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There are different types of rosacea but redness is the most common sign. It typically begins around age 30, but those younger can also experience it.

ExplainerWhat is rosacea? Causes, symptoms and treatments of a disease that causes red skin, spots, lumps and rashes

  • Rosacea is a chronic skin condition that causes persistent redness and often small, acne-like bumps, for which there is no cure
  • Topical ointments or laser treatment can help, as can keeping your skin hydrated and daily sunscreen use

Rosacea is a common but also very misunderstood skin condition that goes way beyond rosy cheeks.

It can manifest itself in many different forms, which is why it can be misdiagnosed or dismissed as else.

It starts with a tendency to blush or your face getting red. As time goes by, the redness covers more areas of your skin, commonly starting on your cheeks and then spreading to nose, forehead, chin, ears, and even eyes and chest, which can feel overwhelming.

However, with the proper diagnosis and treatment, rosacea can be tamed in the long run.

A woman with rosacea with make-up on half her face.

What is rosacea?

Rosacea is a skin disease that causes persistent redness and often small, acne-like bumps. It’s a chronic skin condition so you can treat it and keep it under control, but there’s no cure.

It may appear in different forms and start at different ages. It typically begins around age 30, but those younger can also experience it.

No matter when or how it initiates, it’s crucial to see a dermatologist as soon as you suspect you may be experiencing symptoms, as with time, the redness gets more intense and recurrent. This can lead to visible blood vessels, inflammation, pimples and bloodshot eyes.

Masks can cause those with pre-existing rosacea to flare up as the fabric rubs and irritates the skin, a dermatologist says. Photo: Shutterstock

What causes rosacea?

Unfortunately, there’s no exact answer to this question.

“It may be a combination of hereditary and environmental factors,” says dermatologist Sapna Palep. “You are more likely to develop rosacea if you have a family history of the condition or if you have Celtic or Scandinavian ancestors.

“Women are also more likely to develop the condition than men. However, men who develop the condition often have more severe symptoms.”

Daily sunscreen use is a must to avoid flare-ups caused by UV radiation.

What are the symptoms

There are different types of rosacea but redness is the most common sign.

“Some of the early signs are facial blushing or flushing, typically in the centre part of your face, as well as more visible capillary veins – the small blood vessels around your nose and cheeks that break and become more visible,” says Dr Deanne Robinson, chief medical officer of aesthetics brand Ideal Image and co-Founder of medical group Modern Dermatology PC.

Other typical rosacea symptoms include small, acne-like pimples on your cheeks and/or nose, eyelid swelling, a burning sensation and an enlarged nose. In many cases, these symptoms get mistaken for skin conditions such as acne, eczema or allergies, which is why it is crucial to have a specialist examine your skin to diagnose it properly.

Robinson says there are four types of rosacea: erythematotelangiectatic rosacea (persistent redness); papulopustular rosacea (redness with small papule/whiteheads); phymatous rosacea (skin thickens and becomes lumpy and swollen); and ocular rosacea (watery, bloodshot, burning eyes).

People with rosacea may be more sensitive to skincare ingredients such as alcohol, tea tree oil and, lactic and glycolic acids. Photo: Shutterstock

Knowing your triggers

While the causes of rosacea are still to be determined, a few specific triggers may aggravate rosacea symptoms.

Some of them can be connected to lifestyle – like eating spicy meals, ingesting cinnamaldehyde (a compound found in cinnamon, tomatoes, citrus, and chocolate), smoking, exposure to UV radiation, and drinking hot drinks and alcohol.

Others may be linked to environmental conditions – extreme hot/cold weather, dry air, wind, sunlight and dust – or even emotional components, like stress or anxiety.

Using moisturisers to keep your skin hydrated can help fight rosacea as they create a barrier that keeps irritants away.

Rosacea was the most-searched-for skincare concern in 2021, according to online beauty retailer LookFantastic’s latest Skinfluencer Report, and Covid-19 may have something do with it.

“[Rosacea] can be worsened by lifestyle habits,” says dermatologist and dermatological surgeon Dr Dennis Gross. “In fact, we may be seeing a huge spike in the issue as a result of people having to wear masks. Recent studies have found that masks can cause those with pre-existing rosacea to flare up as the fabric rubs and irritates the skin.”

People with rosacea may also be more sensitive to certain skincare ingredients, including alcohol, tea tree oil, lactic and glycolic acids, eucalyptus oil, colourants, fragrances, and chemical sunscreens.

Remember, everyone experiences rosacea differently. Triggers may not affect some individuals at all while causing intense flare-ups for others.

Treatments and care

For those dealing with flushed skin, persistent redness and visible blood vessels, topical ointments or laser treatment can help. Skincare ingredients such as azelaic acid and topical antibiotics can also help manage symptoms for those who struggle with bumps and pimples.

“It is important to stay consistent with your prescribed topical skincare products as well as to avoid triggers,” Robinson says.

Skincare ingredients such as azelaic acid can help manage symptoms.

She adds, however, that if you suddenly find yourself experiencing a flare-up, certain topicals such as Afrin or Rhofade can help reduce redness for a while. “Both of these medications work to shrink and tighten the blood vessels contributing to the redness – both offer temporary relief, but are not a long-term cure.”

Keeping your skin hydrated is another must-do, as moisturisers create a barrier that keeps irritants away.

Finally, remember that no matter your type of rosacea or what triggers it, daily sunscreen use is a must to avoid flare-ups caused by UV radiation. To avoid possible triggering of symptoms, experts recommend sunscreens formulated with zinc oxide or titanium dioxide, silicones such as dimethicone, or cyclomethicone, no fragrances, and SPF above 30.