FAQs: Rosacea and treatment options
Why do I have rosacea?
That is not an easy question to answer, as the cause of rosacea remains unknown. There are associations with fair complexion and blue eyes, certain microbes on the skin and also bacterial colonisation in the gut. Causal links have not been proved. UV light exposure is thought to play a role. The most recent research suggests that altered immune response is involved. In rosacea, vasodilators are released by white blood cells, causing the visible blood vessels and the redness. We don't know why.
How common is rosacea?
Up to 1 in 10 Caucasians, but most of these cases will be mild. About 14% of Caucasian women have rosacea and about 5% of men. The more severe cases of rosacea tend to be in men.
As no one knows why rosacea occurs, this question is not possible to answer. From observation we know that rosacea mostly (80%) starts after the age of 30.
Is rosacea hereditary?
As mentioned above, people of fair skin seem to be more likely to be affected, and skin type tends to run in families, as can rosacea. It is not directly inherited though, and it?s not possible to predict who in a family may be affected.
Is rosacea infectious?
No, theories regarding the cause of rosacea include reaction to microbes, but the rash does not spread via touch. Antibiotic treatment is thought to be effective due to its anti-inflammatory properties rather than to its anti-bacterial properties.
Can diet help?
A lot of people find that things that cause facial flushing, including alcohol and spicy foods, worsen the redness. Avoiding these can help. Some people do find certain diets to be of benefit. There is no evidence that this is true for most rosacea sufferers, but if this interests you, you may like to read Brady Barrow's Rosacea Diet.
What are common triggers?
As well as alcohol and spices, as mentioned above, sun (although some people report that sunlight eases symptoms), heat, stress, hot or cold weather, wind, alcohol, spicy foods, exertion, hot baths, hot drinks and applying steroid creams or ointments.
What can I do to help?
You can avoid triggers (see above), which are usually things that cause flushing. These may vary from person to person. Keeping a symptom diary may help to work out what yours are. Triggers may include skin care products. Rosacea suffers have a degree of inflamed skin, so skin is likely to be sensitive. Be careful what you apply and stop using any products that irritate your skin. Wearing sunscreen is advised, especially if sun exposure noticeably worsens your symptoms.
Which sun screen should I use?
One that does not aggravate your skin, as sunscreen itself may cause irritation. These tend to be chemical sunscreens (that soak in nicely but work by chemicals absorbing the light) rather than physical ones. Look for ingredients Zinc oxide or titanium dioxide, as these reflect away the harmful rays without being absorbed into the skin, and therefore are less likely to cause irritation.
Is rosacea curable?
Rosacea is treatable rather than curable. Symptoms can usually be controlled with oral or topical medications such as Mirvaso gel.
How long will I need treatment?
In some people treatment settles the symptoms, others need repeated doses or treatment may need to be ongoing. It is generally a long term condition.
Are there any non medical treatment options?
Tackling the visual appearance can be very helpful. There are three ways of doing this: skin camouflage, anti-red make-up, and laser treatment.
You can be colour matched to special camouflage make-up, this can then be prescribed for you by your GP. You can find out about skin camouflage at:
Lasers of certain wave-lengths target various colours. Redness and red blood vessels can be treated with vascular laser or intense pulsed light. The laser causes the blood vessels to shrink. As their capacity for holding blood decreases, so does the redness. Flushing as well as the red colour can improve. Usually more than one treatment is required (2-4) and it is not generally available on the NHS. Treatment does not require anaesthetic but is uncomfortable. The treatment is not guaranteed to be permanent.
Is it linked to migraine?
People with rosacea are twice as likely to suffer with migraines as people without. A Swedish study found that in a rosacea group, 27% also had migraine, compared with 13% in the control group. Regulation of blood flow is likely to be a factor in both these conditions.
Can rosacea affect the eyes?
Ocular symptoms occur in 20% of rosacea cases.
What are the symptoms of ocular rosacea?
Eye dryness is an early sign. Latter blockage of oil glands causes inflammation and crusting around the eyelashes. Other symptoms include bloodshot eyes, eye irritation such as stinging, itch or sensation of a foreign body. Light sensitivity can occur as can blurring of vision.
How to treat ocular rosacea?
Eye care – keeping the eyelid margin (meibomian) glands unblocked and thus eyelids clean from crust – is important. This can be done by applying a warm water compress twice daily or by gently wiping with a cotton bud soaked in cooled boiled water. Your GP may prescribe artificial tears for dry eye and anti-biotic tablets, as for facial rosacea, to ease the inflammation. More severe or persistent cases may be treated by an ophthalmologist.
Will stopping smoking help?
No, probably not. Smoking is associated with a reduced risk of developing rosacea. Of course smoking is not generally beneficial to health.
Can rosacea cause disfigurement of the nose?
Yes in one rare type of rosacea called rhinophyma. This is more common in men. It can be treated either surgically or with a CO2 laser. Either way the bulky tissue is removed. Skin slowly grows over the treated area.