I was diagnosed with rosacea 20 years ago and I’ve been talking about it on the internet for about 12 years. It’s still crazy to me that it’s not as well-known as it should be – there are millions of people worldwide with this condition and, in my opinion, it should be as widely recognisable as acne or psoriasis. April is Rosacea Awareness Month and, as always, I’ll be doing a few posts about different issues related to the condition but I thought I would update this GIGANTIC post containing all the rosacea FAQs that I get every day from people all over the world. I’ve built up so much knowledge and advice in countless blog posts, so this post has become a central hub that I can direct people to. Please ask questions in the comments below, and I will keep adding to this rosacea FAQs post as we go along!
[Rosacea FAQs: Last updated 02/25]
As always, I want to start this rosacea FAQs post with a disclaimer. As I’ve mentioned many times before, rosacea is very individual: what works for me may not work for you and vice versa. However, this blog post summarises the things I have found that work for me over the past 20 years through trial and error (and believe me, there has been a LOT of error!) Please be careful, talk to your GP/dermatologist before doing anything drastic, and take care of yourself. There are a lot of resources at the bottom where you can get a lot more information but I’m hoping this will be a good jumping off point for you.
IMPORTANT NOTE: I now post all of my rosacea articles on Substack, if you are looking for more educational posts, reviews, and community support – THIS IS THE PLACE TO BE. This website will remain live so you have access to all of the free content I’ve shared for the past 12 years.
Let’s strt at the beginning and end at the end. Are you sitting comfortably? Then let us begin the ultimate rosacea FAQs post…
Table of Contents
ROSACEA FAQs: WHAT IS ROSACEA?
- Rosacea is a chronic skin condition with irregular facial flushing that can become more permanent over time. It can be accompanied by visible blood vessels, pustules, swelling, inflamed and irritated eyes, dry patches and – in severe cases – thickening of the skin.
HOW DO YOU PRONOUNCE ROSACEA?
- It’s pronounced ‘ro-zay-sha’.
WHAT ARE THE CAUSES OF ROSACEA?
- It’s believed to be more common in those who are fair and those who have pink-toned skin that flushes easily in childhood. Although it seems to run in families, there doesn’t seem to be a genetic link (my mum and both my sisters have rosacea, although theirs is milder than mine).
- There are many theories; bacteria on the skin, microscopic mites, inflammation, immune system issues, weaker capillaries. There are also theories about a link to the gut, hormones, trauma… the list goes on!
ARE THERE DIFFERENT TYPES OF ROSACEA?
- There is some outdated information out there when it comes to how many types of rosacea there are. At the time of writing this there are 5 rosacea subtypes. You can be diagnosed with 1 subtype in isolation or a combination of a few.
- A common misconception is that subtypes of rosacea represent ‘stages of rosacea’ (e.g. you start with type 1, then progress to type 2…) This is not true.
- Subtype 1 (erythematotelangiectatic rosacea)
- This is what people tend to think of when they hear rosacea. The common ‘rosacea cheeks’ (although the symptoms can appear in other areas of the face) – redness, visible broken veins, and flushing.
- Subtype 2 (papulopustular rosacea)
- This takes all the same issues from Subtype 1 and adds in fluid-filled pimples and bumps. This is often confused with acne (and confusingly referred to by some as ‘acne rosacea’ which isn’t an official term)
- Subtype 3 (Rhinophyma/Phymatous rosacea)
- Sometimes referred to as ‘rosacea nose’. Causes a thickening of the skin, usually on the nose. It’s much more rare that the other types and tends to affect men more than women. The most famous example is W.C Fields. I interviewed a plastic surgeon about rhinophyma HERE if you would like more information.
- Subtype 4 (ocular rosacea)
- This is characterised by red and sore eyes that often feel gritty. You can read my tips on how rosacea affects the eyes (with tips to help) HERE.
- Subtype 5 (neurogenic rosacea)
- This subtype is incredibly rare and still not very well-known, even amongst medical professionals. Read more about it HERE.
- In recent years, the traditional ‘type’ classifications (listed above) have been replaced by phenotypes. They are tricky to explain in a short sentence in this extensive Rosacea FAQs post, so I’ve written a whole post about it HERE.
DOES ROSACEA GET WORSE OVER TIME?
- Rosacea is a progressive condition, so it will get worse over time if untreated. This is why it’s important to be diagnosed by a healthcare professional (HCP) and begin to regain control of your skin. As your skin becomes more stressed and prone to flare ups, the capillaries weaken, which means they are more visible, which then results in permanent redness. This is why I always recommend going to see your HCP, even if you don’t think your skin is ‘bad enough’.
- If you are preparing for your first appointment with your doctor, I recommend my free download with an appointment discussion guide which you can find HERE.
- When I was first diagnosed, I had Subtype 2 but over time, as I got my triggers under control and a better handle on my skin, my subtype changed to Subtype 1. If I have a severe flare up, I will get a few small pustules but these tend to disappear within 12-24 hours.
WHAT DOES ROSACEA LOOK LIKE?
- As explained above, it’s typically characterised by facial redness (in rare cases it can present on the chest and back). It’s most common on the cheeks and nose, but can appear in other areas as well (for example, the right side of my forehead is prone to flushing). Sufferers often have a butterfly pattern across the cheeks, where the skin under the eyes is in stark contrast to the redness. It looks like a cross between deep blushing, sunburn and a rash. My skin takes on an mottled, purple appearance when I’m having a flare up. The skin can also appear very textured, with large pores (often compared to an orange peel texture). When my skin is calm, I still have persistent redness due to the broken veins now scattered across my face. For those with Type 2 it can look like acne to a layperson, with pus-filled bumps across the face.
- Rosacea can present differently in skin of colour – there’s more information and advice HERE.
*Rosacea FAQs disclaimer: above photo by Sophie Harris Taylor. All rights are hers.
WHAT DOES ROSACEA FEEL LIKE?
- I can often feel a flare up before I see it: my skin starts to burn, it feels tight and itchy. It feels a bit like heat rash or sunburn with that awful throbbing, uncomfortable feeling.
WHAT IS THE DIFFERENCE BETWEEN ROSACEA AND ACNE?
- The Instagram post below explains the answer to this question in full:
IS THERE A LINK BETWEEN ROSACEA AND THE SKIN BARRIER?
I have written an entire blog post on the topic of the skin barrier that will answer every question you might have, with the expert help of Dr Anhali Mahto. You can find it HERE.
IS THERE A CURE FOR ROSACEA?
- There is currently no cure. For every school of thought as to the causes of rosacea there is a ‘cure’ to go along with it. The only clinically proven way to help your rosacea is to identify and eliminate triggers to put your skin into a form of remission. In my opinion it is far more helpful to focus on controlling your rosacea rather than a ‘cure’. It took me a long time to accept that I had a chronic skin condition and it can be an upsetting diagnosis to deal with. I’ve written about rosacea and denial HERE.
- I’ve never tried any kind of oral medication for my rosacea.
- I have had incredible results with the Dermatica rosacea treatment, a medicated presciption that comes through the post. You can read my detailed review – with before and after photos – HERE.
- I have been investigating laser treatment for rosacea for years and wrote THIS blog post that will answer all of your questions about laser for rosacea. If I ever decide to go ahead with it, I will of course take you along and blog the process.
HOW DID YOU GET DIAGNOSED WITH ROSACEA?
- At 21, my skin had been bothering me for a while but I didn’t know what to say to the doctor. I didn’t know how to define it: it wasn’t acne, it wasn’t eczema, it wasn’t something that was permanently visible. But as it got worse, I knew I had to do something and assumed the doctor would be able to give me a cream or tablets that would cure me instantly. He knew immediately that it was rosacea and prescribed me Rosex (metronidazole – an antibiotic cream) and sent me away with no other information, help, or comfort. The cream did not help, in fact it made my skin much worse (EDIT: I have recently tried a combination prescription cream that contains metronidazole and have seen great results – read the full review HERE). The original doctor was very dismissive, as though that was our one shot at helping my skin and there was nothing else to do. I didn’t bother going back.
- I eventually did find a lovely (female) GP who was SO much kinder and more knowledgeable and really helped me get a handle on my rosacea. If you don’t feel like your doctor is taking you seriously, tell them or ask for a different doctor. Research has shown the devastating effect a skin condition can have on self-esteem, socialising, and relationships so don’t let anyone make you feel petty or vain for asking for help.
- I’ve written more about how to talk to your doctor about your skin HERE (with a free downloadable discussion guide).
IS THERE ONE THING THAT HELPED YOUR ROSACEA?
- THIS POST is the ultimate summary: 10 things that actually helped my rosacea. It’s where I direct people who ask for ‘the one thing that helped’ (which sadly I can’t give them because it doesn’t exist). Basically I wrote the blog post I wish I’d been able to read 20 years ago and I hope it helps you.
- I wrote an article where I imagined penning a letter to my younger self, where I speak about the things I would tell myself about rosacea if I could time travel. It is pretty personal but I found it oddly cathartic to write. You can read it HERE.
- I also wrote about the 15 things I have learned from 15 years of rosacea HERE. It covers all of the mistakes I made, the things I wish I knew, and things I think that you need to hear.
DO YOU RECOMMEND REGULAR MEDICAL APPOINTMENTS?
- If your skin is under control – like mine – I don’t think it’s necessary to regularly speak to a doctor about your skin. However, if something is bothering you or you think that your skin could be better, I would highly recommend finding a dermatologist who can advise you. My personal recommendation is Dr Anjali Mahto. She is a Consultant Dermatologist (this is very important to note, as ‘dermatologist’ is not a protected term in the UK!) who specialises in acne and rosacea and has personally struggled with acne, which gives her so much empathy as well as a deeper understanding of the psychological and emotional side of skin conditions. A good dermatologist will talk about your current skincare routine, diet and health, as well as examining your skin. They can prescribe any medication that they feel you may need and explain a recommended skincare regime in full.
HOW DO YOU FIND ROSACEA TRIGGERS AND WHAT IS A FLARE UP?
- I’ve written a lot about trigger identification over the years, so to save space in this huge rosacea FAQs post I’m just going to direct you to these blog posts that cover absolutely everything about identifying triggers HERE and HERE.
- I wrote an article with all my tips on how to calm flare ups, even when you’re out of the house. You can read it HERE.
- I’ve also written this instagram summary of flare up tips:
CAN A CHANGE IN DIET HELP ROSACEA?
- If you’re interested in the link between diet and rosacea, THIS LIVE I did with Dr Thivi Maruthappu is fascinating and so informative.
- My Rosacea Trigger Checklist will be useful if you are looking more closely at your diet and the impact it may have on your skin. You can find the free download HERE. I’ve also designed a Rosacea Flare Up Diary which would work well in conjunction so you can diarise your flare ups – you can find the free download HERE.
- The first thing that I made an active decision to remove from my diet was dairy. So many forums and blog posts recommended this with regards to a lot of skin conditions and it seemed like the easiest win for me (a lot easier than the below!) I did notice a big change in my skin and I now notice straight away if I treat myself to some cheese or a delicious creamy pudding. I actually prefer oat milk to regular milk now and think many of the substitute products taste just as good.
- Gluten was a huge one for me. I actually cut out gluten because I’m intolerant, but soon noticed a difference in my skin which was a bonus. There are a few theories that stomach upsets and facial conditions are linked which I would definitely agree with from personal experience.
- I haven’t cut out alcohol completely but I’ve cut down drastically. When I was first diagnosed, I was at university and easily drinking upwards of 30 units of alcohol a week. Nowadays I can go weeks without drinking and am much more of a social drinker. I think when you see an instant correlation between your skin and your habits, it becomes much easier to prioritise. When I really want a glass of fizz I will still have one, but I will bear in mind that the consequences will have to be dealt with the next day… my rosacea is kind of like a visible hangover!
- Many years ago my doctor recommended that I try the FODMAP diet to get control over my food intolerances and I do not recommended undertaking it without the help of a GP. It was not suggested because of my rosacea. I’m not going to lie and say it’s easy, but from my point of view it was worth it for my overall health and the benefits to my rosacea were a happy by-product. You can read about my FODMAP experience HERE.
- Another common diet-related rosacea trigger is processed and sugary food. I definitely notice a difference if I’m eating more junk food, ready-made food, things high in preservatives, or high in sugar.
WHAT SKINCARE IS GOOD FOR ROSACEA?
- If you’re interested in facials and expert treatments (yes, we can have those things even if we have rosacea!) THIS POST will answer all of your questions (covering LED masks, facials, microneedling, and more).
- I have tried a lot of skincare over the past 19 years. I started a skincare series where I share my all-time favourite skincare: The Best Cleansers For Rosacea and The Best Moisturisers For Rosacea.
- You can find my most update skincare routine articles HERE.
- My biggest tips for choosing skincare: Read the ingredients and do a patch test. Remember up there when I said how important it was to find your triggers? I’m repeating that now. I can look through ingredients lists and instantly find things that I know my skin will hate, or I can make an informed decision on what I have to be more careful with. Information is power, so arm yourself accordingly.
- Be gentle with your skin. I avoid manual cleansing brushes and flannels, I only use chemical exfoliants (you can read all about different types of exfoliators HERE if you’re confused), and I avoid actives if I’m having a flare up.
- Avoid hot water on the face. I don’t get my face wet in the shower (as much as possible) as the temperature most of us prefer to wash our body with is far too hot for our facial skin.
- Common ingredient triggers for me are glycolic acid, fragrance, alcohol, menthol, tea tree oil and witch hazel. These may be different for you, but they are common ones to start with.
- Many people incorrectly assume they have – or are actually misdiagnosed with – acne. This can have terrible consequences as products designed for acne are often terrible for rosacea. When I think back to all the products I used on my poor skin when I didn’t know what I was doing I want to weep!
- I have lots of favourite skincare products but the brands I tend to go back to are Avéne and La Roche-Posay: they are so gentle, have so many great products, are not expensive, and I think they are available in most countries. You can see my reviews for Avéne HERE and La Roche-Posay HERE.
- I remove my make up using the Double Cleanse method, you can watch a video of me removing my make-up and talking through the process HERE.
- If you’d like tips for caring for your skin on a long-haul flight, which can often be a nightmare for rosacea/sensitive skin, you can read all about it HERE.
- Most importantly… have faith in yourself and give yourself time. You will soon know what your skin can and can’t handle, so just listen to what it’s telling you. It is worth bearing in mind that skincare can take between 8-12 weeks to have a meaningful impact, so be patient.
WHAT SUNSCREEN IS GOOD FOR ROSACEA?
- I cannot stress enough that you need to wear sunscreen every time you leave the house (…obviously not when it’s night-time, that’s just silly). You need a minimum of SPF30 but I wear SPF50 every day and you can find my recommendations HERE, HERE and HERE.
- Bear in mind how close you sit to windows during the day as this contributes to your sun exposure – also think about car journeys and plane journeys when applying SPF.
- Try to find a broad-spectrum sunscreen: one that protects against UVA and UVB as both cause damage to the skin.
- Most people with rosacea/sensitive skin prefer physical/ mineral sunscreens vs chemical sunscreens. Bear in mind that mineral sunscreens protect your skin from the sun as soon as you apply them, while chemical sunscreens need to have at least 20 minutes to sink in.
CAN LIFESTYLE CHANGES HELP WITH ROSACEA?
- I’ve written a blog post on my lifestyle changes and tips HERE but here are a few additions:
- Once you have found your triggers (my Rosacea Trigger Checklist will help) you need to work out if you can or want to eliminate them or how you can work around them. For example, heat around my face triggers an instant flare up, so I try to leave my hair to dry naturally as often as I can. However, I’ve also accepted that sometimes I want to blow dry my hair or use hair straighteners/curlers. I now know how long my face takes to calm down after that type of flare up (between 15 and 30 minutes) so I factor that into my getting-ready time.
- Only you can make the choices about what you will eliminate and what you will accept the consequences for. I barely drink during the week, but if I want a few glasses of wine at the weekend I do that accepting the resulting flare up. For some of you, it’ll be spicy food, hot baths, running marathons… each person is different and it’s your call on what you want to sacrifice.
- Weather, and temperature in general, are huge triggers for rosacea. I’ve written about dealing with COLD WEATHER and also about WARM WEATHER.
- It took me a long time to realise that sleep (both quality of and lack of) was a trigger for me, which makes sense as it’s putting stress on the body. You can read all about the impact of sleep on skin health HERE.
- Stress is by far my biggest trigger and is also the one thing that is hard to predict and impossible to eradicate from your life. I did a wonderful Instagram Live with Dr Alia Ahmed about stress and its impact on the skin which you can watch HERE.
- I was lucky enough to remove the biggest stress from my life (my old job) but being a freelancer comes with its own unique stressors. Try to find your own way to minimise the stress in your life or, if that’s not possible, how to learn to deal with the impact of it. Meditation, yoga, reading, listening to music… whatever calms you down, or takes your mind off things, is invaluable to your skin health and sanity.
- I’ve written quite extensively about the psychological side of rosacea, which I’ll summarise below for ease in this already lengthy Rosacea FAQs post:
WHAT MAKE UP WILL COVER ROSACEA?
- I have a blog post with my current recommendations for make up for rosacea, split into light, medium, and full coverage. You can read it HERE.
- I’ve done some recent make up reviews on instagram: Dr Jart Colour Correcting Treatment HERE; Erborian CC Red Correct HERE.
- I have a (now abandoned) YouTube channel where I uploaded reviews of make-up and tutorials that show not only how I cover my redness but what products help my skin to feel comfortable and happy. I haven’t used YouTube in a while (it’s not a kind place!) but I’ll keep the videos up.
- I post a lot of pictures of my skin and make up on Instagram if that floats your boat.
- When it comes to make up tools, I am a total Beauty Blender obsessive: it gives a gorgeous finish (even with super high coverage foundation), doesn’t aggravate the skin as you’re not dragging it around, doesn’t disrupt dry skin… they’re just wonderful!
CAN MEN GET ROSACEA?
- Although rosacea diagnoses are more common in women they tend to be more severe in men. However many doctors believe that the genders are equally as likely to have the condition, but men are less likely to go to the doctors about it until it progresses to a more severe level. Many of the tips I have in this post are suitable for both genders as the triggers and issues tend to be the same.
- I wrote a review of some subtle make up tips for men who want to take the edge of their rosacea. I cannot imagine how hard it must be to be a man who feels like he has to go barefaced because society has decided that make up is a female-only product. I could rant about this all day!
- It is believed that men are more likely to develop Rhinophyma. I have written more about that (with help from a plastic surgeon) HERE.
WHAT IS THE EMOTIONAL IMPACT OF ROSACEA?
- I’ve spoken a lot about the emotional impact of rosacea on my blog and on social media over the years. I think it’s something that many doctors do not take into consideration, when actually it’s something that can not only result in severe emotional issues but can also have a huge impact on the rosacea itself. Worrying about my rosacea is guaranteed to make my skin worse, so it’s important that you view treating the inside as well as the outside as equally important. You can read my thoughts on this in more detail HERE.
- I believe that positive affirmations have had a huge impact on my confidence levels and general skin positivity. I wrote a blog post HERE about what positive affirmations are, how to use them, and shared a link to the ones I designed (!!) especially targeted towards skin positivity.
- There’s a post about the impact of rosacea on mental health HERE.
- I wrote about the lack of support from the medical community and why, because they aren’t considered life-threatening, skin conditions are often dismissed. You can read it HERE.
- I’ve written about what it’s like to live with someone with rosacea, from my husband’s point of view, which you can read HERE.
CAN I STILL EXERCISE WITH ROSACEA?
- Anything that gets your heart rate and body temperature elevated is typically going to have an impact on your rosacea. I’m not telling you to stop exercising because that’s a terrible idea (plus exercise is great for stress which – as we know – is a huge rosacea trigger), but if you are really looking to eliminate causes of flare ups then perhaps consider forms of exercise that are medium-intensity. I wrote a whole post about this, with the help from my amazing followers who shared their tips and advice – you can read it HERE.
HOW DOES COVID IMPACT ROSACEA?
- In the past few years I’ve had a lot of questions about the impact of Covid-19 on rosacea, and in particular questions about whether the covid vaccine effects rosacea. I haven’t had Covid (touch wood) but I am double vaccinated and I spoke about my reaction to the vaccine in the post below. I am very aware that my experiences aren’t universal, so I asked my followers for their experiences – I’d recommend having a read through the comments if you’re interested in this topic:
ROSACEA IN THE MEDIA
- A few years ago I took on Facebook/Instagram with my #UndesirablesOfInstagram campaign. You can read the full story HERE, but the short version is that Instagram were removing images and suppressing hashtags of skin conditions and visible differences. When I questioned the rejection of an advert showing my rosacea, they told me they didn’t allow images that show an ‘undesirable’ appearance. I started the campaign and so many of you stood with me to show them that this was unacceptable. We won that war, but the battle continues as they still use their narrow beauty ideals to control what we do and don’t see.
- I wrote a blog post about the absolutely ridiculous link people make between morality and skin, often seen on social media (you can read it HERE).
ARE THERE ANY CELEBRITIES WITH ROSACEA?
- Cynthia Nixon has done lots of work to raise awareness of rosacea, including some YouTube videos. I even remember watching her in SATC years ago and thinking ‘her face looks like mine sometimes!’
- Amy Schumer has been vocal on social media about her rosacea which is incredible as it’s still such a misunderstood and under-diagnosed condition.
- Lisa Faulkner is another person who has spoken about her skin in the media, helping to raise awareness.
- Renee Zellweger apparently has rosacea, but I’ve not seen her address it directly.
- Apparently Prince William, King Charles, and Prince Harry all have rosacea.
ROSACEA FAQS: HELPFUL RESOURCES FOR THOSE WITH ROSACEA
ROSACEA FAQs: Looking for some next steps?
- Sign up for my SUBSTACK: this is where I do all of my rosacea writing these days.
- Follow me on INSTAGRAM for skin and life updates
- Join my private rosacea FACEBOOK GROUP
- And I’ve linked my digital downloads designed by me to help you get to grips with your rosacea: the Rosacea Trigger Checklist and the Rosacea Flare Up Diary
Phew, that’s a lot of information! I will keep updating this rosacea FAQs post as time goes on, but let me know if there’s anything missing or something you’d like me to cover.
Lex
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