rosacea overview for patients

Overview

Rosacea is a long-term (chronic) skin condition that mostly affects the face. It causes redness, flushing, visible blood vessels, and sometimes small red bumps or pus-filled spots. It can also affect the eyes, making them feel gritty and look red. Rosacea is not contagious.

Yes. Rosacea is one of the more common skin conditions. Experts estimate that around 1 in 20 people in the UK have it, and it affects people all over the world.

Rosacea usually starts after age 30. It affects both men and women, though women get it slightly more often. Men are more likely to develop thickening of the nose. People with fair skin are more often affected, but rosacea can happen in any skin tone.

Symptoms

Common symptoms

• Facial flushing or blushing that comes and goes
• Persistent redness on the face
• Visible small blood vessels (sometimes called spider veins)
• Small red bumps or pus-filled spots that look like acne
• A burning or stinging feeling on the skin
• Dry, rough, or sensitive skin
• Thickened skin on the nose, especially in men

Causes

Main causes

• The exact cause of rosacea is not fully understood.
• It likely involves a mix of genetics, an overactive immune system, and blood vessels that widen too easily.
• Common triggers include sun exposure, hot or cold weather, stress, spicy foods, alcohol, and certain skincare products.
• Rosacea is not caused by poor hygiene or dirty skin.

Risk factors

• Having fair skin or a family history of rosacea
• Being between 30 and 50 years old
• Having a tendency to flush or blush easily
• Being exposed to strong sunlight, extreme temperatures, stress, alcohol, or spicy food
• Using harsh skincare products or treatments that irritate the skin

When to see a doctor

See a doctor urgently if:

• Seek same-day medical care if you have severe eye redness, eye pain, or sensitivity to light.
• Seek quick help if you have signs of a skin infection, such as spreading redness, warmth, yellow crusting, or fever.

Book a routine appointment if:

• Make an appointment with your doctor if you notice persistent redness, flushing, bumps, or visible blood vessels on your face.
• See a doctor if your face burns or stings often, or if your eyes feel gritty and look red.
• The earlier you get help, the easier it is to control rosacea.

Diagnosis

A doctor or a skin specialist (called a dermatologist) usually diagnoses rosacea by looking at your skin and asking about your symptoms, triggers, and family history. There is no single test that tells you if you have rosacea.

Tests that may be done

• In most cases, no tests are needed.
• If the diagnosis is unclear, a doctor may sometimes take a tiny skin sample (a biopsy) to rule out other conditions.
• If your eyes are affected, you may be referred to an eye specialist for a detailed eye examination.

What to expect at your appointment

Your doctor will examine your face and may ask about your daily habits, what makes your skin worse, and whether you have any eye symptoms. This is also your chance to ask questions. Together you can agree on the next steps, from skincare routines to prescription treatments.

Treatment

Rosacea is not curable, but it can be managed well. Most treatment plans start with gentle skincare and avoiding triggers. If that is not enough, your doctor may suggest prescription creams or gels applied to the skin, or oral medicines that reduce inflammation. Eye symptoms may need extra care. Always follow your healthcare provider's instructions for any medicine.

Self-care at home

• Protect your face with a broad-spectrum sunscreen every day, even in winter.
• Wash your face with a gentle, fragrance-free cleanser.
• Moisturise daily with a product made for sensitive skin.
• Avoid rubbing, scrubbing, or using harsh exfoliants.
• Keep a diary to learn what triggers your flare-ups.
• Protect your face from strong wind and extreme cold.
• Use lukewarm water when washing or showering.

Medical treatments

Prescription options include topical treatments (creams or gels you apply to the skin) that help reduce redness and bumps. Doctors may also prescribe oral medicines, such as certain antibiotics or other anti-inflammatory tablets. For eye symptoms, your doctor may recommend eye drops or eyelid hygiene. In some cases, dermatologists offer procedures like laser or light therapy for visible blood vessels, or specialist surgery for thickened skin. These treatments should always be discussed with and prescribed by a qualified healthcare provider.

When is surgery considered?

In advanced cases where the nose becomes enlarged and thickened (rhinophyma), a doctor may suggest a short surgical procedure to reshape the nose. This is not a first-line treatment and is only considered when other options are not enough. Ask your dermatologist if this applies to you.

Living with this condition

Living with rosacea can be challenging, but a simple daily routine can make a big difference. Cleanse gently, moisturise, and apply SPF every morning. Notice what makes your face red and try to avoid those things. With the right care, rosacea does not have to control your life.

Lifestyle tips

• Wear a wide-brimmed hat when outdoors to shade your face.
• Choose skincare products labelled 'gentle' or 'for sensitive skin' and test them on your forearm first.
• Limit alcohol, especially red wine, if you notice it causes flushing.
• Manage stress with activities like breathing exercises, walking, or talking to a friend.
• Drink enough water throughout the day.

Diet and exercise

There is no single diet for rosacea. Spicy foods, hot drinks, and alcohol are common triggers, but everyone is different. A balanced diet is always good. Exercise is healthy, but try to avoid overheating. Work out in a cool, well-ventilated space, pace yourself, and cool down gradually.

Mental health and emotional wellbeing

Rosacea can affect your confidence and mood because it is visible on your face. It is normal to feel self-conscious or worried. Please remember that rosacea is not your fault, and you are not alone. If you feel low, anxious, or withdrawn, talk to your doctor or a mental health professional. If you are ever in crisis, reach out to your local emergency number or a crisis support line.

Prevention

You cannot always prevent rosacea, because your skin type and family history play a part. But you can reduce flare-ups by avoiding your personal triggers. Daily sun protection is one of the most helpful steps. Keeping your skincare simple and gentle also helps.

Screening programmes

There is no routine screening for rosacea. However, it is a good idea to keep an eye on your skin. If you notice new or changing patches, persistent redness, or unusual bumps, see a doctor for a check-up.

Complications

If left untreated

• Persistent redness may become permanent over time.
• Thickened, bumpy skin can develop on the nose, especially in men.
• Eye symptoms could lead to discomfort or more serious problems if not treated early, though this is rare.
• Early treatment lowers the risk of permanent skin changes.

Long-term outlook

The outlook for rosacea is good with proper care. While it is a chronic condition, most people can control their symptoms with a combination of gentle skincare, trigger avoidance, and medical treatments. The earlier you seek help, the better. Many people with rosacea live active, confident, and happy lives.

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