Redness that frequently appears on the face, flushes of heat and a blush that becomes permanent over time are often overlooked, mistaken for ‘sensitive skin’. Yet these symptoms can be a sign of a chronic skin disease called rosacea. Rosacea is a condition that can be brought under control with correct diagnosis and management; however, it does not go away on its own and requires follow-up. Noticing it early is very important for slowing the progression of the disease.
What is rosacea?
Rosacea is a chronic skin disease that progresses with redness, prominent capillaries, sensitivity and, from time to time, acne-like lesions in the central region of the face (cheeks, nose, forehead and chin). The disease progresses with periods of flare-up and calming; in some periods the symptoms increase, in others they recede.
Rosacea is generally seen more frequently in fair-skinned people and in middle age; however, it can appear in every skin type. It can be confused with acne, but it is a different disease and its treatment is also different. For this reason, correct diagnosis is the first step of effective treatment.
The disease has different types: in some people redness and capillaries are at the forefront, while in others acne-like lesions predominate. For this reason an approach of ‘a single type of rosacea’ and ‘a single type of treatment’ is not correct.
What are the symptoms?
- Persistent redness in the central region of the face.
- Easily triggered flushing and a sensation of heat.
- Capillaries that become prominent.
- Acne-like red bumps (not always seen).
- Burning, stinging and sensitivity in the skin.
The symptoms vary from person to person and can change over time. In some people, irritation, redness and dryness in the eyes (ocular rosacea) can accompany it. For this reason it is important to look holistically not only at the skin but at all of the person's complaints.
Causes and triggers
Although the exact cause of rosacea is not fully known, genetic predisposition, immune-system responses, the sensitivity of the vascular structure in the skin and some microorganisms are thought to play a role. What matters is determining the factors that trigger and flare up the disease.
Among the frequent triggers are the sun, excessive heat or cold, spicy foods, hot drinks, alcohol, stress and some skin-care products. These triggers are not the same in everyone; for this reason, the person recognising their own triggers is one of the most important parts of treatment.
The management of triggers alone can provide a marked reduction in symptoms. That is why rosacea treatment is not only medication or a procedure; it is at the same time an adjustment of lifestyle and skin care.
How is it diagnosed?
Rosacea is diagnosed with a detailed dermatological examination. The type, distribution and course of the symptoms are evaluated; it is distinguished from other skin diseases that look similar. The diagnosis can usually be made by clinical evaluation, without the need for a special test.
Correct diagnosis determines the direction of treatment. Because when rosacea is confused with other diseases such as acne or eczema, the wrong treatments can make the symptoms even worse. For this reason a skin that ‘constantly reddens and becomes sensitive’ must definitely be evaluated.
Treatment options
Rosacea treatment is planned individually according to the type and severity of the disease. The basis of treatment consists of avoiding triggers, suitable and gentle skin care and regular sun protection. Without these, no treatment can be fully effective.
According to the symptoms, topical or oral treatments recommended by the physician can be used. Acne-like lesions and redness require different approaches; for this reason treatment is always individual.
In marked persistent redness and capillaries, light- and laser-based treatments (for example broad band light applications) can be evaluated as directed at vascular targets. These applications can help reduce redness and the appearance of vessels.
The aim of treatment is most of the time not to ‘eliminate’ the disease completely but to bring the symptoms under control, reduce flare-ups and improve quality of life. In this respect rosacea, just like some chronic diseases, is a long-term management process.
Success in rosacea is not to ‘treat’ the disease once but to keep it under control in the long term by managing the triggers.
Lifestyle and skin care
The care of rosacea-prone skin should be gentle and simple. It is important to avoid irritating products, those containing alcohol or very strong ones, and to support the skin with mild cleansers and suitable moisturisers. Using sunscreen every day, regardless of the season, is indispensable.
The person noticing their own triggers by keeping a diary can markedly reduce flare-ups. Avoiding hot environments, sudden temperature changes and known trigger foods helps the skin stay calmer.
It is known that stress can also trigger rosacea; for this reason stress management indirectly contributes to skin health. A holistic approach supports both the skin and quality of life.
Frequently asked questions
Does rosacea go away? Rosacea is a chronic disease and does not completely go away on its own; however, with correct treatment and trigger management the symptoms can largely be brought under control. Most people, with a suitable plan, reach a comfortable skin life.
Can I wear make-up? Yes, make-up is possible with suitable, non-irritating products; in fact, green-toned bases can help to camouflage the redness. What matters is that the products are gentle and skin-friendly.
How long does treatment take? Rosacea requires long-term management. A more intensive approach is followed during flare-up periods and a protective one during calm periods. Regular follow-up makes controlling the disease easier.
Does treatment give results? In most people, with suitable treatment and trigger management, a marked reduction in redness, sensitivity and lesions is achieved. What matters is to know that the expectation is ‘bringing under control’ and to continue the treatment with patience.
The importance of noticing it early
Rosacea can be a progressive disease; when untreated, redness and capillaries can become more permanent over time, and in some people advanced symptoms such as tissue thickening in the nose region can be seen. For this reason it is of great importance to notice and evaluate the symptoms early.
Many people live for years without noticing rosacea, saying ‘I have sensitive skin’. Yet a management plan started in the early period both brings the symptoms under control and can slow the progression of the disease. That is why persistent facial redness must definitely be evaluated by a dermatologist.
Rosacea can also affect a person's social life and self-confidence. Bringing the symptoms under control positively affects not only the skin's appearance but also the person's daily comfort and psychological ease.
At the clinic of Dr. Burcu Çelen, rosacea treatment is planned holistically with correct diagnosis, trigger management and personalised treatment options. You can make an appointment to evaluate the redness and sensitivity on your face.