Rosacea

Rosacea is a chronic, inflammatory skin condition that usually affects the central areas of the face, such as the cheeks, nose, forehead and chin. People with rosacea may notice persistent redness, visible small blood vessels, bumps and pimples that can resemble acne, and in some cases, thickening of the skin. Rosacea can also affect the eyes, causing dryness, irritation and redness, a form known as ocular rosacea.

Symptoms
Not everyone experiences rosacea the same way. Symptoms can change over time and vary from person to person, but common signs include:

• Persistent facial redness or flushing
• Small visible blood vessels (spider veins) on the nose and cheeks
• Red bumps or pus-filled pimples
• Burning or stinging sensations
• Dry, rough skin patches
• Thickening of the skin, sometimes affecting the nose
• Eye symptoms such as redness, dryness, gritty sensation, light sensitivity or blurry vision

Causes
The exact cause of rosacea is not fully understood, but several factors may play a role:

• Changes in facial blood vessels, leading to flushing and redness
• Immune system involvement and inflammation
• Presence of Demodex mites and changes in skin microorganisms
• Family history and genetic predisposition
• Environmental or lifestyle triggers that worsen symptoms

Risk Factors
Certain factors may increase the likelihood of developing rosacea or having more severe symptoms:

• Fair skin that blushes easily
• Age 30 to 50, though it can occur earlier or later
• Being female, although males may experience more severe symptoms
• Family history of rosacea
• Frequent flushing from hot drinks, alcohol or emotional reactions

Diagnosis
Rosacea is usually diagnosed by a specialist based on skin appearance and symptoms. There is no single blood test for rosacea. A careful skin exam helps differentiate rosacea from acne, eczema or other conditions. Occasionally, a skin biopsy may be performed if the diagnosis is unclear. Eye symptoms may require evaluation by an eye care specialist for ocular rosacea. Early diagnosis and regular follow-up can help prevent progression and reduce complications.

What causes rosacea?
Rosacea develops from a combination of genetic factors, changes in facial blood vessels, immune system involvement and sometimes skin mites or microbes. Environmental and lifestyle triggers can worsen symptoms.

Is rosacea contagious?
No. Rosacea cannot be spread through touch, kissing or close contact.

What triggers rosacea flare-ups?
Common triggers include:

• Sun exposure or hot weather
• Hot drinks or spicy foods
• Alcohol, especially red wine
• Emotional stress
• Heavy exercise
• Hot baths
• Certain skincare products
• Extreme temperatures

Keeping a trigger diary can help identify personal triggers.

Can rosacea be cured?
There is no known cure, but rosacea can be managed. Symptoms often improve with a combination of avoiding triggers, using topical or oral medications and additional treatments as needed.

What are common treatments?
Treatment depends on type and severity and may include:

• Topical medications to reduce inflammation and bumps
• Low-dose oral antibiotics for inflammatory lesions and redness
• Isotretinoin for severe cases under specialist guidance
• Laser and light-based therapies to reduce redness and visible blood vessels
• Eyedrops or oral treatment for ocular rosacea

Your treatment plan at TidalHealth will be tailored to your needs.

How should I care for my skin if I have rosacea?

• Use a gentle, non-irritating cleanser
• Avoid scrubbing
• Choose fragrance-free, non-comedogenic moisturizers
• Apply daily broad-spectrum sunscreen
• Avoid products that cause stinging or flushing
• Use makeup labeled for sensitive skin to cover redness

What about sunscreen and sun exposure?
Sun exposure is a common trigger. Use broad-spectrum SPF 30 or higher daily, wear a wide-brimmed hat and seek shade when possible. Physical or mineral sunscreens like zinc oxide or titanium dioxide are often well-tolerated.

Can diet help manage rosacea?
No single diet cures rosacea. Identifying and avoiding personal food and drink triggers, such as spicy foods, hot beverages or alcohol, can reduce flare-ups. Some people find anti-inflammatory diets helpful, but evidence is limited.

What is ocular rosacea and when should I see an eye doctor?
Ocular rosacea affects the eyes and eyelids, causing redness, irritation, gritty sensation, dryness and light sensitivity. See an eye care professional if you have persistent eye symptoms, vision changes, or if your TidalHealth specialist suspects eye involvement.

Will rosacea get worse over time?
Without proper care and trigger avoidance, rosacea may worsen, leading to more redness, visible blood vessels or thickened skin. Early diagnosis and a treatment plan can help prevent progression.

When should I see a dermatologist?
See a dermatologist or specialist if you have persistent redness, bumps, visible blood vessels or eye symptoms affecting comfort or daily life. If over-the-counter remedies do not help or you are unsure about your skin changes, specialists can confirm the diagnosis and recommend the right treatment.