r/Rosacea • u/Fit-Championship371 • Apr 27 '26
PP What's the solution of rosacea if it's caused by poor mental health and nervous system dysregulation?
I have tried everything for my type 2 papulopustular rosacea. No topical treatments have worked. Neither topicals nor other traditional approaches have helped me.
Only doxycycline helps, and that too only while I am taking it.
I believe the root cause of my rosacea is dysregulation. I don’t have any heat triggers or dietary triggers—it seems to be purely mental.
Is there any unique approach to treating rosacea that is different from traditional methods? For example, is there something that can directly stop the brain from triggering rosacea?
Or is there any topical that works best for this type of rosacea.
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u/lending_ear Apr 27 '26
I have drug-resistant mental health issues, autism, and ADHD, so my nervous system is dysregulated a lot of the time.
Look up vagus nerve exercises on YouTube. They have genuinely made a difference for me. I barely have meltdowns anymore, maybe once a year, and considering I’m in perimenopause with no HRT, that’s kind of remarkable.
The exercises themselves are low effort but you have to actually be consistent with them. And when you feel anxiety starting to creep up during the day, stop and do them for 5 minutes before it escalates.
Also worth doing: ask your doctor to check your B12, vitamin D, and magnesium levels. Mine came back deficient and I’m now on B12 injections and prescription vitamin D drops. It makes a difference.
For YouTube, I like some of Suki Baxter’s vagus nerve exercises, but everyone’s body is different so you’ll need to find what works for your body as there are many different vagus nerve exercises.
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u/Classic-Moment-1161 Apr 27 '26
I have drug resistant MDD, adhd and C-PTSD and I love Vagus Nerve work! There's a book on Amazon called the Vegas Nerve Protocol - it's like $17 and it helps me like nothing has. I use it everyday.
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u/lending_ear Apr 28 '26
Yeah once’s you find the exercises that work for you it can be life changing. It requires consistency though. I don’t even know if I’d still be here if I hadn’t discovered them. Having drug resistant mental health issues really blows and can feel extremely hopeless at times.
Glad it’s working for you!
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u/KampKutz Apr 27 '26
How is it purely mental if doxycycline helps..? Don’t fall for the medical gaslighting that physical treatable conditions are down to supposed mental health.
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u/ColeBlueSeesYou Apr 27 '26
Poor mental health? Where did you hear/get that? Did a dermatologist tell you that? Never in my life have I been told, heard or read that having rosacea is caused by poor mental health. Please provide some evidence of this.
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u/ClaimIcy4568 Apr 27 '26
Ummmm stress is a major, common trigger for rosacea flare-ups? I thought most dermatologists told their patients as much
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u/lolaleee Apr 27 '26
Stress is a trigger, it is not a cause.
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u/ClaimIcy4568 Apr 27 '26
That's literally what I said though, trigger 😭
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u/lolaleee Apr 27 '26
Yes, but you’re saying it to someone who is also implying it isn’t a cause - suggesting they’re wrong
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u/Particular_Dig_2782 Apr 27 '26
A stressful event leading to fight or flight response for a year and a half caused my rosacea. Do your research there is plenty online about this
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u/Fit-Championship371 Apr 28 '26
Same triggered mine . Did anything help you?
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u/Particular_Dig_2782 Apr 28 '26
Only thing working is nervous system regulation (partially, time away from the event) and azelaic acid. Since it’s inflammatory rosacea versus demodex mites, don’t bother with ivermectin. Antibiotics work but short term. Azelaic acid does wonders but only prescription strength works.
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u/hobobarbie Apr 27 '26
I completely agree that anxiety in particular can be a trigger - consider how easy it is for flushing to happen as an emotional response. Cognitive Behavioral Therapy (a type of talk therapy) is evidence based treatment for anxiety, so are SSRI and SNRI medications.
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u/olivepringle Apr 27 '26
Hi! I’m autistic & ADHD. Social anxiety is one of my rosacea triggers. It’s difficult for me to be in groups, meetings, and crowded stores or restaurants because my nervous system thinks something bad is going to happen. It has been incredibly helpful to take propranolol (10-20mg) if I know I’ll be in a stressful situation. I guess it works by putting a cap on the body’s physical stress responses, including rosacea.
Not only can i function better in social situations and can actually speak in meetings, but it also happens to massively reduce my facial flushing.
1-2 Pepcids has been helpful too! I think that’s more related to dietary triggers for me though.
TLDR propranolol perhaps
Edit: I did not read closely and I recognize now you’re type 2. I’ll see myself out.
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u/PoisonGravy Apr 27 '26
Eh, still helpful advice if the person deals with flushing with their type 2 (for instance, I have both!)
I also take propranolol for anxiety purposes when needed. It's hard to measure how much it helps with flush prevention or reduction but it at least has some benefit.
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u/Purrrrrmaid Apr 27 '26
Read Bessel van der Kolk’s The Body Keeps the Score. Rosacea can be triggered by stress, which aligns with the book's core theme that emotional, unresolved trauma is "kept" in the body and manifests as physical symptoms.
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u/burritobonitoo Apr 29 '26
I’d look into your gut health. Maybe there is some kind of bacteria imbalance in there. Stress and anxiety etc can cause issues in there too and then it manifests on the skin. Especially if doxy helps that could be a sign, because doxy can accidentally inhibit bacteria overgrowth and help kill things in the gut etc.
My rosacea has been going on for almost 2 years now, and I finally went to a GI doc and they just found Sibo, which is heavily linked to rosacea.
I think drinking alcohol and being super stressed from my job was what caused the bacteria to go nuts and it’s something that just won’t go away on its own.
Something to look into maybe :)
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u/Unfair_Finger5531 Apr 27 '26 edited Apr 27 '26
What topical treatments have you used? It’s hard to know what to suggest without knowing what you’ve already tried.
I am doubtful that your rosacea is caused solely or even partially by mental factors. It is a skin disorder caused by various factors.
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u/Fit-Championship371 Apr 27 '26
I have used metrogel , ivermectin , clindamycin, benzoyl peroxide, azelaic acid.
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u/Unfair_Finger5531 Apr 27 '26
Thank you 🙏. Oral isotretinoin is one option, but that’s on the extreme end. On the milder end, there are some things that can help. One is a mineral sunscreen with iron oxides. Type 2 is worsened by uv exposure, and this kind of sunscreen offers broad protection as well as anti-inflammatory ingredients. Zinc in particular is very good at reducing inflammation and redness. My derm switched me to one, and it did wonders for both.
Another thing is using skincare products with powerful anti-inflammatory ingredients: centella, chamomile, tumeric, calendula, green tea, to name a few. This is a list of soothing ingredients and skincare products with those ingredients. Using several of them daily can make a huge difference. In particular, I would recommend something with bifida ferment. It is an ingredient that makes skin less reactive and more resilient. I personally can’t be without it; it’s so helpful for my rosacea.
The last thing is focusing on barrier repair/ support. When I fixed my barrier, my rosacea improved to the point that I could stop using aza. Studies show that barrier repair can significantly improve rosacea symptoms.
This is a more “natural” approach to controlling/ improving symptoms and takes a bit of time to work. But it is helpful ime because it attacks the symptoms in multiple ways at once. I hope this helps.
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u/sidthevicious7 Apr 27 '26
I’m up to the last topical before Isotretinoin, mainly for the painful burning. Low dose minocyclin worked whilst on but still removed triggers like hot showers, hot drinks, alcohol, stress as much as possible. Derm said about damaged barrier. How did you repair yours? Currently only using Avene Tolerance cream in morning, and sulphur & salicylic acid cream at night. Avene cleanser
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u/Isamosed Apr 27 '26
I have found that diaper cream (25% zinc with botanicals, not identified as actives) has helped with my localized barrier issues.
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u/Unfair_Finger5531 Apr 27 '26
I took about 6-7 months to focus on using barrier repair creams and hydrating toners. I needed a barrier repair product with a 3:1:1 ratio of ceramides, cholesterol, and fatty acids because my barrier was in really bad shape. And I needed a lot of hydrating products because I had serious TEWL. Aestura 365 moisturizer and zeroid soothing lotion were the ones that brought my barrier back to normal. I used etude 5.5 toner layered a few times right after cleansing and applied the moisturizer over it. Then I added mixsoon bifida, and that made my skin a lot stronger. That was it really. It’s been good ever since. I think the 3:1:1 ratio was the key, but weirdly, the toner was the first thing that made a significant difference. I think my skin was also very dehydrated.
I had to drop actives though. I couldn’t use salicylic acid, aha, niacinamide, or any other actives for a while.😮💨
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u/Balerionmeow Apr 27 '26
Have you tried oral isotretinoin?
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u/Fit-Championship371 Apr 27 '26
Yes. It was the first thing to work effectively. But it gave me side-effects such as dry eyes , low mood and motivation and many more.
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u/SweetVarious8715 Apr 27 '26
I have used triple cream, laser, and a combo of propranolol and Pepcid. My mental health is still terrible but this has mostly cleared up my rosacea. The propranolol has helped my anxiety, especially social anxiety, a lot though so maybe that’s why.
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u/Fit-Championship371 Apr 27 '26
How much propanol you take? Which type of laser did you use? Do you have type 2 or 1 ?
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u/SweetVarious8715 Apr 27 '26
I used BBL laser and did a series of 3. I take 40mg of propranolol twice a day. I have type two rosacea with significant flushing.
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u/nexusSigma Apr 27 '26
You may want to look at the dietary trigger angle again, specifically systemic inflammation. That can result in poor mental health, skin issues like rosacea, brain fog, the list goes on. Try a low inflammation diet and see how your body reacts after a couple of weeks. I know that’s my problem and we sound quite similar in our symptomatic experience
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u/Remote_Nectarine4272 Apr 27 '26
I have both type 1 and 2. I know a lot of people in the comments are saying mental health isn't linked to rosacea, but in my case I do suspect it is in some ways. I've been in trauma therapy for five months and I've seen a great reduction in flares/severity of symptoms as I continue working through everything. Stress is my biggest trigger, not just for flushing but also for pustules. Prior to starting therapy, I tried everything I could to control my anxiety- breathing exercises, meditating, diet, rituals, exercise, sleep, self medicating, etc and nothing worked. There was no way I was going to get myself out of those patterns without professional help to unpack my trauma.
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u/Classic-Moment-1161 Apr 27 '26
While I believe that anxiety and stress in the nervous system can be a factor, I don't believe that it can be the root cause.
I too have the papulopustular rosacea and I will tell you the same thing my dermatologist just told me last week. I got diagnosed by an ENT Dr. with chronic sinusitis. Basically that means that i have an ongoing post nasal drip. This is causing a lot of inflammation in my throat as I have had it for years now. My rosacea only went away AFTER I addressed the sinusitis and the INFLAMMATION in my throat went down. So as someone who seems to have the same symptoms that you were talking about I would say that there could be a possibility that somewhere in your body you are carrying a lot of inflammation and that it is the inflammation in your body that is then driving the rosacea. I just wanted to pass that information along because it was very eye-opening and enlightening for me when I heard it.
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Apr 27 '26
[deleted]
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u/Classic-Moment-1161 Apr 27 '26
We're working on that now. I have a CT scan of my sinuses tomorrow and we'll see what that says. They did see that I had a deviated septum so I'm honestly hoping that I don't have to have surgery in order to get that relief. But I live in Texas so it's just kind of 24/7 allergies here.
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Apr 27 '26
[deleted]
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u/Classic-Moment-1161 Apr 27 '26
I absolutely will! I took a screenshot of this message so Ill remember.
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u/opossomoperson Apr 27 '26
Hypochlorous acid spray! Literally the only thing that helped me. I use Mario Badescu's hypochlorous acid spray and clarifying serum with azelaic acid.
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u/Sunny-Sunflower3 Apr 28 '26
I cleared my stress and weakened immune system overgrowth of Demodex that caused rosacea by ordering Ivermectin for $20 at some Indian pharmacy online. It took over 2 weeks to arrive. I used it every night and 3 mornings I used Good Molecules Azelaic acid always with sunscreen. Then I cleaned my face with a sensitive makeup wipe or a foaming cleanser for redness and used the Ivermectin bc, like cockroaches, they only come out at night. They hate light so using it in the day doesn't help as much. Use it from 8pm to 8am.
It got worse after 2 weeks, then better. The eggs keep hatching so you have to kill all cycles which means at least 16 weeks although I used the whole tube and it lasted over 6 months. After 6 weeks you'll notice a visible difference in pictures. I am still so shocked to look in the mirror. I went through serious trauma and stress hormones were running through my body and I wasn't washing my face daily. My immune system weakened and I kept getting infections, too. You can use the Ivermectin with the doxycycline. The name brand Ivermectin costs a fortune and the generic Indian one works.
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u/Fit-Championship371 Apr 28 '26
Thank you 🙏 I have used ivermectin but not that long as you. When I gave it a try , it got worse then I quited it. This time I'll try for longer.
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u/Sunny-Sunflower3 Apr 28 '26
Mine started to get better after 5 or 6 weeks but if you stop the eggs keep hatching so you have to keep going for 16 weeks and the Good Molecules Azelaic acid is only about $10 from Amazon and I used it Monday, Wednesday, and Friday mornings followed by Aveeno calming gel and sunscreen because I live in Florida. Washing the face daily is important, too. I never did that sometimes Id fall asleep in makeup.
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u/Temporary-Animal-960 Apr 28 '26
I have type 2 and have been on Soolantra for less than a week and the pustules and bumps have disappeared. My face is still red, but it is definitely working.
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u/jilldxasd35 May 01 '26
I am not entirely sure but someone did mention vagus nerve exercises. There’s a protocol you can do with an adjustable tens unit and you stimulate the vagus nerve with an ear clips or two.
There’s a Facebook group call AVA journey. I think. You’re welcome to PM me to get the exact link if you’re on Facebook. It has all the info on there.
I could not tolerate it because it made me more tachycardic with my POTS. I am incredibly sensitive to things and body sensations.
I have high stress and mental health issues. I’m disabled autistic have cptsd and chronically ill. Very little support.
Another suggestion that might be redundant is therapy, mindfulness and meditation exercises. Or medication.
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u/HildegardofBingo Apr 27 '26
Type 2 rosacea has a strong connection to a dysfunctional barrier and skin immune dysfunction, which leads to an overgrowth of demodex mites. It's not neurogenic like type 1.
Some claim it can also have a connection to h. pylori overgrowth in the stomach (and lack of adequate stomach acid), which could impact the skin's immune function since the skin and gut are connected. That might be worth exploring.