Rosacea & Facial Redness

Rosacea is a chronic inflammatory skin condition that most commonly affects the central face, including the cheeks, nose, chin, and forehead. It is characterised by facial redness, flushing, and sometimes red and inflamed lesions.

Symptoms often fluctuate over time and may be triggered by environmental or lifestyle factors.

Rosacea can present in several forms, which may occur alone or together, including:

• Facial flushing and persistent redness

• Red bumps or pustules that can resemble acne

• Visible facial blood vessels

• Skin sensitivity, burning, or stinging sensations

The pattern and combination of features help guide diagnosis and management.

Rosacea may be classified into several subtypes, including:

• Papulopustular rosacea – inflammatory bumps and pustules

• Erythematotelangiectatic rosacea – persistent redness and visible blood vessels

• Phymatous rosacea – skin thickening, most commonly affecting the nose (less common)

• Ocular rosacea – involvement of the eyes and eyelids

Identifying the subtype or subtypes helps guide treatment selection.

Rosacea can involve the eyes and eyelids, sometimes even when skin symptoms are mild. Ocular rosacea may cause:

• Dryness or irritation

• Redness of the eyes or eyelids

• A gritty or burning sensation

Assessment includes asking about eye symptoms and examining for signs of ocular involvement, as untreated eye involvement may lead to ongoing discomfort.

Common triggers may include:

• Heat or temperature changes

• Sun exposure

• Alcohol

• Spicy foods

• Stress

• Certain skincare products

Identifying and avoiding individual triggers forms part of long-term management.

Medical review may be helpful to:

• Confirm the diagnosis and subtype

• Assess severity and symptom impact

• Identify ocular involvement

• Guide appropriate treatment selection

• Review treatment response and adjust management

Diagnosis is made clinically, based on history and skin examination, considering:

• Pattern and distribution of redness or inflammation

• Presence of flushing or triggers

• Inflammatory lesions or visible blood vessels

• Eye symptoms

• Skincare use and medical history

Assessment also helps exclude other conditions that can mimic rosacea.

Management is individualised and guided by rosacea subtype and severity. This may include:

• General skincare advice and trigger avoidance

• Topical treatments for inflammatory components

• Oral therapies for more persistent or moderate disease

In selected cases, referral to a cosmetic dermatologist may be appropriate for management of persistent redness or visible blood vessels.

Rosacea is a long-term condition that benefits from regular review. Ongoing care focuses on symptom control, trigger management, and adjustment of treatment over time.

Dermatologists are trained to distinguish rosacea from other facial inflammatory conditions, assess for ocular involvement, and guide appropriate, evidence-based management. Specialist review supports accurate diagnosis and safe, individualised treatment.

At Ready Dermatology, North Shore Health Hub, St Leonards, our dermatologist assesses rosacea and facial redness, identifies contributing factors, and provides guidance on appropriate management tailored to individual needs.