Rosacea - causes, symptoms, and treatment methods
Constant redness, a burning sensation, skin that reacts to everything – from the sun to a cup of hot coffee. If this sounds familiar, it might be rosacea.
Rosacea is a condition that affects over 400 million adults worldwide and often goes undiagnosed in its early stages.
In this article, we will explore what rosacea is, what its main causes are, how to recognize its different forms, and which treatment methods truly make sense.
What is rosacea?
Rosacea is a common, chronic, and non-contagious inflammatory skin condition characterized by persistent or periodic facial redness.
It can also manifest with visibly dilated blood vessels, a burning sensation, and small inflammatory bumps, sometimes containing pus.
Most often, it affects the central part of the face – the forehead, cheeks, chin, and the lower half of the nose. In rarer cases, rosacea can affect other areas as well.
Symptoms of rosacea
The manifestations of rosacea often develop gradually. Initially, they may seem minor, but over time they become more pronounced.
The most common symptoms are:
- Redness: This is the most characteristic sign of rosacea. Sometimes it looks like a mild sunburn that doesn't disappear.
- Visible dilated capillaries: Small dilated vessels may begin to appear on the nose and cheeks. They are often called "spider veins," but their medical name is telangiectasias. They are more visible on lighter skin and can be more subtle on darker skin.
- Inflammatory bumps: Some people also develop bumps that resemble acne. They sometimes contain pus, and in some cases, can also appear on the chest or back.
- Burning and sensitivity: The skin often becomes more sensitive. You may feel the affected skin warm, tight, or painful to the touch.
- Ocular symptoms: Irritation, dryness, redness, or increased sensitivity to light may occur.
- Nose enlargement: In more advanced cases, the skin on the nose can thicken and appear larger.
Types of rosacea
Depending on which manifestations are dominant, rosacea is divided into four main types. In many cases, however, rosacea occurs with signs of more than one type.
Erythematotelangiectatic rosacea
This is the most common form and often the first manifestation of rosacea. Here, redness dominates, which can become more persistent over time. The skin reacts easily to external factors, and dilated capillaries gradually become more visible.
Papulopustular rosacea
In this type, inflammatory bumps come to the forefront. It usually develops against a background of existing redness.
Phymatous rosacea
This form is characterized by gradual thickening and hardening of the skin. It most often affects the nose, which can appear larger and uneven over time. This condition is called rhinophyma and is more common in men.
Ocular rosacea
This type affects the eyes. Ocular symptoms may appear before skin symptoms or simultaneously with them, and sometimes are more pronounced than facial redness itself.
What is the difference between rosacea and other skin conditions?
|
Condition |
Main manifestations |
How it differs from rosacea |
|
Acne (acne vulgaris) |
Blackheads and whiteheads, inflammatory bumps, sometimes cysts |
Presence of comedones; more common in teenagers; lack of persistent redness. |
|
Seborrheic dermatitis |
Redness with flaking, greasy yellowish scales |
Affects areas with more sebum (eyebrows, nasolabial folds, scalp); pronounced flaking |
|
Allergic or contact dermatitis |
Itching, redness, rash after contact with an irritant |
Usually a clear link to a new product; symptoms resolve after removing the cause |
|
Lupus (cutaneous form) |
Red rash on cheeks and nose ("butterfly") |
Associated with systemic autoimmune disease; requires laboratory diagnosis |
What are the most common causes of rosacea?
The exact cause of rosacea is not fully understood. What we know today is that the condition develops as a result of a combination of factors.
Genetic predisposition
The risk is higher if there are people with rosacea in the family. It is more common in people with fair skin who easily sunburn, as well as in the age group between 30 and 50 years.
Impaired regulation of blood vessels
In rosacea, the small blood vessels in the face are more reactive to external factors. Over time, they lose their ability to fully contract, which leads to persistent redness and visible dilated capillaries.
Overactive immune response
Studies show that in people with rosacea, the innate immunity reacts more intensely. Abnormalities in protective proteins like cathelicidins are observed, as well as increased activity of mast cells – cells involved in inflammation.
Thus, the skin remains in a state of constant, albeit low-level, inflammation – and the redness does not completely disappear.
Impaired skin barrier
When the skin's barrier function is weakened, it becomes more sensitive to external irritants. Increased transepidermal water loss and impaired lipid structure further enhance reactivity.
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Hormonal imbalance
During periods like menopause, pregnancy, or in the presence of endocrine diseases, hormonal changes can affect the tone of blood vessels. This makes the skin more reactive and prone to redness.
Role of microorganisms
Demodex folliculorum is a microscopic organism that naturally lives on our skin, most often in the area of the nose and cheeks. It is present in most people and usually causes no problems.
In people with rosacea, it is often found in larger quantities. It is believed that this can intensify the inflammatory response and contribute to the exacerbation of symptoms.
What triggers flare-ups?
In addition to internal mechanisms, there are also everyday factors that can provoke or worsen symptoms:
- exposure to sun and wind
- very high or very low temperatures
- hot drinks
- spicy food
- alcohol
- emotional stress
- intense physical activity
- medications that dilate blood vessels
- aggressive cosmetic products
These factors do not "cause" rosacea on their own, but they can activate or worsen symptoms.
Treatments for rosacea
Rosacea treatment is always individualized. There is no single universal product or procedure that can "cure" the condition forever.
The good news is that with the right approach, symptoms can be managed, and the skin can remain stable long-term.
Proper daily skin care
Sun protection
Sun protection is absolutely mandatory – every day. Yes, every day. Even in winter. Even when you're at home in front of the computer, TV, or phone.
UV rays are one of the strongest factors that maintain redness and vascular reactivity in rosacea.
Therefore, for rosacea, mineral formulas with zinc oxide and titanium dioxide are most suitable. They act more gently on sensitive skin and are less likely to cause irritation.
It is best to look for products with broad-spectrum protection (UVA and UVB) and SPF 30 or higher.
Azelaic acid
Azelaic acid can significantly help in the fight against rosacea.
In a concentration of 10–15%, and if necessary higher, it can be used daily – morning and evening. With persistence, within two to three months, a noticeable improvement is usually observed.
It has anti-inflammatory, reduces redness, and helps control inflammatory bumps.
Peptides
Peptides can also be a good helper for rosacea-prone skin.
They support the restoration of the skin barrier and have a soothing effect without further irritating sensitive skin. Copper peptides are particularly useful, as they promote regeneration and have an anti-inflammatory effect.
Gentle cleansing
Use a gentle cleansing gel in the evening.
The goal is not for the skin to "squeak" after washing, but to be clean, without further compromising its barrier function. Harsh cleansers, highly foaming formulas, and exfoliants can increase sensitivity and redness.
Choose a cleansing product without drying ingredients that cleanses effectively but gently.
Formulas like PurityX+ are specifically designed with sensitive and reactive skin in mind – they cleanse without compromising the skin barrier.
Stable Routine
Rosacea skin does not like experiments. It likes predictability.
Frequent product changes, introducing new active ingredients every week, or overly complex routines often lead to more irritation than actual results.
A stable, gentle routine helps to:
- reduce skin reactivity
- restore barrier function
- limit the frequency of flare-ups
In this condition, less is often more. Gentle cleansing, a carefully selected active ingredient, hydration, and sun protection – this is the best foundation.
Effective care begins with the right routine
Selected product combinations designed to work together for healthier, calmer, and clearer skin in the long term.
Medications
When inflammation is more pronounced or symptoms are not sufficiently affected by proper care, cosmetics alone are not enough. In such cases, medication therapy is prescribed, tailored to the type of rosacea and the severity of its manifestations.
The most commonly used groups of medications include:
- Topical anti-inflammatory agents – such as metronidazole, ivermectin, and azelaic acid in higher concentrations. They reduce inflammation, papules, and redness.
- Systemic antibiotics – for more severe or persistent forms, doxycycline (in a low anti-inflammatory dose) or minocycline may be prescribed. Here, the goal is not a classic antibacterial effect, but control over inflammation.
- Antiparasitic agents – if there is evidence of an increased amount of Demodex folliculorum, preparations that affect this microorganism are used.
- Redness control agents – in certain cases, medications that temporarily reduce vascular reactivity may be included.
- Therapy for ocular rosacea – if the eyes are affected, specific anti-inflammatory agents are included, and if necessary, collaboration with an ophthalmologist is sought.
In resistant or severe cases, systemic retinoids (isotretinoin), as well as beta-blockers and neuromodulators affecting vascular reactivity, may also be used. These therapies are prescribed only after evaluation by a specialist.
The duration and combination of medications are determined individually. Treatment usually begins with more intensive symptom control, followed by a maintenance phase.
Laser and device therapy
When the main problem with rosacea is persistent redness and visible broken capillaries, device methods can be an effective part of the treatment. They affect the vascular component of the condition but do not eliminate rosacea itself.
The most commonly used methods include:
- IPL (Intense Pulsed Light) – affects diffuse redness and finer broken capillaries.
- Pulsed dye laser – selectively targets dilated blood vessels and reduces their visibility.
- Electrocoagulation – used for single, more pronounced vascular changes.
- LED therapy – has an anti-inflammatory effect and can help soothe the skin. It is suitable as a complementary therapy.
The best results are achieved when inflammation is already under control. The approach, number of procedures, and combination with medication therapy are determined individually after examination.
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Which ingredients help with rosacea?
Among the ingredients that have the most solid support and real practical value are:
- Azelaic acid (10–15%) – anti-inflammatory, antimicrobial, and with a mild keratolytic effect. Very suitable for papulopustular forms.
- Niacinamide (vitamin B3) – reduces redness and supports barrier function when in moderate concentration.
- Ceramides – key for restoring damaged skin barrier and reducing sensitivity.
- Hyaluronic acid – provides hydration without irritating the skin.
- Mineral UV filters (zinc oxide, titanium dioxide) – protect against one of the main triggering factors – the sun.
As supporting ingredients, the following can be used:
- Green tea extract – antioxidant and mild anti-inflammatory effect.
- Aloe vera – soothing function.
- Licorice extract – reduces redness.
- Sulfur – can be useful for acne-like forms of rosacea, but is not suitable for all skin types.
If you want to learn more about how different active ingredients work, you can visit our ingredient library.
How to care for skin prone to redness?
Rosacea cannot be completely prevented, but flare-ups can be limited.
The most important thing is consistency – a stable routine, daily sun protection, and careful observation of personal triggering factors.
If you already know what intensifies your redness – be it certain foods, temperature changes, or stress – try to limit it. Small adjustments in daily life often have a greater effect than we expect.
With rosacea, the skin reacts to instability. Therefore, predictability, moderation, and consistency are key.
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Frequently asked questions
What are the best products for rosacea?
For rosacea, the routine should be gentle and stable – a mild cleanser, restorative hydration, and daily mineral sun protection. If necessary, azelaic acid can be added, and as a complementary therapy – an LED mask like LumiTech+ LED Ultimate Therapy Pack, which helps soothe inflammation.
What foods worsen rosacea?
Redness is most often exacerbated by spicy food, alcohol, hot drinks, and very hot meals. These factors dilate blood vessels and can trigger a flare-up. It is important to observe your own reactions. There is no universal list that applies to everyone.
What are the best cleansing products for rosacea-prone skin?
Cleansing should be gentle, without harsh foaming agents and drying ingredients. The skin should not feel tight after washing. A formula like PurityX+ is suitable for sensitive and reactive skin because it cleanses without compromising the barrier function.
How to soothe my skin during a rosacea flare-up?
During a flare-up, simplify your routine to a minimum: a gentle cleanser, a hydrating cream, and sun protection. Stop new active ingredients and avoid heat. Your skin needs stability, not aggressive "emergency" solutions.
What to use for broken capillaries on the face?
Creams cannot remove already dilated vessels. Cosmetics can help stabilize the skin and limit new flare-ups, but for the capillaries themselves, laser and IPL therapies remain the most effective.
DISCLAIMER: All skincare articles are intended to aid in the education of specific skincare ingredients and topics. Our articles are written to be informative and educational. Any reference to specific patient experiences is not a medical treatment proposal. Please note that all Al+ Cosmetics products with listed ingredients are formulated for cosmetic use only and are NOT intended as substitutes for medical advice and/or pharmaceutical product recommendations.
