Rosacea – Specialist Diagnosis & Treatment for Facial Redness in London

Understanding rosacea

Rosacea is a chronic skin condition that mainly affects the central face, including the nose, cheeks, chin, and forehead. It is characterised by persistent redness, dilated blood vessels, and inflammatory lesions resembling acne. Unlike acne, rosacea does not cause blackheads. The condition typically progresses in flare-ups and remissions, often worsened by triggers such as heat, spicy foods, alcohol, or stress.

Types of rosacea

• Erythematotelangiectatic rosacea: Persistent facial redness, flushing, and visible blood vessels.
• Papulopustular rosacea: Red bumps and pus-filled spots resembling acne.
• Phymatous rosacea: Skin thickening, usually around the nose (rhinophyma).
• Ocular rosacea: Eye irritation, redness, watery or gritty sensation.

Rosacea Causes and triggers

Although the precise cause is not fully understood, rosacea is linked to abnormal vascular activity, immune system response, and skin barrier dysfunction. Common triggers include:

• Sun exposure and heat
• Alcohol (especially red wine)
• Spicy foods and hot drinks
• Emotional stress
• Temperature extremes
• Certain skincare or steroid creams

Rosacea Symptoms

Rosacea symptoms vary but may include:

• Persistent facial redness and flushing
• Visible capillaries (telangiectasia)
• Small red bumps or pus-filled spots
• Burning, stinging, or sensitive skin
• Eye irritation in ocular rosacea
• Skin thickening (rhinophyma) in advanced cases

Rosacea Diagnosis

Rosacea is usually diagnosed clinically, based on characteristic facial patterns and triggers. A dermatologist can differentiate it from acne, seborrhoeic dermatitis, or lupus.

Rosacea Treatment options

Rosacea management aims to reduce redness, control flare-ups, and improve quality of life:

• Topical treatments: Metronidazole, azelaic acid, ivermectin, and brimonidine gel for redness control.
• Oral medications: Low-dose antibiotics (doxycycline) for inflammatory lesions.
• Laser and light therapy: Effective for visible blood vessels and persistent redness.
• Skincare: Gentle, fragrance-free cleansers and moisturisers, plus daily SPF.
• Lifestyle: Avoiding known triggers such as alcohol, spicy foods, and heat.

Living with rosacea

Rosacea can significantly affect self-esteem, but with proper medical management and lifestyle adaptation, flare-ups can be controlled. Supportive care, counselling, and patient education help individuals cope with the chronic nature of the condition.

Your first visit — what to expect

1. History: Review of symptoms, triggers, and family history.
2. Examination: Assessment of facial redness, vascular changes, bumps, and possible eye involvement.
3. Diagnosis: Clinical confirmation and rule-out of other conditions.
4. Treatment plan: Personalised recommendations for topical or oral therapy, skincare, and trigger avoidance.
5. Follow-up: Monitoring progress and adjusting treatment as required.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 22 August 2025