Rosacea in plain language: redness that isn’t “just sensitive skin”

Rosacea is a chronic inflammatory skin condition that most often affects the central part of the face — cheeks, nose, forehead and chin. It manifests as persistent redness, visible vessels, episodes of flushing, small red bumps and sometimes eye irritation.

Rosacea is not contagious, but it can significantly affect quality of life: people often feel embarrassed about their appearance, avoid photos, social events or bright lighting.

What rosacea actually is

In rosacea, the superficial blood vessels of the face become more reactive and fragile. They dilate too easily in response to triggers (heat, alcohol, emotions, spicy food), which leads to:

persistent redness,

visible capillaries (telangiectasia),

inflammatory papules and pustules (rosacea pimples).

Unlike acne, rosacea does not cause blackheads and deep comedones, and the skin is often more sensitive and reactive.

Typical symptoms of rosacea

Rosacea can look different from person to person, but the most common signs are:

Persistent redness on cheeks, nose, forehead and chin

Episodes of flushing and burning sensation

Visible thin red vessels on the skin (couperose)

Small red bumps and pustules that resemble acne

Increased sensitivity to cosmetics, temperature changes, wind

In some cases — eye symptoms: dryness, burning, redness, foreign body sensation

If several of these symptoms persist for weeks or months, it makes sense to see a dermatologist.

Main triggers of rosacea

Rosacea is very individual, but there are classic factors that often provoke flare-ups:

Hot drinks (tea, coffee), spicy food

Alcohol (especially red wine)

Heat, hot baths, saunas, sudden temperature changes

Cold wind and sun exposure

Stress and strong emotions

Aggressive cosmetics, peels, scrubs

Some medications (for example, certain vasodilators or topical steroids used on the face)

Keeping a simple “trigger diary” can help you understand what worsens your rosacea specifically.

Is rosacea dangerous?

Rosacea is not a life-threatening disease, but:

without treatment redness tends to become more persistent,

visible vessels become more pronounced,

flare-ups become more frequent,

thickening of the skin on the nose (rhinophyma) may develop in some cases.

Psychological impact is also important: self-esteem, communication and even professional life can suffer. That’s why it is worth treating rosacea, not just “putting up” with it.

When you should definitely see a doctor

Persistent facial redness that doesn’t go away for weeks

Burning, stinging, painful sensitivity of the skin

Frequent flushing episodes without obvious reason

Eye symptoms: dryness, redness, blurred vision, discomfort

Rapid worsening of skin condition or spread of lesions

A dermatologist will help clarify the diagnosis and distinguish rosacea from acne, dermatitis, lupus and other conditions that may look similar.

Diagnosis of rosacea

In most cases, diagnosis is clinical — based on:

a detailed medical history,

visual examination of the skin,

assessment of triggers and associated symptoms.

In specialized clinics, additional tools may be used:

Dermatoscopy and digital imaging — to evaluate vessels and lesions in detail;

High-resolution photography / AI-based systems like FotoFinder — to document the skin condition and monitor treatment dynamics.

How rosacea is treated

There is no “single magic cream” for everyone. Treatment usually includes several components that your doctor combines and adapts over time.

1. Topical therapy

Metronidazole gels/creams

Azelaic acid preparations

Topical ivermectin

In some cases — calcineurin inhibitors

They help reduce inflammation, redness and the number of papules and pustules.

2. Systemic therapy

For moderate to severe rosacea, or when topical treatment is not enough, the doctor may prescribe:

low-dose oral antibiotics with anti-inflammatory effect,

other systemic medications depending on the clinical situation.

Self-medication with antibiotics is not recommended — this can worsen resistance and not solve the problem.

3. Laser and light-based treatments

To reduce visible vessels and persistent redness, vascular lasers and IPL (intense pulsed light) are widely used. These procedures:

target and “seal” dilated vessels,

reduce general redness,

can make the complexion more even.

The number of sessions and intervals are chosen individually.

4. Skincare and lifestyle

Without daily care and working with triggers, even the best medical treatment will not give a stable result. Important points:

Gentle cleansing without SLS/SLES and strong fragrance

Daily use of moisturizers for sensitive skin

Mandatory sunscreen SPF 30–50 every day, all year round

Avoiding harsh scrubs, alcohol-based toners and aggressive peels

Limiting hot baths, saunas, very spicy food and alcohol if they trigger flushing

Working with stress and sleep hygiene

Rosacea vs. acne: how to tell the difference

They can look similar, but there are key differences:

With acne, comedones (blackheads/whiteheads) are common; with rosacea — almost never

With rosacea, flushing, burning and visible vessels are prominent

Oily, thick skin is typical for acne; sensitive, reactive skin — more for rosacea

In practice, there are mixed cases too, so the safest way is to see a dermatologist rather than self-diagnose by photos from the internet.

Can rosacea be cured?

Rosacea is a chronic condition, but:

with the right treatment,

good skincare,

and trigger control

many patients reach long-term remission with minimal symptoms and comfortable daily life.

If you notice persistent redness, burning or “acne-like” bumps on the central part of your face, it’s worth getting a professional opinion — especially if over-the-counter products don’t help or make things worse.

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