Rosacea: everything you should know about symptoms, treatment and care

Have you had red cheeks for a long time and thought it was blemished skin or just how your skin behaves? Here are answers to the questions most people ask when rosacea comes up.

In brief

• Rosacea is a common, long-term skin condition that causes redness in the centre of the face. A doctor can diagnose and treat it.
• Sun, heat, stress, alcohol and spicy food often bring on redness. Get to know your own triggers.
• For everyday care, skin does best with a mild cleanser, a fragrance-free moisturiser and sunscreen every day.

What is rosacea?

Rosacea is a long-term inflammatory condition affecting the skin on the face. It mainly affects the cheeks, nose, chin and centre of the forehead and comes and goes in periods. It most often starts between the ages of 30 and 50 and is most common in women with fair skin, but men often develop the most severe changes¹.

Rosacea is not contagious, nor is it caused by not washing well enough².

How many people actually have rosacea? Danish researchers have combined figures from many studies to find the answer³. Have a guess before you see the answer.

What are the symptoms of rosacea?

Rosacea looks different from person to person, and most people have more than one of these signs:

• you blush easily and your face becomes warm
• redness that lasts for weeks or months
• small visible blood vessels on the cheeks and nose
• small red spots and sometimes small pus-filled spots
• skin that stings or prickles when you apply something
• dry, rough skin that may flake a little
• eyes that feel dry, itchy or as if there is sand in them

On darker skin, redness is harder to see. Rosacea may instead appear as a brownish or violet colour, dark spots or blemishes².

What types of rosacea are there?

There are typically four types of rosacea. Many people have features of several types at once:

• Redness and blood vessels: redness and warmth in the centre of the face, often with small visible blood vessels. This is the type many call mild rosacea.
• Redness with spots: small red spots and pus-filled spots on top of the redness. Doctors call this papulopustular rosacea.
• Thickened skin: the skin becomes thicker and uneven, most often on the nose. This is seen mostly in men.
• Rosacea in the eyes: irritated, dry or red eyes and eyelids.

A dermatologist directs treatment at the signs you have, such as redness, spots or visible blood vessels. This way, treatment can address what matters most to you⁴.

Is it rosacea, acne or just redness?

Many people get red cheeks when they are warm, have been out in the cold or feel embarrassed, and it then goes away. With rosacea, redness persists or keeps coming back, and spots or visible blood vessels may appear. Rosacea can look like acne, but there are no blackheads, and it affects the centre of the face.

There is no blood test for rosacea. A doctor makes the diagnosis by looking at your skin and eyes. Sometimes a test is needed to rule out other skin conditions⁴.

If your skin is sensitive and becomes red easily, but without the other signs, read our guide to facial redness.

Why do people get rosacea?

The exact cause is unknown. With rosacea, the immune system, blood vessels and nerves in the skin react more strongly than normal. In some people, tiny skin mites (demodex), which we all have on our skin, also play a role¹.

Rosacea is partly hereditary. Using corticosteroid cream on the face for a long time can also trigger rosacea, so only use it on your face if your doctor has told you to¹.

If it feels as though rosacea has appeared suddenly, think about whether anything has changed, such as more sun, more stress, new skincare products or new medication. This is useful information to share with your doctor.

What causes rosacea to flare up?

Triggers vary from person to person. When over 1,000 people with rosacea were surveyed, the most common triggers were⁵:

• sun
• stress and strong emotions
• hot weather, hot baths and indoor heat
• wind and cold weather
• intense exercise
• alcohol
• spicy food
• certain skincare products and makeup

Try keeping track of when your skin reacts, for example by making a few notes on your phone for a few weeks. This can help you identify your own triggers and know what to cut back on. In winter, pulling a scarf over your cheeks can protect them from wind and cold.

What should you avoid eating when you have rosacea?

There is no set rosacea diet, and you do not need to give up lots of foods. But many people find that hot drinks, alcohol, spicy food with chilli and food with cinnamon bring on redness. For some, the same is true of tomatoes, citrus fruit and chocolate⁶.

Often it is the heat of coffee and tea that causes redness, so let your cup cool a little. Cut back on what causes you problems rather than eliminating everything at once. There is also no particular vitamin or supplement you need to take for rosacea.

How is rosacea treated by a doctor?

Your doctor chooses treatment based on the signs you have. For mild to moderate rosacea, it is typically a cream or gel. If you have more spots, a course of tablets for a few months may be added. Visible blood vessels can be treated with laser, and thickened skin on the nose can also be treated by a dermatologist¹.

Laser and light therapy (IPL) can reduce visible blood vessels and redness, but they are rarely the only treatment. Once the skin has calmed down, many people are given a plan to keep it that way⁴. Treatment takes time, so give it a chance and talk to your doctor if it does not help.

Can rosacea go away on its own?

Rosacea cannot be cured, but treatment can keep it under control. Without treatment, it can get worse over time².

It comes and goes in periods, and some redness and visible blood vessels may persist¹. Gentle daily care is a good complement to your doctor's treatment.

How do you care for your skin when you have rosacea?

Keep it simple and gentle: a mild cleanser, a fragrance-free moisturiser and sunscreen every day. Cleanse your skin with your fingertips, not a cloth or sponge, and do not scrub⁷.

What you avoid using also matters. Skip soap and products containing fragrance, alcohol, menthol, camphor, urea and fruit acids such as glycolic acid and lactic acid⁷. And test new products before using them on your whole face.

If you use a cream or gel from your doctor, follow their instructions on when to apply it in your routine. And a few quiet minutes morning and evening are also a little break for yourself.

Retinol and strong acids can be too much for skin with rosacea. If you would like to use them, talk to your doctor first.

Which sunscreen should you use when you have rosacea?

Sun is the most common trigger, so sunscreen is one of the most important things in your routine. Choose a fragrance-free sunscreen with UVA and UVB protection and at least SPF 30, and use it every day as the last step in the morning. If you have very delicate skin, many people find mineral sun filters such as zinc oxide and titanium dioxide work well for them⁷.

Can you wear makeup when you have rosacea?

Yes. Choose fragrance-free makeup and remove it gently in the evening. A green-tinted concealer can make redness look less noticeable because green is the complementary colour of red. Dermatologists often recommend water-based makeup or powder because it is less likely to irritate, and you should test new products before using them on your whole face⁷.

See how in our guide to covering redness.

Can rosacea affect the eyes?

Yes. At least half of people with rosacea also have eye symptoms. These range from mild irritation to inflammation that needs treatment by an eye specialist¹.

Typical signs are dry, itchy or red eyes, a feeling of sand in the eyes, and red, swollen eyelids with crusts along the lash line. Many people benefit from gently cleaning the eyelid margins every day. If you have eye pain, blurred vision or pain from light, seek medical help immediately².

Find gentle care for skin with rosacea here

Our fragrance-free care is suitable for the daily care of skin with rosacea and redness. It does not replace medical treatment, so if you think you have rosacea, have it assessed by your doctor.

Cleanse morning and evening with Cleansing Milk, our mild cleansing milk for dry and sensitive skin. Follow with Anti Redness Cream, a fragrance-free moisturiser with oats and aloe vera. In the morning, finish with Daily Sun Shield SPF 50 (Daily Sun Shield), a fragrance-free sunscreen with SPF 50.

If you want to give your skin a little extra, use Anti Redness Mist after cleansing and before your cream, preferably in the evening. It is fragrance-free and contains 10 % azelaic acid (azelaic acid), a well-known ingredient for skin with redness. Azelaic acid can sting or itch a little the first few times⁸, so try it on a small area first. If you already use a cream or gel from your doctor, ask your doctor before adding the mist. And if you are not happy with your purchase, you have our 100 % satisfaction guarantee.

Not sure what else your skin needs? Take the short test below.

Frequently asked questions

What works best for rosacea?

What works best is a combination: treatment from your doctor, avoiding your own triggers, and gentle daily care with sunscreen. Which treatment is right for you depends on the signs you have.

Is rosacea hereditary?

Partly. If others in your family have rosacea, you may be more likely to develop it too, but it is not certain that you will.

Can you get rosacea on your body?

Rosacea almost always affects the face, and redness can sometimes spread to the neck and chest. If you have a rash elsewhere on your body, it is probably something else, so ask your doctor.

Is rosacea linked to menopause?

Many women notice the first signs in their 40s and 50s. Hot flushes also cause redness and warmth in the face, so it can be difficult to distinguish them from rosacea yourself. Talk to your doctor if the redness persists.

Do men get rosacea too?

Yes. Women get rosacea more often, but men are more likely to develop severe changes, such as thickened skin on the nose. See a doctor early if you notice the signs.

Sources

1. Rosacea. Lægehåndbogen, sundhed.dk. sundhed.dk
2. Rosacea. NHS. nhs.uk
3. Gether L et al. Incidence and prevalence of rosacea: a systematic review and meta-analysis. British Journal of Dermatology. 2018. British Journal of Dermatology
4. Rosacea: Diagnosis and treatment. American Academy of Dermatology. aad.org
5. Rosacea Triggers Survey. National Rosacea Society. rosacea.org
6. Weiss E, Katta R. Diet and rosacea: the role of dietary change in the management of rosacea. Dermatology Practical & Conceptual. 2017. Dermatology Practical & Conceptual
7. 7 rosacea skin care tips. American Academy of Dermatology. aad.org
8. Azelaic acid. DermNet. dermnetnz.org