Rosacea is a non-infectious skin condition that can come and go as flare-ups. Flare-ups occur when the central part of your face becomes red and flushed, alongside small pus-filled lumps (pustules) and spots that can become infected. Your facial skin will often become dry and flaky. Flare-ups can last for weeks or months.
Other symptoms include:
You may also develop swellings on some parts of your face, including your eyelids (blepharophyma) and persistent, small yellow-brown bumps (papules).
Rosacea can lead to Morbihan disease, persistent redness and swelling of your upper face, sometimes with collections of fluid that feel firm to the touch (solid oedema).
There are four types of rosacea. Your GP will be able to tell you which type you’ve got. In some cases, it can affect you psychologically as well as physically.
There is currently no cure but you can find relief from your symptoms by making lifestyle changes. If these do not work, your GP may prescribe cream or pills to clear it up.
The four main types of rosacea are:
A fifth type of rosacea called steroid rosacea is caused by the long-term use of corticosteroids to treat the skin conditions dermatitis and vitiligo.
Who is affected by rosacea
Rosacea usually affects people aged between 30 and 60, especially if you have fair skin. It can be mistaken for acne or a ruddy complexion. You’re more likely to have it if you’re a woman, although it can be more severe in men who do get it. It can run in families and you are at greater risk of developing rosacea if you are of northern or eastern European descent.
You may find that you’re blushing or have sunburn more often than usual, which doesn’t fade away. Over time, the skin on your face may feel:
You may also see obvious blood vessels (telangiectasia), particularly on your cheeks, the bridge of your nose and central face. Your face may appear swollen in areas as fluid and proteins leak out of your blood vessels.
If you have darker skin, you may not develop redness of your skin but there are other symptoms you can look out for, including brown or grey skin discolouration and darker patches of skin.
If your rosacea affects your eyes (ocular rosacea), you may also develop eye symptoms, including:
Left untreated, ocular rosacea can cause permanent blurred vision.
If you’re worried about your symptoms, especially if they affect your eyes, arrange to see your GP as soon as possible.
Before your appointment with your GP, you may want to make a list of questions to ask. You may have questions about rosacea, such as what causes it and whether it is contagious and/or hereditary. You may also have questions about getting a diagnosis and your prognosis, such as:
You may have questions about your symptoms and how they may be affected by other conditions, such as:
You may have questions about what triggers your rosacea, such as:
You may have questions about your treatment, such as:
In most cases, your GP will be able to diagnose rosacea by examining your skin. They will look for common symptoms such as flushing, papules, pustules, telangiectasia and eye symptoms (inflammation, irritation, blepharitis). They will also check to see if your skin is dry or flaky and if you have facial oedema, and will ask if your skin feels stingy or burning. This will help them rule out other common skin conditions such as eczema and dermatitis.
If your eyes are affected, your GP may refer you to an ophthalmologist (a doctor who specialises in treating eye problems).
In some cases, they may refer you to a consultant dermatologist (a doctor who specialises in diagnosing and treating skin conditions). You might have a blood test or a biopsy, where a tiny sample of skin is taken for analysis. This is to check for other conditions such as pityriasis, menopause or lupus and can also detect inflammation and changes in your blood vessels.
It isn’t always possible to know what causes rosacea. It may be to do with:
Differences in fatty acids in facial skin and overactivity of chemicals (niacin) involved in flushing may also contribute to rosacea.
Some things can trigger rosacea or make it worse. These include:
Rosacea can’t be cured but it can be treated. Your GP might suggest some lifestyle changes, such as:
You may want to try holding an ice cube between your gums and cheek to temporarily reduce facial redness. Do not apply a topical steroid to your rosacea — it may temporarily reduce your symptoms but your rosacea will then worsen considerably in the weeks following.
Your GP may prescribe medications to relieve your symptoms. This may include:
If your nose has become swollen, your GP may refer you to a consultant dermatologist or to a plastic surgeon who specialises in repairing or reconstructing the face.
Laser therapy and other light-based therapies are also available to reduce redness caused by blood vessels and to treat papulopustular rosacea. Repeated treatments are usually needed.
Telangiectasia can also be treated with laser or light-based therapies but if these treatments are not successful, telangiectasia can be treated with more invasive procedures ie cautery, diathermy (electrosurgery) or sclerotherapy (strong saline injections).
Rosacea can be mistaken for or occur alongside other skin conditions, such as:
Common types of rosacea may also be mistaken for steroid rosacea and rosacea fulminans, while flushing could be caused by other conditions instead of rosacea. Rosacea can also be mistaken for ageing skin.
Does rosacea go away?
Rosacea can temporarily go away although there is no permanent cure. Making lifestyle changes and having treatment can, however, reduce how often you have flare-ups.
How do I know if I have rosacea?
Rosacea can be mistaken for other skin conditions, however, symptoms include red, flushed facial skin, acne-like spots, skin sensitivity and/or a burning, stingy sensation. To get a diagnosis, see your GP.
What is the most effective treatment for rosacea?
Avoiding triggers is one of the most effective treatments eg avoiding perfumed and oil-based skincare products and hot environments (hot baths, showers and rooms). However, prescription medication is also effective, such as rosacea creams and tablets to reduce acne.
How do you clear up rosacea?
Try to avoid using fragranced and oil-based products on your face and avoid prolonged exposure to intense sunlight, as well as hot and humid environments both indoors and outdoors. Changing your diet to cut out hot, spicy foods and alcohol can also help clear up your rosacea. If these lifestyle changes aren’t effective, see your GP; they may prescribe you creams or tablets.
What is the main cause of rosacea?
Often, the underlying cause of rosacea is unknown. It may be caused by changes in your nervous system and/or facial blood vessels. An overabundance of Demodex mites has also been suggested as a cause — these mites are naturally present on our skin but occur in higher numbers on the skin of people with rosacea, which may therefore trigger an inflammatory response by your body. Genetics also plays a role as rosacea tends to run in families and is more common in people of northern or eastern European descent.
How do you get rid of rosacea on the face?
Lifestyle changes can reduce your rosacea symptoms, such as protecting your skin by using water-based skincare products, avoiding perfumed and oil-based skin care products and wearing a strong oil-free sunscreen. You can also avoid eating hot, spicy foods and drinking alcohol, and reduce your exposure to very hot or cold environments. However, you may need to try medication, prescribed by your GP, such as rosacea cream, anti-acne tablets and eye drops (if you have ocular rosacea). In severe cases, your doctor may also recommend laser or other light-based therapies.
How do you stop rosacea flare-ups?
Avoid factors that trigger your rosacea, such as eating hot, spicy foods, using perfumed or oil-based skincare products, and exposing your skin to very hot, cold, humid or windy environments.
What foods trigger rosacea?
Hot, spicy foods can trigger rosacea, as well as hot drinks and alcohol.
How long does a rosacea flare-up last?
A rosacea flare-up can last weeks or months.
Can rosacea be triggered by stress?
Yes, emotional trauma or stress can trigger a flare-up of rosacea.