Broken capillaries on nose

[Sydney2000]

Hi all,

New to the forum and as the title to my thread suggests, I am over Rosacea and am sure I am not alone.

I don?t seem to have much of an issue on my face per se. I do get flushing and mild redness but It is only mild.

My issue is I have broken capillaries all over my nose. They have become so much more apparent in recent months. It only seems to effect my nose which happens to be the most prominent part of my face.

I have tried laser (pulsed dye), which worked well but it just keeps coming back. This flare up is the worst it has ever been. Which is strange as I have not been in the sun (lockdown), still using mild cleansers, sunscreen if I do go out, haven?t been drinking alcohol.

I have tried retin a cream, rosex for about 5-6.

I don?t use alcohol based products and my skin is sensitive.

I am booked in for laser as I just want it gone and feel as though letting it go for any longer will only make things worse.

Also, I do get quite porous and get blackheads on my nose but at afraid of using an Exfoliants. Any tips on what I can use?

Has anyone has similar issues? What have you tried? Was it successful?

Any advice on products or treatments is much welcome and much appreciated.

[Brady Barrows]

Sidney, welcome to RF. When you say you are 'over rosacea' not sure what you mean? When you say you are 'over a flu' it means to me that you are better, and you do say your rosacea is mild redness and flushing.

As for the 'broken capillaries all over [your] nose' which is Phenotype 3, you are scheduled for the correct treatment when you mention you are 'booked in for laser.' VeinWave, or the newer version, VeinGogh, will remove facial spider veins. Iridex 940 laser, Microfocused Ultrasound, 532 and 940nm wavelength lasers are effective for facial telangiectasias, or what is commonly called spider veins.

You may want to look into tranexamic acid solution for your issue as well. There are a number of different over the counter treatments for spider veins.

As for blackheads, which are usually associated with acne and not rosacea, you may want to scroll through these treatments for blackheads. You may want to know the difference between acne and rosacea?

[ElaineA]

Hi all,

New to the forum and as the title to my thread suggests, I am over Rosacea and am sure I am not alone.

I don?t seem to have much of an issue on my face per se. I do get flushing and mild redness but It is only mild.

My issue is I have broken capillaries all over my nose. They have become so much more apparent in recent months. It only seems to effect my nose which happens to be the most prominent part of my face.

I have tried laser (pulsed dye), which worked well but it just keeps coming back. This flare up is the worst it has ever been. Which is strange as I have not been in the sun (lockdown), still using mild cleansers, sunscreen if I do go out, haven?t been drinking alcohol.

I have tried retin a cream, rosex for about 5-6.

I don?t use alcohol based products and my skin is sensitive.

I am booked in for laser as I just want it gone and feel as though letting it go for any longer will only make things worse.

Also, I do get quite porous and get blackheads on my nose but at afraid of using an Exfoliants. Any tips on what I can use?

Has anyone has similar issues? What have you tried? Was it successful?

Any advice on products or treatments is much welcome and much appreciated.

The common Microscopic Demodex Skin Mites can cause blackheads as well as the broken veins (telangectasia). Recommend getting tested for demodex. A knowledgeable dermatologist can take a skin sample, look at it under the microscope and try to count the number of demodex.

A healthy immune system normally keeps the demodex population in check. The mites can get overpopulated if the immune system is down due to an infection or stress, etc.

If its demodex causing the issue then there are 2 prescription anti-parasitic treatments that can help. The oral treatment is more effective and faster than the topical.

Topical: Soolantra (also known as Rosiver outside the US) Cream - 1% Ivermectin solution in a moisturizing cream base. Used at night before bed on a clean face. Treatment takes 12-16 weeks. Only works on the area treated. Reduces the population though may not eliminate the demodex colonies.

Oral: Best: Inexpensive, Combined 2 Drug Oral Treatment published in a medical study on 120 patients. Other Options: Oral Ivermectin tablets or just Oral Metronidazole tabletss. Treatment takes 2 weeks. Works to kill the demodex all over the body. More information about this treatment is posted here:
https://rosaceagroup.org/The_Rosacea...dex-Skin-Mites

If the prescription treatments are not possible for you, then 1.87% Ivermectin Horse Paste is available from Amazon for about $5 per tube. It can be applied topically and is much cheaper than Prescription Soolantra.

Washing the face with a tea tree oil based cleanser can be helpful (Desert Essence, The Body Shop, eco eyes are several good brands). A DIY borax based cleanser also is helpful.

Use a clean towel for the face every day. Mites can live on a wet towel for up to 54 hours. Ordinary laundering in an automatic clothes washer and dryer at 58 degrees C. will kill the mites.

Products containing Salicylic Acid are good at dissolving blackheads. Here's a few products that I have used: Epionce Lytic (available in 0.5%, 2% and 3% strengths), Paula's Choice 2% BHA LIQUID EXFOLIANT. Other brands and products like Neutrogena Rapid Clear Acne Eliminating Spot Treatment, Clearasil Rapid Rescue Spot Treatment Gel with Salicylic Acid, Derma e and others make products containing Salicylic Acid that can work as well.
The blackheads are the debris left behind by the mites. Once the mites are under control the Salicylic acid products can help more to clear the pores.

[Sydney2000]

Sidney, welcome to RF. When you say you are 'over rosacea' not sure what you mean? When you say you are 'over a flu' it means to me that you are better, and you do say your rosacea is mild redness and flushing.

As for the 'broken capillaries all over [your] nose' which is Phenotype 3, you are scheduled for the correct treatment when you mention you are 'booked in for laser.' VeinWave, or the newer version, VeinGogh, will remove facial spider veins. Iridex 940 laser, Microfocused Ultrasound, 532 and 940nm wavelength lasers are effective for facial telangiectasias, or what is commonly called spider veins.

You may want to look into tranexamic acid solution for your issue as well. There are a number of different over the counter treatments for spider veins.

As for blackheads, which are usually associated with acne and not rosacea, you may want to scroll through these treatments for blackheads. You may want to know the difference between acne and rosacea?

Hi there,

Thank you for responding and the welcome to the forum.

Sorry I should have been a little clearer in my post in regards to being over it. What I mean is that I have become quite deflated by this condition. Please don?t take it the wrong way, I realise people are facing far worse scenarios. I just mean it is getting tiresome trying different treatments, doing the right things ie not drinking alcohol, using sunscreen etc. and it keeps coming back.

Thank you for your detailed response, very informative. I will research those products you mention.

In terms of the blackheads and pores I realise it is not the Rosacea. Due to the Rosacea I am afraid of using abrasive products to manage the blackheads for fear of exacerbating the Rosacea.

I want to get on top of it as I don?t want it to get worse.

Much appreciated.

[Sydney2000]

The common Microscopic Demodex Skin Mites can cause blackheads as well as the broken veins (telangectasia). Recommend getting tested for demodex. A knowledgeable dermatologist can take a skin sample, look at it under the microscope and try to count the number of demodex.

A healthy immune system normally keeps the demodex population in check. The mites can get overpopulated if the immune system is down due to an infection or stress, etc.

If its demodex causing the issue then there are 2 prescription anti-parasitic treatments that can help. The oral treatment is more effective and faster than the topical.

Topical: Soolantra (also known as Rosiver outside the US) Cream - 1% Ivermectin solution in a moisturizing cream base. Used at night before bed on a clean face. Treatment takes 12-16 weeks. Only works on the area treated. Reduces the population though may not eliminate the demodex colonies.

Oral: Best: Inexpensive, Combined 2 Drug Oral Treatment published in a medical study on 120 patients. Other Options: Oral Ivermectin tablets or just Oral Metronidazole tabletss. Treatment takes 2 weeks. Works to kill the demodex all over the body. More information about this treatment is posted here:
https://rosaceagroup.org/The_Rosacea...dex-Skin-Mites

If the prescription treatments are not possible for you, then 1.87% Ivermectin Horse Paste is available from Amazon for about $5 per tube. It can be applied topically and is much cheaper than Prescription Soolantra.

Washing the face with a tea tree oil based cleanser can be helpful (Desert Essence, The Body Shop, eco eyes are several good brands). A DIY borax based cleanser also is helpful.

Use a clean towel for the face every day. Mites can live on a wet towel for up to 54 hours. Ordinary laundering in an automatic clothes washer and dryer at 58 degrees C. will kill the mites.

Products containing Salicylic Acid are good at dissolving blackheads. Here's a few products that I have used: Epionce Lytic (available in 0.5%, 2% and 3% strengths), Paula's Choice 2% BHA LIQUID EXFOLIANT. Other brands and products like Neutrogena Rapid Clear Acne Eliminating Spot Treatment, Clearasil Rapid Rescue Spot Treatment Gel with Salicylic Acid, Derma e and others make products containing Salicylic Acid that can work as well.
The blackheads are the debris left behind by the mites. Once the mites are under control the Salicylic acid products can help more to clear the pores.

Hi Elaine,

Thank you so much for such a detailed response and advice.

I had never heard of demodex and will mention it to the dermatologist.

I did have the laser treatment yesterday and it has minimised the appearance of the Veins but am mindful that they do come back. Do you think it might be an idea to start on the antibiotics to enhance the benefits of the laser treatment? If so, which of those do you recommend? I have tried Doxycycline to no effect.

I was given a script for Tretinoin 0.05% cream. Is it worth trying?

Thanks again for taking the time to respond.

[Sydney2000]

Hi there,

Thank you for responding and the welcome to the forum.

Sorry I should have been a little clearer in my post in regards to being over it. What I mean is that I have become quite deflated by this condition. Please don?t take it the wrong way, I realise people are facing far worse scenarios. I just mean it is getting tiresome trying different treatments, doing the right things ie not drinking alcohol, using sunscreen etc. and it keeps coming back.

Thank you for your detailed response, very informative. I will research those products you mention.

In terms of the blackheads and pores I realise it is not the Rosacea. Due to the Rosacea I am afraid of using abrasive products to manage the blackheads for fear of exacerbating the Rosacea.

I want to get on top of it as I dont want it to get worse.

Much appreciated.

[Mistica]

I was given a script for Tretinoin 0.05% cream. Is it worth trying?

To be honest, I think all forms of vitamin A are likely to increase the appearance of telangiectasia.
Oral forms can worsen rosacea and/or flushing too.
I am currently suffering a severe set back from taking an oral vitamin A supplement. It has reactivated areas that have not flushed in years and it is really distressing. I quit two months ago and it has actually worsened in some ways.
Vitamin A upregulates the TRPV1 receptor which is already overly expressed and dysfunctional in our skins.
I did know this, but was running one of my experiments, hoping to overcome it. A huge mistake.

Retin-A played a huge role in my developing rosacea many moons ago.

You will always find one or two people who can tolerate it and perhaps even benefit from it, but the fact is, it's like playing Russian Roulette and the odds are very much against all rosaceans and flusher.
There are a number of vitamin A victims here on this forum. Topical A, oral supplements and the destructive, accutane.

Why not try topical niacinamide, HA and even perhaps a non irritant form of vitamin C.
Such as Ethyl Ascorbate 2%.
I use all three in a compounded topical and have never experienced any negative effects and my skin is SUPER sensitive. I have it put in a benign gel base, which acts like a second skin, but is very flexible and natural looking.
This helps reduce inflammation and stabilise the skin, but it can't actually eradicate telangiectasia. It might help you retain your Laser benefits, however.

Oral niacinamide and vitamin C can help a lot as well.

Judging by your name, it appears you are located in Sydney, Australia?
If that is the case, you can use the same compounding pharmacy as me. The gel is the pharmacist's own formula and it is just as important as the active ingredients.
If you are interested, please feel free to PM me for details.

[ElaineA]

Hi Elaine,

Thank you so much for such a detailed response and advice.

I had never heard of demodex and will mention it to the dermatologist.

I did have the laser treatment yesterday and it has minimised the appearance of the Veins but am mindful that they do come back. Do you think it might be an idea to start on the antibiotics to enhance the benefits of the laser treatment? If so, which of those do you recommend? I have tried Doxycycline to no effect.

I was given a script for Tretinoin 0.05% cream. Is it worth trying?

Thanks again for taking the time to respond.

Some claim that antibiotics like doxycycline help reduce inflammation. If you have a bacterial infection antibiotics could help - but its important to take an antibiotic that is effective against the specific bacteria causing the issue. The most knowledgeable dermatologists will test for bacterial and fungal infections as well as demodex skin mites as part of nailing down a good diagnosis so they treat the correct problem(s) with the right drugs. It is possible to have any one condition or a combination of 2 or all 3. Unfortunately, a lot of them just do quick visual exams and start playing Russian Roulette with prescriptions if their original visual diagnosis is wrong.

It might be worth trying the Tretinoin 0.05% cream. Retin-A (Tretinoin) works by cutting the skin cell turnover time in half. The faster skin cell turnover can reduce wrinkles and unclog the pores in the process by making the follicles peel out faster than normal. It is commonly prescribed for people that have had laser procedures, particularly fraxel or laser resurfacing to retain a smoother more youthful look. I tolerated the related version called Micro-Retin A better than the original Retin-A. That being said it might help your pores. That would be a prescription option vs. over the counter salicylic acid. I wouldn't use both at the same time though - might be too irritating. Retin-A works by peeling out the dead skin lining the pore-follicle which loosens the blackheads. Salicylic acid apparently dissolves the material in the blackhead. So they work different ways.

[Sydney2000]

Some claim that antibiotics like doxycycline help reduce inflammation. If you have a bacterial infection antibiotics could help - but its important to take an antibiotic that is effective against the specific bacteria causing the issue. The most knowledgeable dermatologists will test for bacterial and fungal infections as well as demodex skin mites as part of nailing down a good diagnosis so they treat the correct problem(s) with the right drugs. It is possible to have any one condition or a combination of 2 or all 3. Unfortunately, a lot of them just do quick visual exams and start playing Russian Roulette with prescriptions if their original visual diagnosis is wrong.

It might be worth trying the Tretinoin 0.05% cream. Retin-A (Tretinoin) works by cutting the skin cell turnover time in half. The faster skin cell turnover can reduce wrinkles and unclog the pores in the process by making the follicles peel out faster than normal. It is commonly prescribed for people that have had laser procedures, particularly fraxel or laser resurfacing to retain a smoother more youthful look. I tolerated the related version called Micro-Retin A better than the original Retin-A. That being said it might help your pores. That would be a prescription option vs. over the counter salicylic acid. I wouldn't use both at the same time though - might be too irritating. Retin-A works by peeling out the dead skin lining the pore-follicle which loosens the blackheads. Salicylic acid apparently dissolves the material in the blackhead. So they work different ways.

Hi Elaine,

Do you think it may be worthwhile trying the Salicylic acid option first? And would I be using it twice a day?

I will speak to the dermo re: antibiotics and testing for demodex.

Thanks again, much appreciated

[Sydney2000]

To be honest, I think all forms of vitamin A are likely to increase the appearance of telangiectasia.
Oral forms can worsen rosacea and/or flushing too.
I am currently suffering a severe set back from taking an oral vitamin A supplement. It has reactivated areas that have not flushed in years and it is really distressing. I quit two months ago and it has actually worsened in some ways.
Vitamin A upregulates the TRPV1 receptor which is already overly expressed and dysfunctional in our skins.
I did know this, but was running one of my experiments, hoping to overcome it. A huge mistake.

Retin-A played a huge role in my developing rosacea many moons ago.

You will always find one or two people who can tolerate it and perhaps even benefit from it, but the fact is, it's like playing Russian Roulette and the odds are very much against all rosaceans and flusher.
There are a number of vitamin A victims here on this forum. Topical A, oral supplements and the destructive, accutane.

Why not try topical niacinamide, HA and even perhaps a non irritant form of vitamin C.
Such as Ethyl Ascorbate 2%.
I use all three in a compounded topical and have never experienced any negative effects and my skin is SUPER sensitive. I have it put in a benign gel base, which acts like a second skin, but is very flexible and natural looking.
This helps reduce inflammation and stabilise the skin, but it can't actually eradicate telangiectasia. It might help you retain your Laser benefits, however.

Oral niacinamide and vitamin C can help a lot as well.

Judging by your name, it appears you are located in Sydney, Australia?
If that is the case, you can use the same compounding pharmacy as me. The gel is the pharmacist's own formula and it is just as important as the active ingredients.
If you are interested, please feel free to PM me for details.

Hi M?stica,

I was trying to work out how to PM you, perhaps I am unable to as I am new member?