Rosacea Treatment

What is rosacea?

Rosacea is a chronic inflammatory skin condition that primarily affects the face—particularly the cheeks, nose, chin, and forehead. It usually appears between the ages of 30 and 60 but can occur at any age, including in children.

While more common in people with fair skin, rosacea can affect all skin types. In skin of colour, it may appear as brown or violet discolouration rather than the classic redness seen in lighter skin tones.

Rosacea often presents with persistent redness, flushing, sensitive skin, and small bumps or acne-like pustules. In some cases, it may cause eye discomfort (ocular rosacea) or skin thickening on the nose (rhinophyma), which is more common in men.

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Who gets rosacea?

Rosacea affects around 5% of adults worldwide and occurs equally in men and women. However, it tends to be more severe in men. People of Celtic, Northern, or Eastern European ancestry are more commonly affected.

Rosacea is associated with a range of other conditions, including:

• Depression and anxiety

• Migraine

• Cardiovascular disease

• Gastrointestinal disorders such as Helicobacter pylori infection and small intestinal bacterial overgrowth (SIBO)

• Autoimmune conditions

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What causes rosacea?

Rosacea is a multifactorial condition involving:

• Genetic susceptibility

• Immune system dysregulation, including an exaggerated response to triggers and inflammation

• Altered skin and gut microbiome, including increased density of Demodex mites and Staphylococcus epidermidis

• Neurovascular dysregulation, where nerves in the skin trigger blood vessel dilation and flushing

• Impaired skin barrier function, allowing irritants and microbes to penetrate more easily

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Environmental triggers such as UV radiation, hot drinks, spicy food, alcohol, stress, and extreme temperatures can worsen symptoms.

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What are the symptoms of rosacea?

Rosacea varies in severity and presentation. Common symptoms include:

• Persistent facial redness

• Flushing or blushing that lingers

• Visible small blood vessels (telangiectasia)

• Acne-like papules and pustules

• Sensitivity, stinging or burning of the skin

• Dry, gritty, or irritated eyes (ocular rosacea)

• Thickened skin around the nose (rhinophyma)

These symptoms can impact self-esteem and quality of life, especially if untreated.

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How is rosacea diagnosed?

Rosacea is typically diagnosed based on the clinical appearance of the skin and patient history. No specific laboratory tests are required. A dermatologist will assess the severity and subtype, and help rule out other conditions that mimic rosacea, such as acne, seborrhoeic dermatitis, and lupus.

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What are the types of rosacea?

Rosacea is commonly classified into overlapping subtypes:

1. Erythematotelangiectatic rosacea: Persistent facial redness and visible blood vessels

2. Papulopustular rosacea: Red bumps and pustules resembling acne

3. Phymatous rosacea: Skin thickening and enlargement, especially of the nose (rhinophyma)

4. Ocular rosacea: Irritated, dry, or inflamed eyes and eyelids

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Treatment for Rosacea

While there is no permanent cure for rosacea, a range of effective treatments are available to reduce symptoms, calm inflammation, and improve the appearance and comfort of the skin. Treatment is tailored to the individual and often involves a combination of medical therapy, skin care adjustments, and lifestyle modifications. With appropriate management, many people achieve excellent control of their condition.

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1. Topical Treatments

Topical therapies are often used to reduce inflammation, calm redness, and prevent flare-ups. These are typically applied once or twice daily and may take several weeks to show benefit. Different topical agents target specific symptoms such as persistent redness, bumps, and skin sensitivity. Your dermatologist will select a preparation suited to your type of rosacea and skin.

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2. Oral Therapies

For more moderate to severe inflammation, or when topical treatments are insufficient, oral medications may be recommended. These are commonly used to reduce the inflammatory lesions associated with rosacea (such as papules and pustules), calm eye symptoms, and improve skin texture. Oral treatments may be used in short bursts or as part of longer-term maintenance strategies, depending on the severity of your symptoms and response to treatment.

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3. Laser and Light-Based Therapies

Procedural treatments using lasers or intense pulsed light (IPL) can be highly effective in reducing persistent redness, visible blood vessels (telangiectasia), and skin thickening. These treatments work by targeting and shrinking dilated vessels and stimulating collagen remodelling. A series of sessions is often required for optimal results. These procedures are typically performed by a dermatologist with experience in treating rosacea and sensitive skin.

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4. Management of Eye Involvement

If rosacea affects the eyes—referred to as ocular rosacea—specific treatments and eye hygiene routines may be required. Symptoms can include dryness, irritation, sensitivity to light, and blurred vision.

 

Treatment might involve eyelid cleansing regimens, warm compresses, artificial tears, and referral to an eye specialist for additional care if symptoms are severe.

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5. Procedural Treatment for Skin Thickening

In some cases, especially in men, the skin of the nose may thicken and become bulbous—a condition known as rhinophyma. When this occurs, surgical or laser-based procedures performed by a dermatologist or plastic surgeon can be used to sculpt and resurface the skin. These interventions can restore normal contour and significantly improve appearance.

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6. Lifestyle and Skin Care Modifications

Avoiding known rosacea triggers is a vital part of treatment. Common triggers include heat, sun exposure, alcohol, spicy foods, hot drinks, emotional stress, and certain skincare products. Identifying and managing your personal triggers through a diary or flare-up tracker can lead to a significant reduction in symptoms.

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A gentle skin care routine is also essential. This includes using a soap-free cleanser, avoiding abrasive scrubs or exfoliants, and applying a non-perfumed moisturiser to maintain skin barrier integrity. Daily sun protection using a high-factor (SPF 30 or above), broad-spectrum sunscreen is strongly advised, as UV exposure can worsen rosacea.

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7. Cosmetic Camouflage

For patients who feel self-conscious about facial redness, professional cosmetic camouflage can be a helpful adjunct. Tinted moisturisers, green- or yellow-based concealers, and mineral-based powders can help mask discolouration without irritating sensitive skin. A dermatologist or trained skin therapist can assist in finding suitable products that do not worsen rosacea.

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Self-care and lifestyle tips

Daily skincare and trigger avoidance are vital for long-term control:

• Use broad-spectrum sunscreen (SPF 30 or higher) daily.

• Avoid hot water, harsh scrubs, and perfumed skincare products.

• Choose gentle, fragrance-free cleansers and moisturisers.

• Identify and minimise triggers—keeping a symptom diary can help.

• Avoid topical steroids unless directed by a dermatologist.

• Consider non-irritating, water-based makeup or skin camouflage products.

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What should I do if I suspect I have rosacea?

If your facial redness or sensitivity is persistent, or if your skin is reacting to products or stress more than usual, it may be time to seek expert advice. Dermatologists are trained to distinguish rosacea from similar-looking conditions and can help guide you to long-term relief.

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Let’s bring your rosacea under control

You don’t have to live with redness, breakouts, or discomfort.

 

At Domain Dermatology, our dermatologists offer personalised rosacea treatment plans using the latest medical therapies, laser treatments, and ongoing support.

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Book a telehealth or in-clinic consultation today and take the first step toward clearer, calmer skin.