Rosacea: symptoms, causes and the treatments that actually work

The change in seasons can trigger rosacea flare-ups – and winter can be the worst time for them due to a mix of cold air, harsh winds and drying central heating.

They can happen at any time of year, though, with triggers ranging from stress to spicy food and sunlight.

Rosacea is a common skin condition that mainly affects the face. It can cause symptoms including redness, flushing and small bumps on the skin. 

If you have rosacea, you’ll know flare-ups can feel unpredictable, uncomfortable and can affect your confidence. But while rosacea can’t be cured, there are treatments that can help manage the symptoms. So how do you know what works?

We asked skin experts to share their insights into common triggers, science-backed treatments and the rosacea myths they want to dispel.

Our experts

Professor Tess McPherson from the British Association of Dermatologists is a consultant dermatologist and associate professor of dermatology at the University of Oxford.

Dr Thivi Maruthappu is a dual-qualified consultant dermatologist and nutritionist who bridges the gap between diet and skin health.

What is rosacea?

Rosacea is a long-term but treatable skin condition characterised by flare-ups of redness that commonly occur across the middle of the face.

While rosacea usually affects the cheeks, chin, nose and forehead, it can also affect other areas such as the neck, chest and ears. It can also make your eyes sore or irritated.

According to the NHS, symptoms can include:

• Redness on the face that comes and goes (like blushing) – as rosacea gets worse, the redness may be there all the time
• Burning or stinging when using water or skincare products
• Broken blood vessels
• Small pink or red bumps, sometimes filled with yellowish liquid
• Dry, patchy or thickened skin
• Swelling, especially around the eyes.

Rosacea can look like other conditions such as acne, contact dermatitis, lupus and keratosis pilaris, so it’s best to see your GP first for an accurate diagnosis.

Who is most affected by rosacea?

Rosacea is more common in women, but can be more severe in men, according to the British Skin Foundation. 

While people with fair skin are more likely to develop rosacea, it can affect people of all skin tones. However, redness can be harder to spot in people with darker skin tones.

If you have a darker skin tone, the American Academy of Dermatology (AAD) says that signs to look out for can include: skin feeling generally warm or more sensitive to skincare products, acne-like breakouts (that don't have blackheads), dry, swollen or discoloured skin patches and itchy or irritated eyes.

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What causes rosacea?

‘The cause of rosacea isn't fully understood, but it’s important to know that it’s not contagious,’ says consultant dermatologist Professor Tess McPherson. 

The British Association of Dermatologists says immune system issues, environmental factors and genetics are all thought to be key elements.

Age can also increase the risk of developing rosacea. A 2018 systematic review and meta-analysis looking into the incidence and prevalence of rosacea found that it mostly affects those aged 45 to 60.

Hormonal changes may also play a role. One 2021 study suggested that menstrual, reproductive and other hormonal factors may be associated with rosacea risk in women.

While more research is needed into the effect of hormones on rosacea, it isn’t uncommon for women to find that symptoms can worsen during perimenopause (which usually occurs between 45 and 55). This can be due to hot flushes and increased skin sensitivity as oestrogen levels decline.

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What's the difference between rosacea and acne?

Rosacea and acne can be confused due to their similar symptoms – specifically the occurrence of small bumps. It’s important to know the difference – particularly as rosacea is a sensitive skin condition and treatments for acne can be drying and aggravating.

Helpful key differences to watch out for, according to the AAD, include that rosacea bumps won’t have blackheads, redness for rosacea tends to be in the centre of the skin, you may also experience eye issues such as bloodshot eyes, swollen eyelids and general eye irritation, and skin tends to be dry and very sensitive rather than oily.

Common rosacea triggers

Certain environmental and lifestyle factors can worsen rosacea symptoms.

According to Professor McPherson, these include:

• Sunlight
• Exercise
• High and low temperatures
• Stress

What you eat and drink can also play an important role. Consultant dermatologist and nutritionist Dr Thivi Maruthappu says: ‘The most commonly reported dietary triggers I see in clinic are alcohol, spicy foods and hot drinks.

‘For some, histamine-rich foods such as aged cheeses, wine and fermented foods can cause flushing to occur. Dietary triggers are very individual, though, so it’s worth exploring which ones are particular to you.’

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Rosacea treatments: what works and what doesn’t

While rosacea can’t be cured, options are available to help manage symptoms. Build a management and treatment plan that fits your specific needs and symptoms.

Track your triggers

Because triggers vary widely from person to person, spotting patterns can help break your flare-up/flare-down cycle.

Professor McPherson recommends: ‘Keeping a rosacea diary can help you identify your triggers.'

This could be stress, extremes in weather or an intense workout, for example. Details of when your flare-ups occur can also be a useful reference if you seek your GP's help for further support and recommendations.

Discuss rosacea medication and prescription creams with your GP

Treatments from your NHS GP can include topical prescription creams and gels, as well as antibiotics for rosacea, which you take for around six to 16 weeks.

Your GP will consider factors such as symptom severity and any previous treatments you’ve tried, so it's best to discuss this with them.

Professor McPherson says: ‘There's no single prescription cream that’s best for everyone. Your GP may prescribe topical ivermectin cream, metronidazole cream, azelaic acid or retinols.

‘Other treatments may be considered where persistent redness or flushing is the main concern, while oral antibiotics can help with more severe inflammation.’

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Adapt your skincare for rosacea: from gentle facial cleansers to rosacea creams

Because rosacea-prone skin is more sensitive, gentle skincare products (and techniques) can help keep irritation at bay and support your skin barrier, the skin’s first line of defence against external aggressors.

‘Supportive skincare is important,’ says Professor McPherson. Instead of a foaming cleanser with harsh ingredients such as exfoliating acids, she recommends using a gentle soap substitute or emollient cleanser, followed by a non-perfumed moisturiser to keep skin hydrated.

Try to avoid aggressive rubbing or scrubbing, too. A patch test (apply a coin-sized amount of product to your upper forearm or behind your ear and leave it for 24 hours) can also help you see how you respond to a new product before applying it to your face.  

For mild cases of rosacea, a green-tinted base can be a helpful next step. Because green sits opposite red on the colour wheel, it helps cancel out redness.

If you’re looking to give your everyday skincare routine a rosacea-friendly refresh, supermarkets, pharmacies, and retailers offer plenty of options. We’ve rounded up some popular options with gentle, nourishing formulas.

Please note that we haven't tested or reviewed these products, so including them here doesn't constitute a recommendation.

• Cetaphil Gentle Skin Cleanser A fragrance-free cleanser for face and body. Available from Sainsbury’s (£11.50) and Boots (£11.50)
• CeraVe Hydrating Cleanser A creamy cleanser that has a huge fan base. SQUIRREL_TEXT_50030294 and Boots (£12.50).
• La Roche-Posay Toleriane Rosaliac AR SPF30 Designed for dry, sensitive and redness-prone skin, this day cream is fragrance-free. SQUIRREL_TEXT_50030295 and Look Fantastic (£27.50).
• Bioderma Sensibio AR+ Cream An unfragranced moisturiser for a soft and supple base. SQUIRREL_TEXT_50030296.
• Rosalique 3 in 1 Anti-Redness Miracle Formula SPF50 A makeup skincare hybrid that has a colour-correcting green tint to help counteract redness. SQUIRREL_TEXT_50030297 and Rosalique (£32.99).

The best sunscreens for rosacea

Because sunlight commonly triggers rosacea, it's a good idea to boost your skin’s defences against UV rays.

Professor McPherson says: ‘I’d recommend applying a sunscreen with an SPF of at least 30 to the face every day and reapplying it regularly when outdoors.’ 

Our independent reviews of the best sunscreens for your face could provide helpful inspiration.

Extra layers can help in the winter months, too, as low temperatures and high winds can trigger rosacea flare-ups in some people. A smooth scarf (rather than scratchy wool) can cover your face and add a layer of protection against the elements.

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Does laser treatment work for rosacea?

Laser treatment can help treat some symptoms associated with rosacea.

Professor McPherson says: ‘Redness and dilated blood vessels can be treated with laser therapy by a dermatologist.’ 

Laser treatment uses pulses of light to shrink and seal blood vessels, helping them gradually fade. But while effective for reducing redness and thread veins, it won’t reduce spots or pustules. The NHS says these are best treated with topical creams or antibiotics from your GP or dermatologist.

Rosacea laser treatment sessions can start at around £250 per session, but you may also need to budget for an initial consultation (about £120) and a patch test (around £150) to check how you respond.

The NHS doesn't routinely fund laser therapy for rosacea.

Can LED masks help rosacea?

Many at-home LED masks claim to help with skin concerns such as redness and inflammation, but can they help with rosacea? 

Professor McPherson isn’t convinced and believes there are better, science-backed options. She says: ‘At-home LED masks are not included among the treatments recommended in current British Association of Dermatologists rosacea guidance, and there’s little evidence that they're effective.'

Low-level light therapy (LLLT) may have potential down the line, though. A 2025 review on photobiomodulation (the principle behind LLLT) in rosacea concluded that experimental and clinical evidence suggests it can reduce inflammatory-cell infiltration and pro-inflammatory signalling. The authors nevertheless emphasised that rosacea-specific studies remain limited in number and quality.

Eat a skin-health friendly diet

While more research is needed on the role of nutrients and vitamins in managing rosacea, Dr Maruthappu says certain foods can support skin health as part of a wider rosacea management plan.

She says: ‘Generally, a balanced, anti-inflammatory Mediterranean-style diet is what I recommend in the clinic.'

‘This includes olive oil, nuts and oily fish to incorporate plenty of good fats and omega 3 fatty acids into your diet, as there is some evidence that this can have a helpful impact on rosacea.’

Could a healthy microbiome play a role? 

Recently, there’s been discussion about whether targeting gut inflammation and eating pre- and probiotic foods may help treat rosacea.

‘It has been theorised that bacteria on the skin or in the gut may play a role, but this has not been proven,’ says Professor McPherson.

Dr Maruthappu feels gut health is more a piece of the puzzle than a silver bullet. ‘The evidence supporting this may be part of a more holistic approach incorporating carefully selected skincare, avoidance of triggers and medical treatment if needed.

‘Probiotic foods such as fermented foods can also actually trigger flushing in some individuals,’ she cautions.  

Can probiotic supplements be helpful? ‘As yet, we don’t have good evidence that probiotics alone can clear rosacea,’ says Dr Maruthappu. However, she notes that as evidence of a gut-skin link in rosacea grows, they may help as part of a wider management plan that includes skincare, trigger monitoring and medical treatment. So for now it's a bit of a 'watch this space'.

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