12174 Rosacea

Overview

Rosacea is a common, long-term skin condition that mainly affects the face. It can make your face look red, flushed, or bumpy, and sometimes you may see tiny blood vessels. It is not contagious and it tends to come and go in flare-ups.

Yes, rosacea is quite common. Studies suggest it affects about 1 in 10 adults, though many people may not know they have it.

Rosacea most often affects adults between 30 and 60 years old, especially people with fair skin. It can affect anyone, but it is more noticeable in lighter skin tones. Men sometimes develop more severe symptoms, especially thickening of the nose.

Symptoms

Common symptoms

• Persistent redness on the cheeks, nose, chin, or forehead
• Flushing or blushing that comes and goes
• Small red bumps or pustules that look like acne but are not
• Visible small blood vessels on the face
• Stinging, burning, or dry feeling on the skin
• Irritated, watery, or red eyes (this is called ocular rosacea)
• Thickened skin on the nose in later stages, especially in men

Causes

Main causes

• The exact cause of rosacea is not fully understood.
• It likely involves a combination of genetics, an overactive immune response, and triggers that dilate blood vessels in the face.
• It is not caused by drinking alcohol or poor hygiene, but these can trigger flare-ups.

Risk factors

• Having fair skin or a family history of rosacea
• Being between 30 and 60 years old
• Smoking
• Hot weather, strong sunlight, wind, or extreme cold
• Spicy foods, hot drinks, and alcohol
• Stress or strong emotions
• Certain skincare products or cosmetics

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you have eye pain, eye redness, or changes in your vision, or if you have a sudden, severe facial rash.
• If you have severe facial swelling or difficulty breathing, call your local emergency number immediately.

Book a routine appointment if:

• Make a routine appointment with your GP if you have persistent facial redness, bumps, or flushing that bothers you.
• See your doctor if a facial rash does not improve with gentle skin care or if you are unsure what it might be.

Diagnosis

Doctors usually diagnose rosacea by looking at your face and asking about your symptoms, triggers, and family history. There is no single test for rosacea, but your doctor may check for other conditions that can cause similar symptoms.

Tests that may be done

• In most cases, no tests are needed.
• A skin swab may be taken to check for infection if your skin has pustules.
• A blood test might be done if your doctor suspects other conditions, such as lupus.
• You may be referred to a dermatologist (skin specialist) if the diagnosis is unclear.

What to expect at your appointment

Your doctor will look at the areas of redness and ask about when flare-ups happen. Be ready to talk about your daily skin routine, toiletries, diet, alcohol intake, and any eye symptoms. The appointment is a good time to ask questions and discuss what treatments might help you.

Treatment

Rosacea cannot be cured, but it can be controlled. Most people need a combination of gentle skin care, trigger avoidance, and medical treatment. The aim is to reduce redness and bumps, calm flare-ups, and prevent long-term skin changes.

Self-care at home

• Wash your face with a gentle, fragrance-free cleanser and lukewarm water.
• Apply a plain moisturizer every day to protect the skin barrier.
• Use a broad-spectrum sunscreen with at least SPF 30 every day, even in winter.
• Avoid harsh scrubs, exfoliants, and products that contain alcohol or fragrance.
• Keep a diary to track what causes your flare-ups, such as certain foods, weather, or skin products.
• Protect your face from wind and cold with a scarf or hat.
• For men, use an electric razor or be careful when shaving to avoid irritating the skin.

Medical treatments

Doctors can prescribe various treatments depending on your symptoms. These may include creams, gels, or foams that you apply to the affected skin to reduce redness and bumps. For more severe flare-ups, oral tablets that work throughout the body may be used. If you have visible thread veins or thickened skin, laser and light therapies can help. Eye symptoms may need prescription eye drops. Your doctor will explain what is suitable for you and how to use it.

When is surgery considered?

Surgery is not the main treatment for rosacea. In rare cases, however, if the nose becomes thickened and misshapen (a condition called rhinophyma), a specialist can use laser, dermabrasion, or minor surgery to reshape the nose and remove excess tissue.

Living with this condition

Living with rosacea means taking care of your skin every day and avoiding your personal triggers. You can still enjoy life, exercise, and social events. Many people use makeup to cover redness if they wish. It can help to explain to friends and family that rosacea is a medical condition, not a hygiene issue.

Lifestyle tips

• Wear sunscreen every day and reapply if you are outside.
• Choose fragrance-free, 'sensitive skin' products for your face.
• Avoid very hot showers, saunas, and steamy rooms.
• Manage stress with deep breathing, meditation, or light activity.
• Keep cool during exercise and take breaks if your face becomes very flushed.
• Ask a pharmacist to recommend suitable moisturizers and cleansers.

Diet and exercise

Some people find that spicy foods, hot drinks, or alcohol cause flushing. You do not need to avoid all of these unless they trigger your symptoms. Gentle exercise such as walking, swimming, or yoga is generally fine. When exercising, try to stay cool and drink water. Keep a note of any foods that seem to make your skin worse.

Mental health and emotional wellbeing

Rosacea can affect your confidence and make you feel embarrassed or anxious. These feelings are very real and important. It may help to talk to someone you trust, or to join an online community of people with rosacea. If you feel low, anxious, or find it hard to cope, speak to your GP or a mental health professional for support.

Prevention

Rosacea itself cannot always be prevented, because it has a genetic link. However, you can reduce how often you get flare-ups by avoiding your known triggers, wearing sunscreen, and following a gentle, consistent skincare routine.

Vaccines

There is no vaccine for rosacea.

Screening programmes

There is no routine screening test for rosacea. It is diagnosed through symptom history and a skin examination by a healthcare professional.

Complications

If left untreated

• The redness and visible blood vessels may become more noticeable and harder to treat.
• Eye symptoms (ocular rosacea) can cause dry eyes, irritation, and rarely, damage to the front of the eye if left untreated.
• The skin on the nose may thicken over time, especially in men.
• Living with untreated rosacea can affect your mood, confidence, and quality of life.

Long-term outlook

With the right care, most people with rosacea can keep their symptoms well controlled. Flare-ups may still happen, but treatment and trigger avoidance make a big difference. Rosacea is a long-term condition, but it is very manageable. The earlier you seek help, the better your chances of preventing permanent changes and feeling confident in your skin.

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