This article is general information about a skin condition. It isn't medical advice, and it doesn't recommend or discuss treatments. Rosacea is a medical condition — if you think you have it, your GP or a dermatologist is the right place to start.
Rosacea is a chronic skin condition that causes facial redness, visible blood vessels and sometimes small bumps. It can affect anyone, though it's most often reported in fair skin and usually appears in adulthood. If you've ever wondered why your face flushes and stays flushed, this is a plain-language look at what rosacea is, what's happening in the skin, and what tends to set it off.
What is rosacea?
Rosacea is an inflammatory skin condition that mainly affects the face — the cheeks, nose, forehead and chin. It ranges from mild flushing through to persistent redness, breakouts that can resemble acne, visible blood vessels, and in rare cases a thickening of the skin on the nose (called rhinophyma).
Dermatologists generally describe four subtypes:
Erythematotelangiectatic rosacea (ETR)
Persistent redness and visible blood vessels.
Papulopustular rosacea
Redness with breakouts, often mistaken for adult acne.
Phymatous rosacea
Skin thickens and takes on a bumpy texture.
Ocular rosacea
Affects the eyes, causing irritation, dryness and sensitivity.
Many people experience features of more than one subtype, which is part of why self-diagnosis is unreliable and a proper assessment matters.
What's happening in the skin
The mechanisms behind rosacea aren't fully understood, and research is ongoing. Researchers have identified several factors that appear to contribute, most of them involving the immune system and the blood vessels in facial skin.
An inflammatory response. Rosacea is understood to be an inflammatory condition. Skin cells — particularly keratinocytes and fibroblasts — appear to become more sensitive and to release higher levels of inflammatory signalling molecules such as cytokines, which draw in immune cells and sustain inflammation in the skin.
Blood vessel regulation. In rosacea, small blood vessels in facial skin dilate more readily and stay dilated longer. This is thought to relate to the nerve signals that normally regulate how those vessels contract and relax.
Cathelicidins. These are antimicrobial peptides the skin produces as part of its natural defences. In rosacea, levels are often elevated and the forms present are altered, which is associated with more inflammation rather than more protection.
Demodex mites. These microscopic mites live harmlessly on most people's skin. In rosacea, populations are often higher, and the immune response to them is thought to play a role.
Reactive oxygen species. UV exposure and pollution increase the production of unstable molecules that can damage skin cells, and this oxidative stress is understood to contribute to the inflammatory picture.
Common triggers
Triggers are highly individual, and part of living with rosacea is working out which ones are yours. The ones people most commonly report are:
Sun exposure
Stress
Heat, hot showers and extreme temperatures
Spicy food
Alcohol
Wind and cold
Skincare containing harsh or stripping ingredients
A simple trigger diary — a note on your phone each time your skin flares, with what you ate, did and wore that day — is the most useful thing you can bring to a first appointment. Patterns show up in a fortnight that are invisible day to day.
Everyday habits people find help
None of this replaces treatment, and none of it will resolve a flare. But the general approach dermatologists tend to recommend for easily-reddened skin is consistent, and it's mostly about doing less:
Keep the routine short. Fewer products means fewer variables, and makes it far easier to identify the one that doesn't agree with you.
Go fragrance-free. Fragrance, synthetic or essential-oil based, is a common irritant for reactive skin.
Skip scrubs, astringents and strong actives. Physical exfoliants, high-strength acids and alcohol-heavy toners are the products most often reported to trigger flares.
Wash in lukewarm water. Hot water encourages flushing. So do hot showers and, for some people, saunas.
Wear sunscreen daily. Sun exposure is the single most commonly reported trigger, and broad-spectrum SPF is standard advice for rosacea-prone skin year-round in Australia.
Patch test anything new. On the inner forearm or behind the ear, for a few days, before it goes near your face — and introduce one new product at a time.
When to see a doctor
If your face is persistently red, if you're flushing in ways that feel new, if you're getting bumps that don't behave like ordinary breakouts, or if your eyes are dry, gritty or irritated alongside facial redness, it's worth getting assessed. Rosacea is diagnosed clinically, several other conditions look similar, and the sooner it's identified the more straightforward it is to manage.
Your GP can diagnose and manage many cases, and can refer you to a dermatologist where that's useful.
Where to read more
For reliable Australian information on rosacea:
healthdirect Australia — government-funded health information service
The Australasian College of Dermatologists — A-to-Z of skin conditions
Written for general information only. Pure Earth makes cosmetic products; we don't make products that treat, prevent or manage rosacea or any other medical condition, and nothing here should be read as suggesting otherwise. Please speak with your GP or dermatologist about your own skin.
