Rosacea

What is rosacea?

Rosacea is a skin condition that is quite common. It causes red patches and visible blood vessels, mostly on your face. Sometimes, small red pus-filled bumps can appear on your skin. Rosacea is a long-lasting condition. 

The condition usually starts on the nose and cheeks. In severe cases of rosacea, the inflammation spreads to the forehead and chin. Over time, the redness can become more intense. 

Rosacea is often mistaken for acne. It mostly affects middle-aged women with light skin, but anyone can develop it. There's no cure, but certain treatments can reduce the symptoms. 

Types of rosacea

There are four types of rosacea. 

• Erythematotelangiectatic rosacea: This is the most common type. It involves widened blood vessels, redness and flushing. 

• Papulopustular rosacea: This is where acne-like bumps form on your face. These can cause swelling and fill with pus, resembling whiteheads. 

• Phymatous rosacea: This is where the skin thickens, sometimes on the nose (rhinophyma). As a result, the skin texture becomes bumpy. 

• Ocular rosacea: This results in watery-looking eyes that burn.

In some cases, rosacea can appear on the chest, back and neck. 

What are the causes of rosacea?

In the UK, around 1 in 10 people are affected by rosacea. However, most of these people don't even know they have it. We don't yet know the exact cause of rosacea, but studies suggest that it might involve:

• The nerves and blood vessels

• The immune system

• A skin mite called Demodex (which hav been found in large numbers on the skin of people with rosacea)

• Genetic factors

Skin experts believe that the cause is likely a mix of genetics and environmental factors. Lifestyle choices can also affect your risk of developing rosacea. Therefore, a healthy lifestyle is very important to reduce your chances of getting it.

Another possible cause is a type of bacteria called H. pylori, which can be found in your gut. Studies suggest it can raise the amount of the hormone gastrin in the body. This might cause your skin to look flushed.

Triggers and risk factors for rosacea 

Certain things in your environment can contribute to rosacea. These include:

• Sunlight or wind

• Some makeup and skin products

• Temperature

• Spicy foods and some drinks

• Alcoholic drinks, such as red wine

• Drugs that make the blood vessels widen

• Exercise

More generally, you are more likely to get rosacea if:

• You are a woman.

• You have fair and sensitive skin.

• You are over the age of 30.

• You smoke.

• You have a family history of rosacea.

What are the symptoms of rosacea?

The most common symptoms of rosacea include the following. 

• Facial rednes: Rosacea typically causes redness in the central part of your face. Tiny blood vessels on the nose and cheeks swell and become more visible. 

• Swollen red bumps: Rosacea may cause small, pus-filled pimples on the face. These can look like acne. The skin may feel hot, tender and very irritable. 

• Eye problems: The eyes may water, burn or feel irritated. This is known as ocular rosacea. Also, they may get very swollen. In some people, eye symptoms occur before skin symptoms. 

• Enlarged nose: Rosacea tends to thicken the skin on the nose. As a result, your nose may look bigger. This is more common in men than in women. 

• Flushed face: People who have rosacea often have a history of facial flushing and blushing. This is one of the earliest signs of rosacea. 

• Burning: Rosacea causes skin irritation, making the skin burn and itch.  

• Dryness: Rosacea can cause the skin to look and feel rough and dry.

If you or someone you know has these symptoms, see a dermatologist for a proper check-up.

How is rosacea diagnosed?

To diagnose rosacea, a doctor will typically go over your medical history and look at your skin. They will ask questions such as whether anyone in your family has or has had rosacea. They will also ask about possible triggers. In addition, they'll check your skin for redness, bumps, and visible blood vessels, while ruling out other conditions with similar symptoms. 

Usually, no special tests are needed. In fact, there is no specific test for rosacea. Diagnosis relies mainly on your symptoms and how your skin looks and feels. So, if you think you may have rosacea, see a doctor for a proper diagnosis and appropriate treatment.

How to treat rosacea?

While there is no known cure for rosacea, lifestyle changes and medicines can help reduce the signs and symptoms. Treatment options include:

• Over-the-counter skincare products

• Prescription topical treatments (gels and creams, eye drops)

• Oral medicines

• In-office treatments

• Lifestyle changes

Over-the-counter skincare

Over-the-counter products may not help to permanently reduce visible blood vessels, but they can temporarily make your skin less inflamed. Products that contain azelaic acid and niacinamide can also help reduce redness. Because people with rosacea have very sensitive skin that is prone to damage, it is important to use gentle skincare products. Sunscreen is also vital, as the sun can damage your skin. 

Prescription topical treatments

Prescription creams such as those with the antibiotic metronidazole can help reduce redness and inflammation, which might be a cause of rosacea. For example, Mirvaso gel, which contains brimonidine, can reduce redness by tightening blood vessels in your skin.

Eye drops can help with the symptoms of ocular rosacea. For example, your doctor may recommend Blephamide, a type of steroid eye drop. These are prescribed for a few days to a week, followed by a break or tapered use.

Oral medicines

Oral medicines like antibiotics are often used to manage rosacea. Tests have shown that some drugs can help reduce the number of Demodex skin mites, such as:

• Doxycycline (an antibiotic that also fights inflammation)

• Ivermectin (which fights parasites)

Tetracycline and minocycline can help reduce eye symptoms such as dryness, itching and watering. 

Isotretinoin (Accutane) is an oral medicine used in severe rosacea cases and only when other treatments have not worked. This is a strong drug that restricts the skin from making oil, and its side effects can be severe.

In-office treatments

In-office treatment procedures that may help with rosacea include:

• Laser therapy. Lasers use intense light to narrow widened blood vessels and make them less visible. This can be painful, but most people do not need anaesthetic for this process. 

• Dermabrasion. This sands off the top layer of skin. 

• Electrocautery. This uses an electric current to zap the damaged vessels. 

Lifestyle changes

As a final non-prescription rosacea treatment, lifestyle changes can heavily reduce your symptoms. These include:

• Cutting down on alcohol

• Eating less spicy food

• Avoiding sugary drinks

• Stopping smoking

• Protecting your skin from sunlight

Getting rosacea treated is vital. If you leave it untreated, it may develop into something more serious and could even put your life in danger.

Soolantra cream vs Finacea gel

The main difference between Soolantra cream and Finacea gel is in their active ingredients.

Soolantra is a topical cream used for the treatment of rosacea. It contains the active ingredient ivermectin. Soolantra is an anti-inflammatory cream that reduces symptoms associated with rosacea, including facial redness, swelling, bumps and spots.

Finacea, on the other hand, is a gel treatment for rosacea. It contains azelaic acid.

How to prevent rosacea?

You can prevent rosacea by:

• Avoiding known triggers. If certain products or situations tend to trigger your rosacea, try to avoid them. For instance, switch to lukewarm showers if hot showers are a trigger.

• Looking after your skin. Invest in a good skincare routine. In particular, get a cleanser and moisturiser that suit your skin.

• Using camouflage makeup. To combat the redness caused by rosacea, you can use makeup to conceal red patches. 

• Keeping your eyelids clean. If rosacea affects your eyelids, make sure that you clean them thoroughly and regularly. This will help reduce any inflammation or irritation. Also, if you use eye makeup, choose products that are mild and wash off easily.

Can I buy rosacea treatment online?

Yes! You can buy rosacea treatment online quickly and discreetly through our UK online pharmacy. First, you'll need to complete a brief online assessment. One of our prescribers will review your responses. If approved, our pharmacy team will post the medicine to you for next-day delivery.

Can I get rosacea cream over the counter?

Yes, some non-prescription rosacea creams and gels are available, and these may help manage your symptoms. Look for products containing ingredients such as niacinamide, azelaic acid or liquorice extract.

How long does it take to treat rosacea?

Rosacea is a lifelong condition with no cure. However, effective treatments, including medicines and lifestyle changes, can help reduce the signs and symptoms in approximately 6 months. With patience and the correct treatment plan, you can keep your symptoms to a minimum.

Does alcohol cause rosacea?

Rosacea flare-ups can be triggered by drinking alcohol. And alcohol can even worsen existing symptoms. Experts say it is best to avoid alcohol completely if you suffer from rosacea. This means you should not consume alcohol even in moderation.

What foods trigger rosacea?

Many foods may trigger rosacea. For some people, hot drinks, such as tea and coffee, can set off rosacea symptoms. In addition, you may find that foods containing dairy can cause an outbreak. Spicy foods are also common triggers for rosacea flare-ups.

Furthermore, most foods with cinnamaldehyde can aggravate rosacea symptoms. These include cinnamon, citrus fruit, tomatoes and chocolate. Try cutting down on these foods to see whether your flare-ups calm down.

What is papulopustular rosacea, and what are its symptoms?

Papulopustular rosacea is a type of rosacea commonly referred to as acne rosacea.

This condition involves a combination of symptoms of rosacea and acne. Common papulopustular rosacea symptoms are:

• Constant redness

• Inflammation

• Flushing or looking like you're blushing

• Burning or stinging of your face

• Red bumps in the skin (papules)

• Pus-filled spots (pustules)

• Itching

• Extremely sensitive skin

• Rough or dry skin

• Widened blood vessels (telangiectasia)

• Thickening of the skin (rhinophyma)

Generally, these symptoms occur in the middle of the face. In most cases, the affected areas are the cheeks, nose and chin. You may also see these symptoms on your forehead, although this is rare. Acne rosacea can also affect other parts of your body.

Will my nose swell or change shape (rhinophyma)?

Sometimes, rosacea can affect the nose, making it look bigger. However, this is not common. It only develops in rosacea cases where the condition has been left untreated for a while. 

Is rosacea a sign of poor hygiene?

No. Rosacea isn't a sign of poor hygiene.