Rosacea

Rosacea is a chronic inflammatory condition that generally affects the face. It presents as redness, visible blood vessels and even acne-like bumps or pustules. Some people also experience eye irritation or thickened skin around their nose.

Although rosacea is not contagious, it tends to have a relapse-remitting pattern, with flare-ups triggered by certain environmental or lifestyle factors. While there is no cure, there are a variety of medical treatments that can effectively reduce symptoms and improve skin appearance.

Types of Rosacea

There are 4 main subtypes of rosacea. An individual may have one or a combination of them:

• Erythematotelangiectatic rosacea – causes persistent facial redness and visible blood vessels (telangiectasia). Flushing is common, especially on the cheeks and nose.
• Papulopustular rosacea – involves red bumps and pustules that resemble acne. It often affects the central face and may include swelling and sensitive skin. 
• Phymatous rosacea – leads to thickened, bumpy skin. It most often affects the nose (rhinophyma) and is more common in men.
• Ocular rosacea – affects the eyes, causing dryness, burning, redness and irritation. It may also involve swollen eyelids and blurred vision.

What causes Rosacea?

The exact cause is unknown, but rosacea is linked to overactive immune responses, genetics and environmental triggers. Blood vessel abnormalities and certain skin mites (Demodex) may also contribute to the development of the condition.

Some of the common triggers that can worsen rosacea include:

• Alcohol
• Heat or cold weather
• Hot drinks
• Skin care products with alcohol or fragrance
• Spicy food
• Stress
• Sun exposure

What are the symptoms of Rosacea?

The symptoms vary depending on the type. But the common signs include:

• Burning or stinging sensations
• Dry or sensitive skin
• Enlarged blood vessels
• Facial redness and flushing
• Small red bumps or pus-filled spots
• Thickened or rough skin texture
• Eye irritation such as redness, dryness or a gritty feeling

Who is at risk of developing Rosacea?

The skin condition can affect anyone. However, some individuals are more prone to developing the condition. Some of these risk factors include:

• Age – rosacea is more common in adults aged 30 to 50 years old, when skin and blood vessels become more reactive.
• Ethnicity – people of Celtic or Northern European descent often have fair skin that flushes easily, making them more prone to rosacea.
• Gender – women are more likely to develop rosacea, but men tend to have more severe symptoms such as thickened skin.
• Family history – having a close family member with rosacea increases your chances of developing it, suggesting a genetic link.
• Immune and vascular factors – irregular immune responses and unstable blood vessels can trigger inflammation and facial redness.
• Skin sensitivity and reactivity – if your skin flushes or stings easily, you are more likely to develop rosacea over time.
• Skin tone – individuals with fair skin are more prone to visible redness and broken blood vessels, which are common signs of rosacea.
• Environmental and occupational exposure – regular exposure to sun, wind or heat can damage blood vessels and lead to flare-ups.
• Lifestyle and health habits – stress, alcohol and smoking widen blood vessels and increase inflammation, worsening rosacea symptoms.

How is Rosacea diagnosed?

Diagnosis is typically made by a dermatologist through a clinical assessment of your skin and symptoms. 

• Physical examination – our dermatologist will look for common signs such as redness, visible blood vessels or acne-like bumps.
• Medical history review – a discussion about our medical history and lifestyle helps identify possible triggers or contributing factors.

Throughout the process, you may be asked:

• Do flare-ups happen with sun, stress or spicy food?
• Have you noticed any eye irritation or dryness?
• Is there a family history of facial redness or similar skin issues?

How is Rosacea treated?

The treatment depends on the type and severity of symptoms. For mild cases, topical treatments and skincare changes may be enough. In more persistent or moderate-to-severe cases, oral medication or laser therapy may be recommended.

Our dermatologist will tailor the approach based on your skin subtype, triggers and lifestyle.

Topical treatments

Topical medications are commonly prescribed to reduce redness, inflammation and acne-like bumps. These include:

• Azelaic acid – helps calm redness and swelling. It also reduces the appearance of visible bumps by targeting inflammation and abnormal skin cell turnover.
• Brimonidine or oxymetazoline – vasoconstrictive gels are used to reduce facial redness by narrowing blood vessels. The results are temporary but rapid. It should also be used under guidance to avoid rebound redness.
• Ivermectin – targets microscopic skin mites (Demodex) thought to contribute to rosacea. It also has anti-inflammatory effects and is often used in more resistant cases.
• Metronidazole – a topical antibiotic that helps reduce inflammation and control papulopustular lesions. However, it is suitable for long-term maintenance in mild rosacea.

Oral medications

Oral treatments are prescribed when rosacea is more widespread or unresponsive to topical therapy. These include:

• Tetracycline antibiotics – these are frequently used to control inflammation and reduce flare-ups. Low doses may be used long term for maintenance.
• Isotretinoin – may be considered in severe, treatment-resistant papulopustular or phymatous rosacea. It is not suitable for everyone, especially pregnant individuals or those with certain health conditions.

Laser or light-based therapy

For redness and visible blood vessels, energy-based treatments can provide effective long-term results. These include: 

• Intense pulsed light (IPL) – uses broad-spectrum light to address redness and inflammation. Often done in multiple sessions for gradual improvement.
• Vascular laser – such as pulsed dye laser (PDL) or long-pulsed Nd: YAG, targets dilated blood vessels to reduce flushing and visible capillaries.

Laser therapy is safe when performed by trained professionals and may be combined with other treatments for optimal results.

Lifestyle and skincare modifications

A crucial part of rosacea management involves identifying and avoiding personal triggers that worsen symptoms. These include:

• Avoiding hot drinks, spicy food and alcohol
• Managing stress and regulating temperature exposure
• Protecting skin from sun exposure with daily SPF
• Using gentle, fragrance-free skincare
• Avoiding high-strength actives (retinoids, acids) unless supervised

Patients may also benefit from tailored skincare routines and support in identifying hidden triggers, such as ingredients in cosmetics or environmental exposures.

Summary

While rosacea is neither harmful nor contagious, it can, understandably, still significantly impact one’s quality of life. Thankfully, there are effective treatments available to help manage your symptoms and achieve clear, calm skin. 

At Dermatology Collective, we will help you identify your triggers and create a personalised treatment plan that restores confidence in your skin. If you are struggling with persistent flushing, irritation or breakouts that do not respond to over-the-counter products, schedule a consultation with us today for a detailed diagnosis.