Rosacea is a common skin condition that affects millions of people worldwide. Though it can be frustrating, especially as it leads to persistent facial redness and visible blood vessels, effective treatments are available to manage its symptoms and improve skin health. In this guide, we will explore the causes, symptoms, and how to treat rosacea.
Rosacea is a chronic skin condition that mainly affects the face, causing persistent redness (erythema), visible blood vessels (telangiectasia), and, in some cases, thickened skin (rhinophyma). Although rosacea typically appears on the nose, cheeks, and forehead, it can affect any area of the face and sometimes the eyes. The condition can appear suddenly and is more common in people with fair skin, especially those aged 30 to 50.
While the exact cause of rosacea is still not entirely understood, it’s believed that several factors contribute to the development of the condition. These may include genetics, skin sensitivity, and environmental triggers. Additionally, people with rosacea tend to have a heightened response to certain factors, such as sun exposure, extreme temperatures, certain foods and even stress.
Rosacea is often confused with acne, but unlike acne, it does not involve clogged pores or blackheads. It can also lead to more serious complications, such as ocular rosacea, which affects the eyes and can cause symptoms like dry eyes, irritation, and even blurry vision.
While rosacea is a lifelong condition, with proper rosacea treatment and management, its symptoms can be reduced significantly.
The symptoms of rosacea can vary greatly from person to person, depending on the type and severity of the condition. The main symptom across all types of rosacea is facial redness or erythema, which typically appears in the central portion of the face. The redness is often permanent in association with periodic centrofacial flushing. Other symptoms may also be present. For example, individuals with rosacea often suffer from skin sensitivity and notice that they have more prominent pores.
For individuals with mild rosacea, the symptoms are often limited to persistent redness (often referred to as facial erythema), slight swelling, and occasional flare-ups of pimples or pustules. Visible blood vessels may also begin to appear, especially on the nose and cheeks.
As rosacea progresses, it may become more severe. In cases of severe rosacea, the skin may thicken, causing the appearance of excess tissue, especially around the nose. This is called rhinophyma and is often associated with a bulbous nose. Thickened skin can lead to an uneven texture and may make the skin feel dry or rough to the touch. Additionally, more prominent blood vessels may develop, making the redness of the face more noticeable.
Ocular rosacea affects the eyes and can cause dryness, irritation, and redness in the eyes and eyelids. It may also cause blurred vision, eye sensitivity, and a gritty feeling, which can be very uncomfortable. If left untreated, ocular rosacea can lead to serious complications, so it’s essential to seek rosacea treatment as soon as symptoms appear.
One of the key challenges in managing rosacea is identifying and avoiding the triggers that cause flare-ups. These triggers vary for each individual but commonly include:
While rosacea cannot be cured, there are several treatment options available to help manage its symptoms and reduce the frequency of flare-ups. Depending on the severity of your rosacea, treatment options may include topical medications, oral treatments, laser therapies, and lifestyle changes.
For those with mild rosacea, topical medications are often the first line of treatment. These medications are applied directly to the affected areas of the skin and help reduce inflammation, redness, and bumps. Some of the most commonly used topical treatments include:
Topical medications can provide noticeable improvements within weeks of treatment, but it’s essential to follow the dermatologist’s instructions to avoid irritation or adverse effects. Topical medications also work best when used in combination with skincare that is non-irritating and soothing to ease rosacea symptoms.
In more severe cases, oral treatments may be necessary. Oral antibiotics, like doxycycline or minocycline, help to reduce inflammation and prevent the formation of bumps and pustules. These medications work by controlling bacterial activity, reducing the severity of flare-ups.
Oral retinoids, such as isotretinoin, may also be prescribed for persistent or severe rosacea, particularly if the skin becomes thickened or if over-the-counter treatments do not provide adequate results. Retinoids can help shrink sebaceous glands, reduce excess tissue, and improve skin texture.
However, oral retinoids come with potential side effects and should only be used under strict medical supervision.
Should there be deep flushing associated with rosacea, oral beta blockers can also be prescribed.
For individuals with visible blood vessels (telangiectasia), vascular lasers offer a promising treatment option. These laser treatments use focused light to target dilated blood vessels, causing them to shrink and reducing the visible redness in the skin.
Vascular lasers such as pulsed dye lasers (PDL) and intense pulsed light (IPL) are commonly used to treat rosacea. These treatments are effective in reducing persistent erythema and visible blood vessels.
The number of sessions required will vary depending on the severity of the rosacea and the individual’s skin response. Although side effects like temporary redness and swelling may occur after rosacea treatment, they generally subside within a few hours to a few days.
Polynucleotide treatments such as rejuran and plinest are non-steroidal treatments that help reduce inflammation in the skin, boost hydration and boost skin repair. They are often used synergistically with vascular lasers (e.g pulsed dye lasers) to manage rosacea symptoms.
Patients with rosacea often have very sensitive skin, which makes selecting the right skincare products an essential but tricky task. Skin that is prone to rosacea can easily become irritated, and harsh skincare treatments or products can exacerbate symptoms like redness, inflammation, and visible blood vessels. Therefore, it’s vital to be cautious about the products you use and to prioritise gentle, non-irritating options that help calm the skin rather than aggravate it.
A good moisturiser is one of the most important products for managing sensitive rosacea skin. Choosing a moisturiser specifically formulated for sensitive skin helps to lock in moisture, reduce dryness, and protect the skin’s natural barrier. Keeping the skin hydrated is crucial because dry skin can make rosacea symptoms worse by increasing irritation and discomfort. Look for moisturisers that are fragrance-free and contain soothing ingredients like ceramides, hyaluronic acid and niacinamide, which help to replenish the skin’s moisture without causing irritation. Additionally, moisturisers that offer anti-inflammatory benefits, such as centella asiatica and aloe vera, can also provide relief from the redness and swelling often associated with rosacea.
When it comes to cleansing, it’s important to choose a mild, non-foaming, and fragrance-free cleanser. Strong or foamy cleansers often contain harsh chemicals and fragrances that can irritate rosacea-prone skin, making it more sensitive, dry and inflamed. A gentle cleanser without exfoliating beads or strong detergent effects will clean the skin without stripping it of its natural oils. These oils are vital for maintaining a healthy skin barrier, which is crucial in protecting against environmental irritants. Cleansing should be done gently with lukewarm water and a soft washcloth.
Avoiding exfoliants is another key aspect of rosacea skincare. While exfoliating can be beneficial for some skin types, patients with rosacea should steer clear of harsh exfoliating products, such as physical scrubs with gritty particles, because they can aggravate rosacea symptoms. Scrubs can create microtears in the skin and increase redness and inflammation. Instead, patients should focus on moisturising and soothing products that help build the skin's resilience and prevent irritation. If exfoliation is desired, opt for gentle chemical exfoliants, such as those containing mild acids like polyhydroxyacids (PHAs), which can provide gentle resurfacing without the abrasiveness of traditional scrubs. If in doubt, always consult your medical practitioner who can better advise and personalize your skincare based on your skin type.
Overall, maintaining a simple skincare routine with the right products is essential in managing rosacea. Overloading the skin with multiple products or harsh treatments can lead to more irritation.
Aside from medical treatments, several lifestyle changes can help reduce rosacea flare-ups and improve overall skin health. These include:
Rosacea treatment is a gradual process. While some people may see improvement within a few weeks of starting treatment, it often takes several months to achieve noticeable and sustained results. Even with effective treatment, rosacea symptoms may still flare up from time to time, particularly if triggers are not avoided.
The goal of rosacea treatment is not only cosmetic improvement but also long-term control of symptoms, allowing for periods of remission. Regular follow-up with a healthcare provider, particularly a dermatologist, is essential for managing the condition and adjusting treatments as necessary.
Although rosacea cannot be cured, effective treatment options are available to help manage its symptoms and improve skin appearance. There are many ways to reduce redness, visible blood vessels, and other symptoms of rosacea. Additionally, managing triggers and practising a skincare routine tailored to sensitive skin can help prevent flare-ups and promote skin health. By working closely with a dermatologist and following a consistent treatment plan, those with rosacea can experience significant relief.
