Rosacea
Rosacea is a chronic condition affecting the skin of the face, with redness, visible blood vessels and, in some people, acne-like lesions.
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Medicines commonly prescribed for Rosacea
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 500 mgActive substance: azithromycinManufacturer: Neuraxpharm Spain S.L.Prescription requiredDosage form: TOPICAL SOLUTION, 50 mg/g (5% w/w)Active substance: minoxidilManufacturer: Jntl Consumer Health (Spain) S.L.Prescription not requiredDosage form: TABLET, 250 mgActive substance: azithromycinManufacturer: Teva Pharma S.L.U.Prescription required
Rosacea is a chronic condition affecting the skin of the face, with redness, visible blood vessels and, in some people, acne-like lesions. It is not acne, it is not an allergy and it is not caused by poor cleansing. It cannot be cured but it is well controlled, and an important part of that control lies not in creams but in identifying what triggers it in your particular case.
How it presents
- persistent redness across the centre of the face: cheeks, nose, forehead and chin;
- episodes of flushing with heat and burning, lasting minutes or hours;
- fine visible blood vessels;
- red papules and pustules without comedones: the absence of blackheads is what distinguishes it from acne;
- burning, tightness or stinging, with intolerance of many cosmetics;
- rough or thickened-looking skin;
- in some men, thickening of the skin of the nose — rhinophyma;
- eye involvement in around half of people: dry, gritty, burning eyes, red lids, recurrent styes.
Ocular rosacea is very frequently overlooked, and it sometimes appears before the skin symptoms. If your eyes are persistently irritated and you have facial rosacea, mention it to your doctor.
Triggers
These are personal: what affects one person does not affect another. That is why a diary works better than any general list.
- sun — the most frequent trigger;
- heat: sauna, hot baths, central heating, cooking;
- cold and wind;
- alcohol, particularly red wine;
- spicy food and very hot drinks;
- stress and lack of sleep;
- intense exercise;
- cosmetics containing alcohol, fragrance, menthol or exfoliants;
- topical steroids on the face, which improve things briefly and make them much worse afterwards;
- some vasodilator medicines.
When to see a doctor
- facial redness has become persistent;
- papules and pustules have appeared on the face;
- your eyes are irritated, dry or you get repeated styes;
- the skin of the nose is thickening;
- your skin reacts badly to almost every cosmetic;
- it is affecting your mood or your social life — a legitimate reason to attend;
- you have been using steroids on your face;
- there is eye pain or blurred vision — do not wait.
How it is diagnosed
By examination; there are no specific tests. The doctor will exclude lupus, seborrhoeic dermatitis, perioral dermatitis, acne and topical steroid reaction, which look similar and are treated differently.
Skin care
Here less is more: rosacea worsens with almost anything aggressive.
- a gentle soap-free cleanser with lukewarm water, applied with the hands and rinsed off thoroughly;
- pat dry, do not rub;
- a simple moisturiser without fragrance or alcohol, to restore the skin barrier;
- sunscreen daily, all year round, with mineral filters, which are usually better tolerated;
- no scrubs, facial brushes, alcohol toners or clay masks;
- test any new product on a small area first;
- green-tinted make-up to neutralise redness, if you wish;
- keep a trigger diary for a month: the single most useful tool of all.
Treatment
- topical metronidazole, azelaic acid and ivermectin — the mainstay for papules and pustules;
- topical brimonidine and oxymetazoline — reduce redness temporarily;
- doxycycline at an anti-inflammatory dose for moderate to severe disease, in courses;
- low-dose isotretinoin for resistant cases;
- vascular laser or intense pulsed light for visible vessels and fixed redness: the only thing that acts on vessels already formed;
- treatment of ocular rosacea: lid hygiene, artificial tears, and doxycycline or ophthalmic treatment if needed;
- laser or surgery for rhinophyma;
- never topical steroids on the face for rosacea.
Common questions
Is it adult acne? No. Rosacea has no comedones, and the treatment differs.
Can it be cured? No, but it is controlled very well. With maintenance treatment most people spend most of their time with settled skin.
Is it caused by drinking? Alcohol is a trigger in some people, but it is not the cause of the condition.
Can I exercise? Yes. It helps to train somewhere cool, drink cold water and cool the face afterwards.
Does winter sun count? Yes. That is why sunscreen is daily and year-round.
Online consultation
In an online consultation the doctor reviews photographs, distinguishes rosacea from acne and from a steroid reaction, reviews your cosmetics, asks specifically about the eye symptoms that usually go unmentioned, and sets out both an initial and a maintenance treatment.
This material is for information only and does not replace a medical consultation.
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Medically reviewed by
Reviewed on Jul 19, 2026
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