Poll

Diagnosis

What are the early signs of rosacea that might appear before the first major flare-up?

Symptoms

I was diagnosed with flushing rosacea last year, and recently I have been experiencing irritated and gritty feeling eyes. Could this be related?

I have pimple/acne-like rosacea. Why do the spots usually appear in the same place?

I suffer from spotty, greasy skin and I also have rosacea. Is rosacea more common with this skin type?

Causes

Is rosacea contagious?

Triggers

How does the weather affect my rosacea?

Treatment

Why are the blood vessels on my face more noticeable since starting treatment for rosacea?

Skincare tips

What kind of skincare regimen do you recommend?

I have red marks over my nose and cheeks that don't seem to disappear? What can I do about them?

Answers:

What are the early signs of rosacea that might appear before the first major flare-up?
It is sometimes possible to identify early rosacea symptoms, which may occur in teenagers and those in their early 20s. These symptoms usually consist of frequent flushing or blushing episodes that last longer than normal. It is especially important for the doctor to be aware of these signs as these symptoms are often mistaken for acne. If over-the-counter or prescribed topical acne preparations are used they can cause irritation and make the redness even worse. If you recognise symptoms that could indicate early rosacea in a younger member of your family, take them to see your doctor.
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I was diagnosed with flushing rosacea last year, and recently I have been experiencing irritated and gritty feeling eyes. Could this be related?
Yes, it is possible that this could be a condition called ocular rosacea. In ocular rosacea, eye symptoms may involve irritation, a watery or a bloodshot appearance, and a dry, gritty feeling with burning, itching and/or stinging. The eyelids may also become red and swollen. The involvement of the eyes may appear before or after you notice any skin signs or symptoms. Severe cases can result in corneal damage and vision loss, so if you are experiencing any eye symptoms you should consult your doctor immediately.
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I have pimple/acne-like rosacea. Why do the spots usually appear in the same place?
The pus-filled spots (pustules) that are characteristic of pimple/acne-like rosacea (papulopustular rosacea) are not the result of blocked pores, but are caused by damage to the blood vessels under the skin. When you have a flushing episode, it is in these areas that the skin becomes more susceptible to pustule development, which is why the spots may appear in the same place.
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I suffer from spotty, greasy skin and I also have rosacea. Is rosacea more common with this skin type?
No. Rosacea can develop in any skin type, for example, many people with rosacea experience dry, flaky skin, while others may have normal or oily skin, or a combination of both. However, rosacea does tend to be more common in fair skinned people, who burn easily, have red or fair hair, and are of Celtic or Northern European heredity (Fitzpatrick Type I or II). It is important to try and identify your skin type so that you can use skincare and medication products that are suitable for you.
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Is rosacea contagious?
No, rosacea cannot be passed from one person to another and is therefore not considered to be a contagious disease. There are no identified germs or bacteria that cause rosacea. Antibiotics appear to work to control rosacea symptoms by reducing inflammation, not by destroying bacteria that are present. 
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How does the weather affect my rosacea?
There are many environmental triggers that can aggravate rosacea, with weather at the top of the list. People, however, react differently: for some it is the heat and sun that acts as a trigger; for others, it is the wind and cold. In most cases the skin will adapt to changes in temperature within four to six weeks and the rosacea should calm down. If the sun worsens your rosacea, you may find it helpful to use a sunscreen. Click here for more information about triggers.
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Why are the blood vessels on my face more noticeable since starting treatment for rosacea?
Visible blood vessels are a primary symptom of rosacea. However, before your treatment started, they were probably masked by the redness of the skin. The appearance of these blood vessels is actually a clear and positive sign that the treatment is working.
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What kind of skincare regimen do you recommend for rosacea?
Avoid irritating facial skincare products or cosmetics, such as alcohol-based cleansers, exfoliators and oil-based or waterproof make-up. Use products and cosmetics designed especially for sensitive skin. The use of cosmetic skin camouflage can be a very successful lifestyle choice for both men and women. See here for more information on skincare routines.
 
I have red marks over my nose and cheeks that don’t seem to disappear and I am noticing more visible blood vessels around my nose. As a man, I don’t want to use make-up. What can I do about them?
These red marks are usually very easy to conceal and this is where skin camouflage can be most useful. It doesn’t matter if you are a man or woman, skin camouflage will be suitable for both and take no longer than five minutes to apply once you have learned how to do it. The creams will cover much better than conventional green based make-up and will not slide off or look obvious. The aim is to conceal, not leave a ‘made-up’ effect. Usually the creams are set by using a special fixing powder (which can also be prescribed) and will help it to stay on for up to three days.

The British Red Cross run a free cosmetic camouflage service based at hospitals. You will need to make an appointment and will be shown how to apply and remove the creams. They will match the camouflage creams to your natural skin colouring and then write a letter to your doctor so that you can have creams prescribed in the future. The British Association of Skin Camouflage is a national organisation whose members have been trained to match and apply camouflage creams in the same way as the British Red Cross – the only difference is that they will visit you in your own home at a time convenient to you. There is usually a small charge for this service.  
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