Rosacea — triggers and treatment options
Reviewed by the My London Pharmacy clinical team, Zaynab Ali, Pharmacist Independent Prescriber
·29 July 2026
·7 min read
Quick answer
Rosacea is a long-term skin condition causing facial redness, flushing and sometimes spots, usually across the cheeks, nose, forehead and chin. It cannot be cured but is well managed by avoiding personal triggers and using treatments such as topical gels or oral medication, chosen by a clinician to suit your symptoms.
What rosacea is
Rosacea is a common, long-term skin condition that mainly affects the central face: the cheeks, nose, forehead and chin. It typically begins with episodes of flushing, where the skin reddens easily, and can progress to persistent redness, visible small blood vessels, and spots that can look similar to acne. Some people also experience a burning or stinging sensation, and in a minority the skin of the nose can thicken over time.
Rosacea is most common in adults between 30 and 50 and is often more noticeable in people with fairer skin, though it affects all skin tones. The exact cause is not fully understood, but it involves a combination of factors including how the blood vessels behave, the immune response, and in some cases tiny mites that naturally live on the skin. It is not related to poor hygiene, and it is not contagious. Rosacea also tends to be a condition that develops gradually, so many people put the early flushing down to sensitive skin or the weather before realising it is part of a recognisable pattern. Spotting it earlier, and understanding that it is a manageable long-term condition rather than something that will simply pass, allows treatment and trigger management to begin sooner, which usually makes it easier to keep under control.
Recognising the signs
Rosacea can look different from person to person, which is part of why it is sometimes mistaken for acne, sunburn or simply sensitive skin. Common features include:
- Frequent flushing or blushing that comes and goes
- Persistent redness across the central face
- Small red bumps or pus-filled spots
- Visible thread veins on the cheeks or nose
- Eyes that feel dry, gritty or irritated, known as ocular rosacea
Because rosacea is a long-term condition that tends to fluctuate, recognising your particular pattern helps you and a clinician choose the most useful treatment. Unlike acne, rosacea does not usually cause blackheads.
Understanding your triggers
Most people with rosacea find that certain things bring on flushing or worsen their redness. Triggers vary widely, but common ones include heat, sunlight, hot drinks, spicy food, alcohol, stress and sudden changes in temperature. Wind and vigorous exercise can also provoke symptoms in some people.
Keeping a diary of flares alongside what you ate, drank or did beforehand can reveal your personal triggers. Once identified, avoiding or reducing them is one of the most powerful ways to keep rosacea calm. Daily sun protection is particularly valuable, as ultraviolet light is one of the most common aggravating factors.
It helps to remember that avoiding triggers is about reducing frequency and severity, not achieving perfection. You do not need to give up everything you enjoy; often it is a matter of moderation, such as letting hot drinks cool a little, choosing a mineral sunscreen that suits sensitive skin, or stepping outside to cool down when a room becomes warm. Because triggers are individual, what affects one person may not affect another, so your own diary is more useful than a generic list. Over time, most people build up a clear picture of what settles their skin and what stirs it up.
Gentle skincare that helps
Rosacea-prone skin is often sensitive, so a gentle routine matters. Use a mild, non-soap cleanser and lukewarm water, and pat the skin dry rather than rubbing. Fragrance-free, non-irritating moisturisers help support the skin barrier, and a broad-spectrum sunscreen worn daily protects against one of the biggest triggers.
Avoid products containing alcohol, menthol, witch hazel or strong exfoliating acids, which can sting and worsen redness. Introducing any new product slowly, one at a time, lets you check how your skin reacts before it becomes part of your routine.
Topical treatment options
Several prescription creams and gels target the spots and redness of rosacea. Soolantra, which contains ivermectin, reduces the inflammatory bumps and is thought to act on the skin mites that can contribute to rosacea. Finacea, an azelaic acid gel, calms inflammation and helps with both redness and spots, while a metronidazole preparation such as Metrogel or Rozex is a well-established option for the papules and pustules.
For the persistent background redness rather than spots, a gel such as Mirvaso can temporarily reduce flushing by narrowing the small blood vessels in the skin. Topical treatments usually take several weeks to show their full effect, so consistent daily use as directed is important, and a clinician can advise which option best matches your symptoms.
When oral treatment is considered
For more troublesome or widespread rosacea, particularly where there are many spots, a clinician may consider an oral treatment. A low-dose option such as Efracea works mainly by reducing inflammation rather than acting as a conventional antibiotic, which suits long-term rosacea management and aligns with responsible prescribing.
Oral treatment is often combined with a topical product and continued skincare, then reviewed and adjusted as symptoms settle. The thickened skin changes and prominent thread veins that some people develop may be helped by specialist treatments, which a clinician can discuss or refer for if appropriate.
Living well with rosacea
Because rosacea is a long-term condition, the aim is steady, everyday control rather than a one-off fix. Combining trigger management, a gentle skincare routine and the treatment your clinician recommends gives the most reliable results. Keeping a consistent routine, even when your skin is calm, tends to prevent flares from building up. Many people find that once they understand their own pattern, they can head off flares before they take hold.
Rosacea can affect confidence, and it is worth acknowledging that the emotional impact is real and valid. Gentle, colour-correcting make-up with a green tint can help neutralise redness for those who want it, and choosing fragrance-free, non-irritating products means cosmetics need not aggravate the skin. Managing stress, keeping cool, and protecting your skin from strong sun all contribute to fewer flares over time. Small, sustainable adjustments usually work better than sudden overhauls, and support is available if rosacea is weighing on you. Ocular rosacea, where the eyes feel dry and gritty, benefits from gentle eyelid hygiene such as warm compresses, and should be mentioned to a clinician so it can be managed alongside the skin.
When to seek advice
It is worth seeking advice if you have persistent facial redness, spots that keep returning, or flushing that is affecting your confidence. Prompt treatment can prevent symptoms from becoming more established and helps you feel more in control of your skin. If your eyes are frequently sore or gritty, mention this too, as ocular rosacea benefits from specific care.
A clinical consultation allows a suitable treatment to be recommended based on your symptoms and skin type, with advice on triggers and skincare alongside. All treatment is subject to suitability, and a clinician can advise on the safest approach for you.
Because rosacea can look similar to other conditions, including acne, seborrhoeic dermatitis and simple sensitivity, having the diagnosis confirmed helps ensure you are treating the right thing. It also opens the door to a plan tailored to which features trouble you most, whether that is flushing, spots, or persistent redness, since these respond to different treatments. Rosacea tends to be a long-term companion rather than a one-off problem, and the good news is that with the right combination of skincare, trigger awareness and treatment, most people are able to keep it quiet and comfortable. Regular reviews allow the plan to be fine-tuned as your skin and circumstances change over the years.
Frequently asked questions
Can rosacea be cured?
Rosacea cannot be cured, but it can usually be well controlled with treatment and by managing your triggers. Many people keep their symptoms mild and infrequent with the right routine.
Is rosacea the same as acne?
No, though they can look similar. Rosacea causes redness, flushing and spots without the blackheads seen in acne, and it responds to different treatments, so it helps to have the right diagnosis.
Does alcohol make rosacea worse?
For many people alcohol, especially red wine, is a trigger for flushing. It does not affect everyone, but keeping a trigger diary can show whether it is a factor for you.
How long do rosacea treatments take to work?
Topical and oral treatments usually take several weeks to show a clear improvement, and ongoing use helps maintain results. Patience and consistency are important.
Can I wear make-up with rosacea?
Yes, gentle non-irritating make-up is fine and can help you feel more comfortable. Choose fragrance-free products and remove them gently with a mild cleanser.