Rosacea

Persistent facial redness and spots. Not acne, not caused by drinking, and the assumption that it is causes real harm.

What it is

Rosacea affects around 1 in 10 people in the UK, most often those with fairer skin, and typically starts after 30.

It causes persistent redness across the central face, visible blood vessels, and sometimes spots and pustules. In a minority, mostly men, the skin of the nose thickens.

The social damage comes from a specific and persistent misunderstanding: that a red face means heavy drinking. People with rosacea are judged for something that has nothing to do with them, and studies find rates of anxiety and depression substantially raised.

Alcohol is a trigger for flushing in some people with rosacea. It does not cause the condition.

Ocular rosacea affects the eyes in a substantial proportion and is regularly missed entirely.

Signs you might notice

Persistent redness across the cheeks, nose, chin and forehead.

Flushing, easily triggered.

Small visible blood vessels.

Papules and pustules, but without the blackheads that characterise acne.

Burning or stinging of the skin, and sensitivity to most products.

Ocular rosacea: gritty, dry, red eyes, recurrent styes, and light sensitivity. Ask about eyes in anybody with facial rosacea.

How it can affect day-to-day life

The visibility is the burden. It is on the face, it fluctuates, and it invites comment.

Triggers vary enormously between individuals: sun, heat, cold wind, spicy food, alcohol, exercise, stress, and certain skincare. A diary is the only reliable way to find yours.

Sun is the most consistent trigger across people, and daily sun protection is genuinely part of the treatment.

Topical steroids make rosacea significantly worse, and they are still sometimes prescribed for the redness. That is a trap worth knowing about.

Supporting someone well

Use sun protection daily, all year. Mineral sunscreens are usually better tolerated.

Keep skincare minimal and bland: a gentle cleanser, a simple moisturiser, nothing with alcohol, fragrance or exfoliants.

Never use topical steroids on rosacea.

Keep a trigger diary rather than following a generic avoidance list.

Ask about treatment. Topical ivermectin, azelaic acid and metronidazole all work, and oral doxycycline helps papulopustular rosacea. Laser treatment for visible vessels is effective and often available privately only.

Ask about the eyes at every review, and use lid hygiene for ocular rosacea.

Take the psychological impact seriously.

Where to get help

A GP can diagnose and treat, and refer to dermatology.

Changing Faces support people with visible differences, including the confidence side.

Eye symptoms need an optometrist or GP; ocular rosacea can affect the cornea.