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Read articleRosacea: Causes of Persistent Facial Redness and Treatment
Rosacea is a long-term skin condition affecting the centre of the face. It appears as recurring or persistent redness on the cheeks, nose, forehead and chin, sometimes with fine visible blood vessels, acne-like spots and a burning feeling. There is no permanent cure yet, but it can be largely controlled by identifying and avoiding triggers and following a treatment prescribed by a dermatologist.
What are the symptoms and types of rosacea?
Rosacea varies from person to person, and one patient may have more than one type. Its most common features are:
- Recurring redness or flushing of the face that comes in episodes and may become permanent over time.
- Thin visible blood vessels on the cheeks and nose.
- Red bumps and small pustules that look like acne but without blackheads or whiteheads.
- Sensitive skin with burning or stinging from many products.
- Thickening of the skin on the nose in a small number of cases, more often in men.
- Irritated, red and dry eyes, known as ocular rosacea.
What causes rosacea and who gets it?
The exact cause is not fully known. Doctors believe it is a mix of genetic tendency, over-reactive blood vessels in the face and a disturbance in the skin's natural immunity; an increase in a type of mite that normally lives on the skin may play a role in some patients.
It usually appears after the age of 30 and is more visible in fair skin, but it also affects olive and darker skin, where diagnosis may be delayed because redness is less obvious. Rosacea is not contagious and is not caused by poor hygiene.
What triggers make the redness worse?
Triggers differ between people, and knowing yours is one of the most important parts of treatment. Some of the most common in our climate are:
- Sun and heat, including summer heat and moving suddenly from air-conditioning to the outdoors.
- Very hot drinks, such as Arabic coffee and tea while still hot, and spicy, heavily seasoned food.
- Hot showers, saunas and steam rooms.
- Intense exercise in hot weather.
- Stress and strong emotions.
- Some skincare products, especially fragranced ones, those containing alcohol or harsh exfoliants.
How is rosacea treated?
A dermatologist chooses treatment based on the type and severity of rosacea. Topical creams and gels can reduce spots and inflammation, including those containing azelaic acid, metronidazole or ivermectin, and other creams reduce redness temporarily by narrowing blood vessels. For moderate to severe cases, a doctor may prescribe certain antibiotic tablets at doses that act as an anti-inflammatory. All of these are prescription treatments that need follow-up. Some of these medicines are not suitable during pregnancy or breastfeeding, so tell your doctor if you are pregnant or planning a pregnancy.
Visible blood vessels and persistent redness may improve with vascular laser or intense pulsed light (IPL) sessions. Several sessions may be needed, with maintenance sessions because vessels can return over time.
It is important not to put cortisone creams on your face on your own; they may hide the redness for a while, then make rosacea worse when you stop.
A gentle routine for rosacea-prone skin
Rosacea skin is sensitive, so fewer and gentler products are better. Wash your face with lukewarm water and a mild, fragrance-free cleanser, and pat it dry. Use a simple moisturiser that supports the skin barrier and a daily sunscreen; many patients do well with mineral sunscreens containing zinc oxide or titanium dioxide.
Avoid grainy scrubs, alcohol-based toners, fragranced products and strong acne treatments unless your doctor prescribes them. Patch-test any new product on a small area before using it on your whole face.
Frequently asked questions
What is the difference between rosacea and acne?
Rosacea usually affects people over 30, is dominated by redness and burning, and has no blackheads or whiteheads. Some strong acne treatments can irritate rosacea, so telling them apart needs a doctor.
Does rosacea go away for good?
Rosacea is a chronic condition with calm periods and flares, and no treatment guarantees it will disappear permanently. With treatment and avoiding triggers, however, many patients control it well and have far fewer flares.
Can I wear make-up with rosacea?
Yes. Light, fragrance-free, non-comedogenic make-up can be used, and green-tinted products help cover redness. Remove it gently at the end of the day with a mild cleanser.
Can rosacea affect the eyes?
Yes, in some patients, causing red, dry eyes, a gritty feeling and swollen eyelids. These symptoms need medical assessment, and you may need to see an eye doctor.
When to see a doctor
See a dermatologist if facial redness lasts more than a few weeks, if spots and burning do not improve with gentle care, if you notice thickening of the skin on your nose, if the redness comes with eye symptoms, or if your skin got worse after using cortisone creams. You can book a consultation at Medical Care Clinics in Dammam, where our dermatology team will diagnose the condition and build a treatment plan for your type of rosacea.
This article is general health education and does not replace a medical examination. Every case needs its own assessment by a doctor.
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