Rosacea
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Rosacea is a common skin condition that causes redness and visible blood vessels on your face. It may also produce small, red, pus-filled bumps. It is a long-term condition that tends to come and go, but treatments can help control it.
Key facts
- Rosacea usually starts after age 30.
- It is not contagious and you cannot catch it from someone else.
- Certain triggers like sun exposure, spicy foods, and stress can make it worse.
Yes, rosacea is a common skin condition. It affects millions of people worldwide, especially those with fair skin.
Rosacea is more common in fair-skinned people, particularly those of Celtic or northern European descent. It can affect women more often than men, but men often have more severe symptoms. It typically appears in adults between the ages of 30 and 60.
Symptoms
- Sudden, severe eye pain or vision changes.
- A very severe, painful flare that covers a large area of your face and is accompanied by fever or chills (may indicate a skin infection).
- ⚠Eye symptoms like redness, pain, sensitivity to light, or blurred vision that do not improve with self-care.
- ⚠A sudden worsening of your rosacea that does not respond to your usual treatments.
- ⚠Signs of a secondary skin infection, such as increased pain, warmth, or pus.
Common symptoms
- Redness on the cheeks, nose, chin, or forehead that comes and goes.
- Visible small blood vessels (telangiectasias) on the face.
- Small red bumps or pus-filled pimples (papules and pustules) that may be mistaken for acne.
- A burning or stinging feeling on the skin.
- Dry, rough, or scaly skin in the affected areas.
- Swelling of the face, especially around the eyes.
Symptoms in children
- Rosacea is rare in children, but when it occurs, it may cause redness and bumps on the face, especially around the nose and cheeks.
Symptoms in older adults
- In older adults, rosacea can become more persistent and harder to treat. The skin may thicken, especially on the nose (a condition called rhinophyma). Eye symptoms (ocular rosacea) also become more common with age.
Causes
Main causes
- The exact cause of rosacea is not fully understood, but it involves a combination of genetic, immune system, and environmental factors.
- A tiny mite called Demodex folliculorum, which lives on everyone's skin, may be more plentiful in people with rosacea and could trigger inflammation.
- Problems with the blood vessels in your face that make them expand too easily, leading to redness and flushing.
Risk factors
- Fair skin, especially if you have a family history of rosacea.
- Being over 30 years old.
- Being female (though men may have more severe symptoms).
- Having a tendency to flush or blush easily.
- Exposure to triggers such as sunlight, hot or cold weather, wind, stress, heavy exercise, hot baths, alcohol, spicy foods, and certain skincare products.
When to see a doctor
See a doctor urgently if:
- If you develop eye symptoms like pain, redness, blurred vision, or sensitivity to light.
- If you have a sudden, severe flare with a lot of swelling or pain.
Book a routine appointment if:
- If you have persistent facial redness, bumps, or visible blood vessels that bother you or affect your self-confidence.
- If over-the-counter or home remedies do not help after a few weeks.
- If your symptoms get worse or appear on other parts of your skin.
Diagnosis
There is no single test for rosacea. A doctor, usually a dermatologist, will diagnose it by looking at your skin and asking about your symptoms and medical history.
Tests that may be done
- A visual examination of your face to check for redness, bumps, and visible blood vessels.
- Sometimes a skin scraping may be taken to rule out other conditions like a skin infection or mites.
- If you have eye symptoms, an eye doctor (ophthalmologist) may examine your eyes with a special microscope.
What to expect at your appointment
The doctor will look at your face under a good light and may ask you about your triggers. They might also press a clear plastic disc (dermatoscope) against your skin to get a closer look at the blood vessels. The diagnosis is usually made during that first appointment. If needed, they may refer you to a specialist.
Treatment
Rosacea cannot be cured, but it can be managed well. Treatment aims to reduce redness, bumps, and discomfort, and to prevent flares. It often combines good skin care, avoiding triggers, and use of prescription treatments.
Self-care at home
- Use a gentle, non-soap cleanser and lukewarm water to wash your face twice a day.
- Apply a moisturiser that is labelled 'fragrance-free' and 'non-comedogenic' (won't clog pores) to keep your skin hydrated.
- Protect your face from the sun every day with a broad-spectrum sunscreen of SPF 30 or higher, and wear a wide-brimmed hat.
- Avoid known triggers such as spicy foods, hot drinks, alcohol, extreme temperatures, and harsh skincare products.
- Keep a diary to identify your personal triggers and avoid them.
- Use a humidifier at home if you live in a dry climate or during winter.
Medical treatments
A doctor may prescribe topical treatments to apply to the skin to reduce redness and bumps. Oral antibiotics taken at a low dose can also help control inflammation. Laser and light-based treatments can target visible blood vessels and redness. These treatments do not cure rosacea but can keep it under control for many people. Always talk to a healthcare provider before starting any treatment.
When is surgery considered?
For some people with rosacea, the nose may become thickened and bumpy (a condition called rhinophyma). This can be treated with laser therapy or surgery to reshape the nose and improve its appearance.
Living with this condition
Living with rosacea means managing it day by day. The key is to stick to a gentle skincare routine and avoid things that make your skin flare. You may need to try different products and triggers to see what works best for you. Many people find their rosacea gets easier to control over time.
Lifestyle tips
- Protect your face from sun, wind, and extreme temperatures.
- Manage stress through relaxation techniques like deep breathing, meditation, or yoga.
- Get enough sleep and avoid late nights, as lack of sleep can trigger flares.
- Exercise regularly, but choose activities that do not cause overheating – swimming or walking in a cool environment may be better than running in the heat.
- Avoid rubbing or scrubbing your face, and use a soft towel to pat it dry.
Diet and exercise
While no specific diet is proven to cure rosacea, many people find that avoiding certain foods helps. Common food triggers include spicy dishes, alcohol (especially red wine), hot drinks, and foods high in histamine like aged cheese and cured meats. Eating a balanced, anti-inflammatory diet rich in fruits, vegetables, and omega-3 fatty acids may help some people. Exercise is good for overall health, but try to keep cool during workouts to avoid flushing.
Mental health and emotional wellbeing
Rosacea can affect how you feel about your appearance. The visible redness and bumps may make you feel self-conscious or embarrassed. This can lead to social anxiety or even depression for some people. It is important to remember that you are not alone, and many others share your experience. If rosacea is affecting your mental health, talk to a healthcare professional or a counsellor.
Prevention
Rosacea cannot be prevented entirely, because its exact cause is not known. However, you can reduce the number and severity of flares by avoiding your personal triggers, using gentle skin care, and protecting your face from the sun.
Complications
If left untreated
- Persistent redness and visible blood vessels that may become permanent.
- Thickening of the skin, especially on the nose (rhinophyma), which can change the shape of your nose.
- Eye problems such as blepharitis (inflammation of the eyelids), conjunctivitis (pink eye), or more serious keratitis (inflammation of the cornea) that can affect vision if not treated.
Long-term outlook
With proper management, most people with rosacea can keep their symptoms under control and prevent lasting damage. Treatment works well to reduce flares, improve skin appearance, and protect your eyes. While rosacea is a long-term condition, it does not have to stop you from living a full and active life. Many people find ways to manage their triggers and feel confident in their skin.
Find support
International organisations
Local organisations
- NHS (National Health Service) – Rosacea information ↗ · United Kingdom
- Healthdirect Australia – Rosacea ↗ · Australia
Helplines
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.