Rosacea- triggers, causes & treatment

Rosacea- triggers, causes & treatment

Rosacea- triggers, causes & treatment

What is Rosacea?

It is a common rash/redness usually found on the face and though the cause isn’t certain, it is related to some defect in the blood vessels, in the skin, which looks like spider veins and tends to dilate easily. Your skin could swell, sting, burn and flush more easily than other people. Eventually, it might get dry, rough, and scaly. It is generally a chronic condition that can end up having an effect on one’s mental well-being and confidence levels depending on its severity.

Types of Rosacea

Rosacea has four subtypes and each subtype has its own set of symptoms. People can even have more than one subtype of rosacea at a time. Generally, Rosacea affects the skin on the nose, forehead, and cheeks and seems to be more common in those with fair skin.

The four types of rosacea are:

  • Subtype one, known as erythematotelangiectatic rosacea (ETR), is associated with facial redness, flushing, and visible blood vessels.

  • Subtype two, papulopustular (or acne) rosacea, is associated with acne-like breakouts, and often affects middle-aged women.

  • Subtype three, known as rhinophyma, is a rare form associated with thickening of the skin on your nose. It usually affects men and is often accompanied by another subtype of rosacea.

  • Subtype four is known as ocular rosacea, and its symptoms are centred on the eye area.
Rosacea flare-ups occur in cycles which means that symptoms are experienced for months or weeks at a time and then the symptoms go away for a while only to return again. Research around this does seem to draw a pattern between unresolved emotional issues and certain lifestyle behaviours. Because Rosacea seems to run in families, there are possible genetic links to Rosacea. Here in Europe, those with Celtic or Scandinavian ancestry are more likely to have a family history of this condition.

Rosacea is completely different from acne because the skin is not particularly oily, and there are no associated blackheads or scarring.
No treatment is guaranteed to stop Rosacea. But it is possible to control the symptoms and clear spots.
Here’s what to do:

Avoiding triggers

Drinking alcohol, excessive exercise, fluctuations between high and low temperatures, spicy foods, direct exposure to sunlight and regular stress all seem significant in the flare-up of Rosacea.

Moisturise daily-

Moisturisers create a barrier to lock out irritants and help keep symptoms at bay. But choose the right one. The fewer the ingredients are the better. Oil-free creams and moisturisers work well. It is best to consult a doctor/dermatologist who’ll advise you of the best skincare regime.

Choose the right Facials-

Avoid anything too abrasive such as microdermabrasion, which can be too harsh and make Rosacea worse. During a flare-up, it may be best to avoid any facial with steam, heat or chemical peels. However certain skin peels, and also micro-needling, can actually help with conditions like Rosacea and strengthen the skin. Your Doctor can advise you.

Light make-up-

No matter how strong the urge to cover up Rosacea, piling on make-up only irritates the skin further. Liquid make-up clogs the pores and this can lead to a stronger flare-up. Also, try and use make-up that is fragrance-free. There are certain medical foundations with anti-inflammatory properties, which again your Doctor may be able to advise.

Sun protection

Sun exposure is a major trigger and applying sun-screen is an absolute must for someone who suffers from this condition. Also avoiding the sun as far as possible is in fact wiser than just putting on sunscreen. Ensure that sunscreens are broad-spectrum and have physical blockers like zinc oxide/titanium as they have the ability to block the sun’s UVA and UVB radiation from penetrating the skin (creating heat). Sunscreens also need to be hypoallergenic and fragrance-free.

Calm down flares

Cool showers, aloe vera and ingredients like green tea extract and liquorice can help soothe the skin and tackle flare-ups. Look for medical skincare specially designed for Rosacea.


Treatment for Rosacea focuses on controlling signs and symptoms. This can require a combination of medical skincare and prescription medication. The treatment duration depends on the type and severity of your condition as it is a recurrent phenomenon.


New Rosacea medications have been developed in recent years. The medication your Doctor prescribes depends on which signs and symptoms you experience. You may need to try different options or a combination of things to find a treatment that works for you.

Prescription drugs for rosacea include:

  • Topical drugs that reduce redness For mild to moderate Rosacea, your doctor may prescribe a cream or gel that you apply to the affected skin. Brimonidine (Mirvaso) and Oxymetazoline (Rhofade) reduce redness by constricting blood vessels. You may see results within 12 hours after use. The effect on the blood vessels is temporary, so the medication needs to be applied regularly to maintain improvements.

  • Oral antibiotics: Your doctor may prescribe an oral antibiotic for moderate to severe rosacea with bumps and pimples.

  • Oral acne drug: If you have severe Rosacea that doesn't respond to other therapies, your doctor may suggest (Roaccutane, Amnesteem, Claravis, others). It's a powerful oral acne drug that also helps clear up acne-like lesions of Rosacea. Don't use this drug during pregnancy as it can cause serious birth defects.

Laser therapy (ND YAG wavelength) and other light-based therapies (IPL) may help reduce the redness of enlarged blood vessels. Repeat treatments may be needed periodically to maintain the improved appearance of your skin.
It’s a good idea to consult your dermatologist to discover what might work for your skin.

Get in touch to book your consultation

Author: Dr Amit Goyal, Aesthetic Skin Doctor at MK Aesthetics is also a well established GP Partner at a prestigious surgery in Milton Keynes with an interest in Dermatology and is the lead GP for Dermatology in Milton Keynes. He is also part of the Dermatology team at Bedford Hospital.

Get in touch to book your consultation:
Tel: 01908 766276