Rosacea
WHAT IS ROSACEA?
Rosacea (pronounced “roh-zay-shuh”) is a common skin condition that primarily affects the face, causing redness and flushing across your nose, forehead, cheeks, neck and chest. This redness usually comes and goes and might be more difficult to see on brown or black skin. Initial signs also include a burning or stinging feeling when using water or skincare products.
While the exact cause of rosacea is unknown, it tends to affect adults, especially those with fair skin, between the ages of 30 and 60. Early diagnosis and appropriate treatment can help manage your symptoms.
ROSACEA & HOW TO MANAGE IT
Rosacea is a relapsing condition, meaning that symptoms may worsen during certain periods but become less severe at other times. It can be controlled with long-term treatment, but sometimes the physical impact can affect how you feel.
The initial signs of rosacea include:
• Redness (blushing) across the nose, cheeks, forehead, chin, neck and chest, which comes and goes, lasting a few minutes each time
• A warm, hot or painful sensation on the face
People with brown or black skin may find it harder to see the redness.
Other symptoms of rosacea can include:
• Persistent facial redness that looks like blushing or sunburn that doesn’t go away
• Round red bumps (papules) and pus-filled swellings (pustules) on your face
• Visible tiny broken blood vessels that don’t go away
• Dry skin
• Swelling (especially around the eyes)
• Patches on the skin
• Sore eyelids or crusts around the roots of your lashes
• In severe cases, thickened skin may develop, particularly on the nose
If you experience symptoms that could be rosacea, speak to your GP. Early diagnosis and appropriate treatment can help prevent it from getting worse. If you’re looking for dermatology care outside the NHS, the Boots Skin Scanning Service1 can help. It’s a private service which gives you the option to have a consultant dermatologist review your skin and give you a diagnosis, advice and treatment if needed. Although there’s no specific test for rosacea, your GP can often diagnose it by examining your skin and looking into your symptoms and triggers. In some cases, additional tests may be arranged to rule out other conditions.
The exact cause of rosacea remains unknown, but certain things can make symptoms worse. Understanding these triggers can help you to manage and reduce the impact of rosacea. Common triggers include:
• Alcohol (especially red wine)
• Spicy foods
• Hot drinks
• Sunlight
• Exposure to hot or cold temperatures
• Activities like aerobic exercise such as running
• Being under stress
A tiny mite called Demodex folliculorum has been linked to rosacea. While it usually lives harmlessly on our skin, people with rosacea tend to have higher numbers of these mites. It’s uncertain whether the mite is a cause of rosacea or an effect of rosacea, but research so far has suggested that the skin might react to bacteria found in the mite’s poo, leading to symptoms. Genetics may be involved with rosacea as it tends to run in families.
Helicobacteria pylori bacteria, which is commonly found in the digestive system, has also been proposed as a potential cause of rosacea. Some theories suggest that these bacteria can make blood vessels expand due to the increase in certain protein production. While the exact cause of rosacea remains unknown, understanding potential triggers can help people manage their condition and potentially reduce how many flare-ups they have and their severity. You can also speak to your GP to get personalised advice to manage your rosacea.
Keratitis is a potential complication of rosacea that involves inflammation and damage to the cornea (the transparent layer at the front of the eyeball). This condition can be a serious threat to your vision as it can make the cornea vulnerable to infection. The inflammation and damage to the cornea can lead to symptoms like:
• Eye pain
• Sensitivity to light (photophobia)
• Deterioration in your vision
Make an urgent GP appointment if you have rosacea and experience any concerning symptoms related to your eyes, such as:
• Pain
• Blurred vision
• Light sensitivity
• A red eye
• A gritty feeling
If you can’t speak to your GP, go to A&E as it could be keratitis, a potentially serious condition that needs urgent treatment.
In some instances, rosacea can lead to skin thickening, particularly on the nose, resulting in a bumpy appearance known as rhinophyma. This is uncommon and almost only affects men. Rhinophyma is a condition that can happen in some people. While it mainly affects the nose, it can occasionally involve other parts of the face. If you have rhinophyma, speak to your GP who may then refer you to a dermatologist. A dermatologist can discuss your options to help improve the appearance of your skin. Several surgical treatments are available to manage rhinophyma. The procedures involve removing excess tissue and reshaping the nose. They include:
Laser treatment
Laser treatment is a common approach to treating rhinophyma. It involves using focused beams of light to precisely remove or reshape the affected tissue, which can help to give it a smoother and more even skin texture.
Dermabrasion
Dermabrasion is another option that uses special instruments to remove the top layer of the skin. This allows new skin to emerge and can help to improve the skin’s overall appearance. The choice of treatment depends on the severity of the rhinophyma and your individual situation. It’s important to note that while surgical treatments can significantly improve the appearance of rhinophyma, they may not be suitable for everyone. It’s important to speak to your healthcare professional about your available options.
Living with rosacea requires proactive management to minimise symptoms. Here are some practical tips to help you cope with your symptoms:
Protect your skin
Protect your skin from harmful UV rays by wearing a high-SPF sunscreen (at least SPF 30) every day. Additionally, try to avoid prolonged exposure to heat, sunlight or humid conditions.
Prepare for cold weather
Cover your face during colder weather to protect it from harsh winds and cold temperatures which can make rosacea symptoms worse.
Choose gentle skincare
Use gentle skincare products specifically designed for sensitive skin. Avoid harsh cleansers that may irritate your skin.
Minimise everyday stress
Stress can be a trigger for rosacea flare-ups. Take steps to manage everyday stress through relaxation techniques, mindfulness or other stress-reducing activities.
Make lifestyle adjustments
Certain lifestyle changes can have a positive impact on managing rosacea. Avoiding alcohol, hot drinks, spicy foods and smoking can help reduce flare-ups caused by triggers.
Choose gentle exercises
Instead of intense aerobic exercises, try strength exercises or gentle activities like walking or Pilates, which are less likely to trigger flare-ups.
Treating rosacea is essential to managing its symptoms and preventing it from getting worse. Although it can’t be cured, there are various treatments available that can help control it. Treatment choices depend on which of your symptoms is troubling you the most. They usually involve a combination of medication and self-help steps. If you think you have rosacea, it’s important to speak to your GP who may suggest the following treatment options:
Topical creams & gels
Your GP might prescribe creams and gels that can be applied directly to your skin to help reduce redness and control spots.
Oral antibiotics
In some cases of rosacea, oral antibiotics may be advised to reduce inflammation. The duration of antibiotics is usually four to six weeks, but longer courses may be necessary.
Laser therapy
Some people respond well to laser therapy, which can destroy tiny blood vessels under the skin without damaging nearby tissues. This can help improve redness, however, this treatment isn’t usually available under the NHS. This usually requires a referral to a dermatologist. Depending on your symptoms, other treatments may also be needed. When taking any prescribed medication, it’s essential to take it as prescribed and to follow your healthcare professional’s instructions.
If you have mild or moderate rosacea, Boots Online Doctor Rosacea Service2 can help support you with topical treatment, following an online consultation. If you have severe rosacea or your rosacea is affecting your eyelids or eyes, please speak to your GP. If you have a prescription for rosacea treatment, you can use the Boots Repeat Prescription Service.
You may also choose to access a Circle Health Group private dermatologist for face-to-face assessment and, if appropriate, treatment1.
Some people with rosacea have small bumps (papules) and pus-filled swellings (pustules). Topical treatments are usually prescribed first, but oral antibiotics may be prescribed for more severe papules and pustules. It’s essential to be patient with your treatment. Medications are usually taken for four to six weeks but you may need to take a longer course if your spots are persistent. To achieve the best results, it’s important to stick with your treatment for the entire course. You might not notice an improvement in your symptoms for several weeks.
Some people with rosacea may experience eye symptoms, referred to as ocular rosacea, which can include sensations of foreign objects in the eyes, burning, itching, dryness and sensitivity to light. In severe cases, inflammation and infection of the cornea may impact vision and require immediate medical attention. In cases where your eyelids may become inflamed (blepharitis), maintaining regular eyelid hygiene can help.
It’s essential to be vigilant about your eye health and seek medical attention if you have any concerning symptoms. If you notice eye pain, sensitivity to light (photophobia) or deterioration in your vision, contact your GP immediately or call 111. While most rosacea-related eye symptoms are manageable with care, it’s important to be aware of any changes or worsening symptoms. Regular eye check-ups can help prevent serious complications.
Living with rosacea can have an impact on mental health and emotional well-being. Coming to terms with having rosacea can be challenging for some but it can be managed with the right treatment plan and lifestyle adjustments. Persevering with your treatments and avoiding your triggers are the best ways to help manage rosacea symptoms effectively. By following your healthcare professional's advice and making necessary changes to your daily routines, you can take control of your condition and reduce its impact on your life. As you progress with your treatment and manage your physical symptoms, you may notice a positive shift in your mental health and how you feel. Feeling better physically can often increase your confidence and improve how you feel generally.
It's important to recognise that you’re not alone on this journey. Millions of people across the UK and around the world live with rosacea. Support is available and connecting with others who understand your experiences can help. Organisations like Changing Faces, a charity dedicated to supporting people with visible differences or facial disfigurements, provide counselling and advice. You can reach them at 0300 012 0275 to access their resources and services.
Seeking support from friends, family or support groups can be empowering. Sharing experiences with others who face similar challenges can offer a sense of community and understanding. Remember that your mental health is just as crucial as your physical well-being. Taking care of your emotional needs and seeking support, when necessary, can positively impact how you cope with rosacea. Don't hesitate to reach out to healthcare professionals, support organisations, or friends and family if you need someone to talk to. Speak to your GP if you’re struggling with your mental health.
Taking care of your skin is important as rosacea can make your skin more sensitive and prone to irritation. By following a suitable skincare routine, you can help manage rosacea symptoms and reduce discomfort.
Cleansing
Start by cleaning your skin gently every morning and evening using a cleanser suitable for sensitive skin, like the No7 Derm Solutions Calming Gel Cleanser Suitable for Sensitive Skin. Rinse your face with lukewarm water and let your skin dry completely before applying any medication or make-up.
Skincare products
When choosing skincare products, always look for those suitable for sensitive skin. Look for products described as mild, hypoallergenic, fragrance-free and non-comedogenic, meaning they won't clog pores. A suitable moisturiser can help soothe sore skin and provide hydration. Products like the No7 Derm Solutions Rosacea Treatment can help reduce rosacea symptoms like redness while keeping your skin hydrated.
Shaving
For those who shave, using an electric razor instead of a blade can help reduce skin irritation during shaving. Additionally, some people find that regular, gentle facial massages can help reduce swelling (lymphoedema). You can use tools like the Boots Twin Facial Massager, for facial massage.
Sun protection
As sun exposure is a trigger for rosacea, daily use of SPF is essential. A broad-spectrum sunscreen that protects against UVA and UVB light should be used. SPF 30 and over which is suitable for sensitive skin is recommended, like the La Roche Posay Anthelios UVMUNE 400 Invisible Fluid.
It's essential to avoid using steroid creams unless specifically instructed by your GP, as they may worsen rosacea symptoms. Stick to the treatment plan prescribed by your healthcare professional and avoid any products or treatments that could irritate your skin. Taking good care of your skin is an essential part of managing rosacea. By following these skincare guidelines, you can help manage your rosacea and minimise discomfort. If you're unsure about any aspect of your skincare routine, speak to your healthcare provider for personalised advice and recommendations.
If you have rosacea and want to cover patches of red skin, you can use specially designed camouflage make-up. This type of make-up is formulated to provide coverage for skin conditions like rosacea.
The charity Changing Faces offers a skin camouflage service that is available in England and Scotland and free of charge. They can help you learn how to use camouflage creams effectively and provide guidance on using them to cover redness caused by rosacea. To access this service, you can ask your GP or dermatologist for a referral and a prescription for skin camouflage make-up. Green concealers can be particularly useful for covering redness. Green is the opposite of red on the colour wheel, meaning a green concealer can help neutralise the appearance of red patches on the skin. After applying the green concealer, you can use a full-coverage foundation and concealer that matches your skin tone to achieve a natural and even complexion.
When applying makeup, it's essential to be gentle with your skin, as rosacea-prone skin can be sensitive. Choose products that are labelled as hypoallergenic, fragrance-free, and non-comedogenic to avoid irritating your skin further like the Estée Lauder Double Wear Stay-in-Place Foundation. If you're wearing eye makeup, choose types that can be easily washed off to make sure you can still clean your eyelids properly. Proper eyelid hygiene is essential, especially if you have blepharitis, an inflammation of the eyelids that can be associated with rosacea. Using camouflage makeup can be valuable for managing the appearance of rosacea and boosting your confidence. Remember that each person's skin is unique, so it may take some experimentation to find the best combination of products and techniques that work for you.
If you're unsure about the best approach or need guidance on using camouflage make-up effectively, don't hesitate to seek advice from healthcare professionals or specialists. They can provide personalised recommendations and support to help you make the most of your make-up routine while managing your rosacea symptoms.
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JOIN THE EXPERTS
Boots Pharmacist Karen Shaw and Boots Beauty Specialist Leanna Zaman team up with writer and makeup artist Rose Gallagher. Together, they discuss some of the most frequently Googled questions about Rosacea, providing valuable insights and practical advice on how to effectively treat and manage this common skin condition.
LEARN MORE ABOUT ROSACEA
FREQUENTLY ASKED QUESTIONS
Rosacea looks like redness (blushing) across your nose, cheeks forehead, chin, neck and chest. It might look like a sunburn that hasn’t gone away. There may also be skin thickening around the nose, bumps, pimples and visible blood vessels.
A well-formulated moisturiser can help to hydrate and soothe your skin. It’s important to use gentle formulas that are made for sensitive skin and designed to keep your skin hydrated. You can learn more about moisturisers for rosacea with Boots.
Rosacea used to be called acne rosacea due to its similarities with acne. Rosacea and acne are different conditions which require different management.
1 Subject to availability. Eligibility criteria may apply. Charges may apply.
26 Service operated by ScreenCancer. Eligibility criteria and charges apply. In selected pharmacies, subject to availability.
