Rosacea is a chronic inflammatory skin condition that primarily affects the central face.

It typically causes redness on the cheeks, nose, forehead, and chin. Some people also develop visible blood vessels, burning, stinging, and red bumps that resemble acne.

Rosacea can flare up periodically, and symptoms vary from person to person.

Rosacea is not contagious. Appropriate dermatologic treatment and daily skincare can help control its symptoms.

What Causes Rosacea?

The exact cause of rosacea is not fully understood. Several mechanisms are thought to contribute, including:

• Genetic predisposition
• Changes in the skin’s immune response
• Increased reactivity of facial blood vessels
• Impairment of the skin barrier
• Increased numbers of Demodex skin mites in some patients
• Environmental factors

Rosacea involves more than sensitive skin alone. Mechanisms involving the skin’s blood vessels, nerves, and immune system all play a role.

What Are the Symptoms of Rosacea?

Common symptoms include:

Facial Redness

Episodes of flushing or persistent redness may occur, particularly on the cheeks and around the nose.

Visible Blood Vessels

Small, superficial blood vessels can become enlarged and appear as fine red lines on the skin.

Acne-Like Breakouts

Some people develop red bumps and small, pus-filled lesions. These differ from typical acne.

Burning, Stinging, and Sensitivity

Skin affected by rosacea may feel warm, dry, tight, or irritated. Skincare and cosmetic products may cause burning or stinging.

Eye Symptoms

Rosacea can also affect the eyes, causing redness, dryness, stinging, light sensitivity, and eyelid inflammation.

Eye pain, reduced vision, or significant light sensitivity requires prompt evaluation by an ophthalmologist.

What Can Trigger Rosacea Flare-Ups?

Certain environmental and individual factors can worsen rosacea symptoms.

Commonly reported triggers include:

• Sun exposure
• Very hot or cold environments
• Hot drinks
• Spicy foods
• Alcohol
• Overheating during intense exercise
• Emotional stress
• Irritating skincare and cosmetic products

Triggers vary from person to person. Identifying your own triggers is more helpful than avoiding all foods or activities that might cause a flare-up.

How Is Rosacea Diagnosed?

Rosacea is usually diagnosed through a dermatologic examination.

The examination assesses the pattern of redness, visible blood vessels, inflammatory lesions, and skin sensitivity.

When needed, rosacea is distinguished from acne, seborrheic dermatitis, contact dermatitis, and other conditions.

There is no specific blood test that everyone needs for a rosacea diagnosis.

Current Rosacea Treatments

Treatment is planned around the patient’s main symptoms.

Redness, enlarged blood vessels, and acne-like lesions may require different approaches.

1. Topical Medications

Topical medications may be used for mild to moderate rosacea with inflammatory lesions.

Ivermectin: May help reduce red bumps and inflammatory lesions.

Azelaic acid: Can help reduce inflammatory lesions and, in some patients, redness.

Metronidazole: A topical option used to control inflammatory symptoms.

The choice depends on skin sensitivity, the type of lesions, and previous treatments.

2. Oral Medications

Oral medication may be needed for moderate to severe inflammatory rosacea or when topical treatment is insufficient.

Doxycycline may be used to reduce inflammatory symptoms in suitable patients.

A dermatologist may consider other systemic treatments for selected cases that have not responded adequately.

3. Treatments for Persistent Redness

Some patients with persistent facial redness may benefit from topical medications that temporarily narrow blood vessels.

Options include brimonidine and oxymetazoline.

Their effects are temporary. Some patients may experience irritation or increased redness. A dermatologist should assess whether these medications are appropriate.

4. Laser and IPL Treatments

Certain laser and light treatments may help reduce persistent redness and visible blood vessels associated with rosacea.

Options for selected patients include:

• Intense pulsed light (IPL)
• Pulsed dye laser (PDL)
• Other appropriate vascular laser systems

These treatments aim to reduce the appearance of superficial blood vessels and the redness associated with them.

Laser and IPL treatments do not address every rosacea symptom on their own. Medication and appropriate skincare may also be needed for inflammatory lesions.

Treatment selection depends on skin type, the characteristics of the blood vessels, and disease activity.

Can Rosacea Go Away Completely?

Rosacea is a chronic condition. There is currently no treatment that permanently eliminates it in every patient.

However, appropriate treatment can substantially reduce redness, inflammatory lesions, and skin sensitivity.

Consistent skincare, managing triggers, and maintenance treatment when needed are important for limiting recurrences.

Daily Skincare Tips for Rosacea-Prone Skin

Appropriate skincare can be as important as medication in managing rosacea.

• Wash your face with lukewarm water and a gentle cleanser.
• Avoid abrasive washcloths, brushes, and harsh exfoliating products.
• Be cautious with fragrance and other potentially irritating ingredients.
• Use a suitable moisturizer that supports the skin barrier.
• Apply a broad-spectrum sunscreen with SPF 30 or higher every day.
• Stop using products that worsen redness and consult your dermatologist.
• Do not apply corticosteroid creams to your face unless advised by a physician.
• Try to identify your individual triggers.

A consistent routine with a few well-tolerated products may be more helpful than using many different cosmetic products.

How Does Rosacea Differ From Acne?

The red bumps and inflammatory lesions of rosacea can resemble acne.

However, blackheads and whiteheads, known as comedones, are common in acne and generally absent in rosacea.

Persistent facial redness, flushing, burning, and visible blood vessels are more characteristic of rosacea.

An accurate diagnosis matters because the two conditions may require different treatments.

When Should You See a Dermatologist?

A dermatologic evaluation is recommended if you have persistent facial redness, recurring flushing, visible blood vessels, or acne-like breakouts.

Consult a dermatologist if cosmetic products repeatedly cause burning, redness is worsening, or lesions persist despite treatment.

Dermatologic Evaluation and Treatment

Rosacea treatment aims to reduce redness, control flare-ups, and protect the skin barrier.

At Dr. Armin Müştak’s private dermatology practice, patients with rosacea receive a dermatologic examination. A treatment and follow-up plan is developed based on their symptoms, skin characteristics, and previous treatments.

For suitable patients, laser or IPL treatments may be considered alongside medication to reduce visible blood vessels and redness.

Accurate diagnosis, treatment suited to the patient’s skin type, and consistent skincare are central to managing rosacea.