What is rosacea?
Rosacea is a chronic inflammatory skin condition that causes facial redness, visible blood vessels, and sometimes acne-like bumps on the central face. About 1 in 20 US adults has it, more common in fair-skinned people aged 30–60.
It's not the same as acne, though it's often confused with it — rosacea bumps don't have blackheads, and the persistent redness is the defining feature. Untreated, it can progress to thickened skin (rhinophyma) and ocular involvement.
Do I have rosacea? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Cause unclear — likely involves abnormal blood vessel reactivity, immune dysregulation, demodex mites, and skin barrier disruption. Common triggers: sun, heat, hot drinks, alcohol (especially red wine), spicy food, stress, exercise, certain skincare products.
Is it contagious?
No.
The redness comes and goes for a reason — every rosacea patient has their own trigger list. Identify yours and you control most of it.
Can it be treated online?
Rosacea is well-suited to telehealth — photos make diagnosis straightforward. Severe ocular rosacea or rhinophyma needs in-person dermatology.
How rosacea is treated
Metronidazole gel/cream and azelaic acid are first-line for papulopustular rosacea. Ivermectin cream (Soolantra) targets demodex. Brimonidine gel (Mirvaso) reduces redness temporarily. Oxymetazoline (Rhofade) is another vasoconstrictor. For severe inflammatory rosacea, oral doxycycline (40mg SR) helps. SPF daily is non-negotiable.
Self-care while you wait
- SPF 30+ daily — sun is the #1 trigger
- Identify and avoid your personal triggers
- Gentle, fragrance-free cleansers only
- Lukewarm (not hot) water on the face
- Mineral makeup tolerated well; avoid heavy fragranced products
- Limit alcohol, hot drinks, spicy food if they flare you
- Manage stress
How long does it last?
Chronic — flares and quieter periods. Most people achieve good control with sustained treatment and trigger avoidance.
Frequently asked questions
Can I use retinol with rosacea?
Sometimes, but introduce slowly — many rosacea-prone skin types don't tolerate retinoids well. Azelaic acid is often a better starter.
Why does my nose look like it's getting bigger?
Subtype 3 rosacea (phymatous) can thicken the skin of the nose. Early treatment helps prevent progression.
Can I drink red wine if I have rosacea?
If it flushes you, probably best to limit. Some people tolerate it fine. Pay attention to your triggers.
Is rosacea the same as adult acne?
No. Rosacea has redness and flushing, lacks blackheads, and responds to different treatments. They can coexist.
Will laser help?
Yes — vascular lasers (IPL, pulsed dye) can significantly reduce redness and visible vessels. Done in dermatology offices, multiple sessions.
