Rosacea: Facial Redness, Flushing, Triggers and When to Be Seen

What it involves

MedlinePlus describes rosacea as a long-term skin condition that makes the face turn red and can also cause swelling and sores that look like acne. It says rosacea sometimes affects the eyes, that it cannot be cured, and that it can usually be controlled with treatment.

Who this is for

• Patients whose cheeks, nose, or forehead stay red or flush easily with heat, wine, or spicy food
• Patients who were told they have adult acne but find that acne products make the skin worse
• Patients with red, dry, itchy, or watery eyes along with facial redness
• Patients who feel self-conscious about visible blood vessels or a thickening nose

What to expect

• Questions about when the redness started, what seems to set it off, and what you have already tried
• A close look at the skin, since MedlinePlus says a provider can often diagnose rosacea from an exam and your history
• A talk about triggers, sun protection, and medicines applied to the skin or taken by mouth
• A referral to a skin specialist if the case is severe or does not settle with first-line care

What rosacea looks and feels like

MedlinePlus lists the usual signs as redness of the face, blushing or flushing easily, many small spider-like blood vessels, a red nose that may look swollen, and acne-like sores that can ooze or crust. A burning or stinging feeling and irritated, bloodshot, watery eyes are also on its list. MedlinePlus notes that the condition is less common in men, but when it does occur in men the symptoms tend to be more severe.

Who tends to get it

MedlinePlus says the cause is not known, and that people are more likely to develop it if they are between 30 and 50, fair-skinned, or a woman. It describes the swelling of blood vessels just under the skin as the underlying change, and notes that rosacea may be linked with other skin disorders, such as acne vulgaris and seborrhea, or with eye disorders such as blepharitis. The acne guide explains why the two conditions are often confused.

Finding and avoiding your triggers

Triggers differ from person to person, and MedlinePlus says avoiding them may prevent or reduce flare-ups. Its self-care suggestions include:

• Avoid sun exposure and use sunscreen every day
• Avoid a lot of activity in hot weather
• Try to reduce stress with deep breathing, yoga, or other relaxation techniques
• Limit spicy foods, alcohol, and hot beverages
• Watch for other triggers it names, including wind, hot baths, cold weather, certain skin products, and exercise

Why acne products can make it worse

MedlinePlus is direct on this point: rosacea is not acne and will not improve with over-the-counter acne treatment. Harsh scrubs and drying products can irritate skin that is already inflamed. If you have been treating redness as acne for months without progress, that mismatch is a good reason to have a provider look. Redness with scaling in the creases beside the nose can also be a different condition, which the seborrheic dermatitis guide describes.

Treatment options a provider may discuss

MedlinePlus says there is no known cure, but a provider can help control it. Antibiotics taken by mouth or applied to the skin may control the acne-like sores. Isotretinoin is a strong medicine that a provider might consider for severe rosacea that has not improved with other medicines. In very bad cases it says laser surgery may help reduce the redness, and surgery to remove swollen nose tissue may improve appearance. Those procedures are done by specialists, and a primary care provider can start the conversation and make the referral.

When to be seen and what to watch

See a provider if redness is persistent, if the eyes are red, dry, or painful, or if the skin burns or sores crust over. Sudden redness with swelling, heat, and fever is a different problem, and the cellulitis guide explains how to tell. Daily sun protection also matters for everyone, and the sunburn guide covers how to care for skin after too much sun.

Sources

• MedlinePlus — Rosacea
• MedlinePlus — Rosacea (health topic)