed all given instructions and that symptoms had gotten markedly better then significantly worse. I explained that I was able to find immediate but short-lasting relief from the redness, swelling and pain by splashing cold water on my face, but that this would last for a very short time. Dr J then said that it was not a rash, but perhaps I was merely prone to flushing, and that the red splotches were in fact prominent and dilated blood vessels. Dr J advised me to stop using the corticosteroid cream, and try to keep my temperature as low as possible. I was clearly dissatisfied with such a diagnosis, and Dr J admitted to being unsure about it. Dr J then posited that perhaps I may have Acne Rosacea, and wrote me a referral to a dermatologist, whom I am yet to see .
My experience with these flare-ups has given me a good idea of what typically happens. Something causes the initial intense flare-up, which is characterised by extreme, localised redness and swelling; burning and stinging pain; a feeling that the affected areas are foreign; spontaneous occurrence of symptoms lasting for hours; persistent redness even when not “flared-up”. Then, as weeks go by, the flare-ups become less intense and the persistent redness fades to small red splotches . Over time, flare-ups will occur less and less often, and the red splotches will randomly vary in their redness. The affected areas (now covered by red splotches) will be slightly raised and puffy looking, with a different texture and enlarged pores (or holes). Gradually, over years, the puffiness will flatten out and the red splotches will fade, turning dark purple and then brown. The skin will then appear (almost) normal, and the splotches will only be noticeable under close inspection. However, minor flare-ups will occur after a night of insufficient sleep, but these flare-ups are resolved easily and within a day.
At the time of writing this, I am at the stage where I have the red splotches that are quite visible and apparent, and vary in their redness from time to time. If my recollection and inference of past experiences is correct, it will take years to get back to where my face was before this most recent series of flare-ups.
I want to fix this. I cannot wait any longer. I want to find out what initially caused these symptoms, what keeps causing these symptoms, how to treat these symptoms, and how to cure my problem.