Red Cheeks and Flushing? You may have Rosacea.

If you suffer with red cheeks, red thread veins on your face and find that you look like you are blushing easily, you may have a skin condition called Rosacea.

What is Rosacea? Rosacea is a fairly common but poorly understood long-term skin condition that mainly affects the face. It is thought to affect up to 1 in 10 people and around 600 new cases are diagnosed in the UK every year. Unlike Acne, which is more common in teens and early 20’s, people with Rosacea tend to be in their late thirties and early forties, and are classically fair-skinned and female, although both sexes and all skin types can be affected.

What are signs that you may have Rosacea? Symptoms often begin with episodes of flushing (where the skin turns red for a short period of time), but other symptoms can develop as the condition progresses, such as:   ▪    Erythema (redness) ▪    Sensitive/ easily irritated skin ▪    Spots (papules and pustules) looking a bit like acne ▪    Small blood vessels on the skin surface (Thread Veins/ Telangiectasia)

What are thread veins? Thread veins are tiny blood vessels which run really close to the surface ofthe skin and look like fine red wiggly lines. They are sometimes called ‘spider veins’ or ‘broken veins’. The veins are not actually broken but are slightly enlarged or dilated, which is what makes them more noticeable under the skin surface. The medical term for them is telangiectasia. Thread veins can appear at any age but they are more common as we age. Just as the collagen in our skin reduces, leading to looser skin and wrinkles, the collagen in the walls of the blood vessels reduces too. It is the dilation of these blood vessels that give us thread veins. Rosacea is a relapsing condition, which means there are periods when symptoms are particularly bad, followed by periods when the condition is less severe.

What causes Rosacea? The exact cause of rosacea is unknown, although a number of possible factors have been suggested, including abnormalities in the blood vessels of the face and there is thought to be a connection with Demodex mites. Scientists still have a long way to go before they understand it fully. Although they are not thought to be direct causes of the condition, several triggers have been identified that may make rosacea worse. Sufferers often complain that the facial redness is exacerbated by the following:

  • Stress
  • Strenuous exercise
  • Hot or cold weather
  • Hot drinks
  • Alcohol and caffeine
  • Certain foods, such as spicy foods

Rosacea is photoexacerbated, which means it gets worse in the sunshine. It can also be triggered by the prolonged use of topical steroids on the face, particularly ones which are too strong to use on facial skin

How can Rosacea be treated? There is no cure for rosacea, but treatment can help control the symptoms. Long-term treatment will usually be necessary, although there may be periods where your symptoms improve and you can stop treatment temporarily. For most people, treatment will involve a combination of trigger avoiding (caffeine, alcohol etc.) and over-the-counter or prescription treatments, such as antibiotics.

Many patients with rosacea also complain of sensitive skin. What they usually mean by this is that any products rubbed onto the skin such as creams, cleansers etc or even touching the skin can cause discomfort, stinging and often redness. I advise avoiding products which may trigger off this sensitivity, particularly products containing lactic acid, azelaic acid, AHAs, vitamin C,or benzoic acid.

Recent studies have shown that the most effective prescription medications to use are Doxycycline antibiotics , topical Metronidazole creams (rather than gels) and topical azelaic acid as first line treatments. Here the antibiotics work in lower doses where they are used for their an anti-inflammatory effect, rather than their bacteria fighting effect. These treatments can help to reduce the spots seen in Rosacea, and to a lesser extent the redness. They will not help to reduce thread veins however.

There are laser treatments that work particularly well for Thread veins. During the laser treatment beams of light are aimed at the visible blood vessels in the skin to shrink them and make them less visible. Because the laser is set to a controlled wavelength, it only targets the blood vessels and not the surrounding skin. This enables the walls of the veins to collapse and be harmlessly absorbed by the body without causing any damage to the skin or surrounding tissue. Recommended frequency of treatments is every 2-4 weeks.

Homeopathic products such a milk thistle have been used for years to reduce redness by vasoconstriction (making the vessels smaller).

There are a range of green tinted moisturisers and cosmetics /cleansers designed for people with rosacea and in the UK the British Red Cross offers a cosmetic camouflage service.

Patient support group -rosacea It is a very useful resource and support for patients and their relatives. The address is: Rosacea Support Group, 16, Dufours Place, Broadwick St, London W1V 1FF

At my Nuriss Skincare and Wellness Clinic we offer a number of solutions for Rosacea Sufferers. For more information visit