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Rosacea

Information about the skin conditions rosacea and guidance on the support available through Changing Faces and other organisations.

What is rosacea?

Rosacea (pronounced “roh-zay-shuh”) is a long-term skin condition which mainly affects the face. It tends to be characterised by redness in the affected areas and often begins with prolonged and excessive blushing.

It is more common in women and people with lighter skin. However, when it occurs in men, symptoms can be worse. It tends to begin between the ages of 30 and 40, but early signs may appear in your 20s.

If you have rosacea, you may feel self-conscious about the way it affects your appearance. On this page, we look at the different types of rosacea and how they can be treated, and provide support and guidance to help you manage the impacts of living with rosacea.

I have come to realise that rosacea is nothing to be ashamed of and that I am not defined by my skin condition… Nowadays, when people make comments about my skin, I try to embrace my new confidence and remind myself that not everybody understands what rosacea is.

Gabby, Changing Faces young media champion who has rosacea

Signs and symptoms

Rosacea tends to affect the nose, cheeks, forehead and chin, although the neck and shoulders may be affected in some cases. At first, you may appear to be blushing. However, as the condition develops, the redness can become longer-lasting or permanent.

Other symptoms include:

  • Small bumps and pus-filled spots
  • Dry skin
  • Swelling (“lymphoedema”) of the facial skin, particularly around the eyes
  • Thickening and swelling of the skin on the nose, known as rhinophyma. This is caused by an overgrowth of the oil-secreting glands on the nose. It tends to be more common in men and usually happens after many years

In some cases, rosacea may cause eye or eyelid problems:

  • Sore eyelids or crusts around the roots of eyelashes, which may be blepharitis
  • “Rosacea keratitis” is a painful inflammation of the front part of the eye. Keratitis may cause blurred vision and can be serious, and you should see your GP if you think you have it

There are four types of rosacea and symptoms are different in each variant. Have a look at the section “types of rosacea” below for more information.

Causes of the condition

The characteristic redness of rosacea is caused by dilated blood vessels. However, the root cause of the condition is unknown, although there are many theories.

You may find that your rosacea is triggered or worsened by certain foods, drinks or activities. Known triggers include:

  • Aerobic exercise, such as brisk walking, swimming, running or cycling (also known as “cardio”)
  • Alcohol
  • Caffeine
  • Cheese
  • Hot drinks
  • Spicy food
  • Stress

Your triggers may not include all or any of these things, but you may find it useful to try to identify your own triggers and avoid them.

Is rosacea genetic?

Although rosacea appears to run in some families, there is no known genetic link.

Types of rosacea

There are four types of rosacea:

Erythematotelangiectatic rosacea

This causes flushing in the central portion of the face, often with a burning, stinging or itching sensation. There may also be scaliness of the skin, which may be caused by low-level dermatitis. Creams and gels may worsen the discomfort.

Papulopustular rosacea

This causes redness and small pustules in the central portion of the face. It may look a bit like acne. You may experience burning and stinging sensations.

Phymatous rosacea

This type of rosacea causes the skin surface to become thick and irregular. Most often, it affects the nose (this is known as “rhinophyma”). However, it can also affect the chin, forehand, one or both ears and/or the eyelids.

Ocular rosacea

In ocular rosacea, the patient’s eyes or eyelids are also affected. It causes eye or eyelid conditions including blepharitis, conjunctivitis, inflammation of the eyelids and meibomian glands. Have a look at the NHS pages to find out more about these individual conditions. Symptoms may include a stinging or burning sensation in the eyes, dryness, sensitivity to light or the feeling of having something in your eye.
In roughly one in five cases, symptoms occur in the eyes before the skin is affected. Ocular rosacea may therefore be difficult to diagnose before skin symptoms occur.

Gabby, a 17-year-old young white woman with shoulder length brown hair. She's standing outdoors in front of some trees and smiling at the camera.

Gabby's story: "I am not defined by my skin condition"

Gabby talks about her journey with rosacea and the importance of mental health support for young people with visible differences.

Read Gabby's story

How is rosacea diagnosed?

A diagnosis will usually be made by your GP based on your medical history and a physical examination. Occasionally, a skin biopsy may be performed.

Treatments for rosacea

There is not currently a cure for rosacea. However, there are lots of things you can do to reduce symptoms and limit progression.

Creams, gels and antibiotics

The most common treatments include medicines applied to the affected area or taken by mouth:

  • Creams and gels (“local applications”) tend to take eight or more weeks to take effect.
  • Your GP may prescribe a course of oral (taken by mouth) antibiotics of between six and 16 weeks. The most common include tetracycline, oxytetracycline, lymecycline and minocycline.

Intense pulsed light (IPL)

In IPL, a multi-wavelength beam of light is shone onto the skin, which has the effect of constricting (narrowing) the dilated (widened) blood vessels which cause the flushing of rosacea. IPL is not always available on the NHS.

Other medications

Beta blockers are sometimes prescribed to help with flushing. In severe cases of rosacea, a dermatologist may prescribe medicines usually used to treat acne.

Rosacea and my appearance

You may feel self-conscious about the effects of rosacea on your appearance. You may become more aware of others looking at your and it may find it particularly distressing if people ask questions or make comments about your appearance. People may ask why you are blushing.

These things may affect your self-confidence and mental health.

My self-confidence was at an all-time low throughout school and I felt as if my rosacea was completely out of control. Even everyday things like talking to people became an embarrassment and I used to touch my face a lot to try to cover the redness.

Gabby, Changing Faces young media champion who has rosacea

What rosacea support can we offer?

If you are struggling with the social, emotional or psychological effects of living with rosacea, there are many support services available which can help.

Here at Changing Faces, we offer counselling and wellbeing support sessions. Our trained wellbeing practitioners provide confidential, one-to-one support and guidance and many of our clients find it helpful to talk through how they are feeling. Find out more on this page.

We also offer a wide range of self-help resources covering topics from self-esteem and mental health to coping with others’ reactions and managing working life and relationships when you have a visible difference. You can view the whole set of guides here.

You don’t need to change to your appearance or hide your condition to fit in with societal norms. However, if you decide that reducing your visible difference is the right thing for you, we offer a Skin Camouflage Service which may be able to lessen the redness caused by rosacea.

However, we cannot apply skin camouflage to skin that is infected, inflamed, or broken, so please contact the team to find out what we can do for you. Find out more in our dedicated skin camouflage section.

There are a number of other ways we can support people with rosacea here at Changing Faces:

  • Online Community: An online forum moderated by Changing Faces staff, where you can talk to others with rosacea and other visible differences.
  • Peer Group Chat Service: An online support group of up to eight participants, taking place on Zoom or via a chatroom and facilitated by Changing Faces staff.
  • Workshops for children and young people and their parents: An opportunity to meet others and learn tools, tips and techniques for managing challenges with your visible difference.
  • Real stories: Read stories by other people living with skin conditions such as rosacea.

Please contact our Support and Information Line if you are interested in accessing our services. As well as providing information and connecting you to our other forms of support, our friendly team offer support calls for you to talk about the impact of rosacea on your life.

Other organisations

Guidance, support and advice is also available from other organisations. Please follow the links to their websites to learn more.

British Association of Dermatologists (BAD) logo

British Association of Dermatologists (BAD)

BAD specialises in the practice, teaching, training and research of dermatology (the branch of medicine dealing with the skin). They offer patient information on rosacea, general advice for people with skin conditions and opportunities to take part in research for skin conditions.

Outlook logo

Outlook

A national, highly specialist psychological service based at North Bristol NHS Trust, supporting adults (16+) with appearance-related distress. They can provide face-to-face and remote support via NHS Attend AnyWhere. Please speak to your GP or healthcare professional to discuss a referral.

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NHS

Please have a look at the NHS conditions page for official guidance on rosacea, advice on when to see a GP, information about treatments available on the NHS and a video interview with a rosacea patient. The page also contains information about the impact of coronavirus (COVID-19) on NHS services.