Is My Sex Life Making My Rosacea Worse?

“I love it when you go all red,” said my boyfriend, looking lovingly at me post-sex. I was mortified. I burrowed into the nearest pillow and slunk off to the bathroom. “Red” was an understatement; I was covered in maroon blotches and my face felt hot to the touch. This wasn’t my first rodeo (for my skin, that is). I have rosacea, a chronic inflammatory condition that affects approximately 16 million people in the US. It can appear as a flush at the best of times and a rash at the worst. Through trial and error, I’d learned how to keep flare-ups to a minimum but sex seemed to be the latest trigger. 

A post-orgasm flush is the norm, thanks to a speedier heart rate and increased blood flow, but mine wasn’t going away, even after a post-climax breather. Don’t get me wrong, I’d had plenty of sex before, but this was my first relationship. As such, I was having intercourse consistently for the first time, and my rosacea was punishing me for it. The randomness of casual sex meant I’d never connected the dots between a roll in the sheets and a flare-up. However, I couldn’t ignore the aggressive redness that appeared like clockwork after an orgasm.

For most people, sex could actually be beneficial for the skin. One study found that regular sex can even leave you looking years younger. As usual, everything is linked to hormones. “Endorphins and oxytocin are both released by the body during sex,” says Dr. Emma Craythorne, consultant dermatologist and founder of personalized prescription skincare brand Klira. She says that oxytocin helps relieve stress, which can benefit rosacea-prone skin as getting worked up is often a trigger. 

However, the physicalities of sex — touch, sweat, steamy temperatures — seemed to trump the benefits for me. Dr. Ifeoma Ejikeme, medical consultant and founder of Adonia Medical Clinic, explains: “Physical exertion and warmth generated during physical activity can elevate skin temperature, which may trigger a rosacea flare-up.” That’s before you add the friction, panting and my partner’s body heat into the mix — no wonder my skin was acting up. It’s not just the sex itself, though. Even our choice of contraception can be a factor. Dr. Craythorne says that high levels of progesterone — a hormone found in many contraceptives — can exacerbate skin sensitivity and redness. Where my rosacea was concerned, it seemed like the odds were stacked against me when it came to enjoying sex. 

A quick whip round friends and peers proved that I'm not the only one. “I was once on a date with someone who had a beard,” says Rose Gallagher, makeup artist and fellow member of the rosacea club. “We’d been snuggled up on the couch kissing, and when I went to the bathroom my face was bright red from the friction.” Swiping right on a man with facial hair may have unexpected consequences for your skin, suggests Dr. Craythorne. “If you’re kissing somebody and they have a beard then that might scratch the skin and irritate it,” she says. So my boyfriend’s beard is a turn-on for me but also potentially for my rosacea. Great. 

Gallagher’s solution? Date night preparation. “I will wear different long-wear makeup if I’m going on a date or feeling lucky because it’s a logistical nightmare otherwise,” she says. For her, this involves using IT Cosmetics Bye Bye Under Eye, as a base rather than foundation.  

It’s not just the physical; psychology plays an influential role, too. “Emotions such as excitement or anxiety, which may accompany physical activity, can also lead to flushing and exacerbate symptoms,” says Dr. Ejikeme. Various studies like this one from 2020 have even found that women with rosacea are more likely than those without the condition to experience sexual dysfunction like lower libido levels and weaker orgasms. 

Sex with a new partner is often awkward, nerve-wracking and tricky to navigate — and that’s without having to worry about how your skin looks. As Gallagher puts it: “[Rosacea is] already an annoying extra thing you have to worry about when you are trying to look relatively nice.” I’m lucky that my boyfriend’s a good ‘un who finds my ruby cheeks endearing. Not all my sexual partners have been this kind. Some have been patronizing. I remember one saying, “Wow, you must be really enjoying yourself, huh?” Others were more blunt and asked what was “up” with my skin. I can’t recall a time before my mid-20s when I didn’t have sex in complete darkness; most men attributed this to me being self-conscious about my body but it was really about my rosacea. 

It seems others can relate. “I never looked the person I was sleeping with in the eyes,” Hannah* tells me. “My theory being that if my eyes were closed, theirs would be, too, and they wouldn’t be able to see my rosacea.” Looking back, she admits it makes no sense but describes it as a “coping mechanism”. Diligent in her attempts to neutralize her cheeks, she would top up her concealer when her partner dashed to the bathroom. The insecurity stemmed from when a guy she was seeing commented on the redness. “He was just being a dick and pointing out an insecurity,” she says. Since then, Hannah has had open discussions with her latest partner about her rosacea. “He found it cute, which has helped me with my insecurities,” she tells me.

Personally, I’d often sleep in full makeup, fearing that the guy I was with would find my redness repulsive come sunrise. Now I’m nearing my 30s, it sounds dramatic (and too similar to the plot of Shrek for my liking) but my vulnerable teenage self — who couldn’t keep her rosacea “under control” — was weighed down by self-loathing. I was often so preoccupied with how my skin looked that I didn’t enjoy myself or, as silly as it sounds, didn’t speak up and explain what I did (and didn’t) like for fear of drawing attention to myself during intercourse. 

I’m older and wiser now. My confidence has grown and I no longer want to prioritize my appearance over my pleasure and enjoyment, which has been freeing. Besides, if a man is pointing out your skin at such a vulnerable moment as during sex, I think that’s what they call a “red flag”.

Streamlining my skincare routine, staying clear of high-dose AHAs (glycolic acid, I’m looking at you) and using the right products has helped me feel more in control than ever of my rosacea. Introducing azelaic acid into my routine (The Ordinary 10% Azelaic Acid Suspension, is a great budget-friendly option) and prescription skincare have been the biggest game-changers. Happily, I’ve discovered a few tweaks I can make for my newest trigger that mean I won’t have to compromise on orgasms.

“Keep the room cool during physical activity to minimize the likelihood of overheating,” advises Dr. Ejikeme. In case of emergencies, she believes applying a cold compress to the face can speed along the soothing process. To prevent that facial hair friction, Dr. Craythorne recommends moisturizing the skin beforehand to help relieve aggravation. 

Understanding your triggers is essential, too, which is why Dr. Craythorne encourages keeping a skin diary. “Each time you get a flare of rosacea, whether that’s lots of spots, flushes or redness, think about what’s happened in the one hour before that: what you’ve eaten, where you’ve been, the environment that you’ve been in,” she says. Doing this for three months will show any patterns — or if it’s just coincidental. 

Open communication between you and your partner is also key (and better for your sex life, too). “I haven’t had a boyfriend since knowing that I have rosacea and I’m not sure how that will work,” Gallagher admits. She’s positive about crossing that bridge when she comes to it but confesses that her rosacea is something she remains “mindful” of. 

As for me? While there’s no “cure” for rosacea, I’ve come to learn that it’s not the be-all and end-all. My skin looking red and feeling uncomfortable seems like a small price to pay for a healthy sex life with the right person. 

*Name has been changed