An expert's guide to rosacea

Written by: Dr Aleksandar Godic
Edited by: Conor Dunworth

Rosacea is a very common skin conditon that causes the face to become red and painful. In our latest article, renowned dermatologist Dr Aleksandar Godic explains everything you need to know about this condition, including its causes, symptoms and treatments. 

What is rosacea?

Rosacea is a very common inflammatory skin condition, which is poorly understood. It presents with a variety of signs and symptoms. The most common symptom is a red face. This redness can initially come and go, and later on be more permanent.

Patients also have tendency to flush. The most common trigger is heat, but certain foods such as garlic, spicy foods, citrus, chocolate, and alcohol can also trigger rosacea. Some patients can develop pustules similar to acne spots, affecting the centre of the face.

Certain patients can develop ocular rosacea, which affects eyelids, causes conjunctivitis, or leads to other manifestations in the eye. In certain patients, we see swelling of certain parts of the face, and phymatous rosacea which leads to an expansion of soft tissue. This can cause the formation of clumps and bumps, mainly affecting the nose and to a lesser extent the forehead, earlobes, eyelids or chin.

Patients suffering from rosacea also have a low pain threshold, and a low tolerance to heat and irritants. Many patients complain of having dry and flaky skin associated with general soreness, or a painful, burning sensation in the face.


What does rosacea look like?

Patients suffering from rosacea usually present with a red face. They may also have broken blood vessels on their face, which are called telangiectasis. Rosacea can sometimes also cause pustules to form.

Another characteristic of rosacea is a thinner skin barrier, which means that patients don't tolerate irritants very well. They can find it difficult to find skincare and sun protection products that don’t cause burning or stinging.

Some patients may have rosacea nodules, or phymatous rosacea symptoms. Patients may present with all of these symptoms or just one or two symptoms, there is no rule.


What is the main cause of rosacea?

The main cause of rosacea is unknown. Rosacea is most common in Caucasians, and many rosacea patients have concomitant sun-damaged skin. Whether this sun damage is a cause of rosacea is unknown. We also see rosacea in children, and people with dark skin, but this is less understood.


How do you get rid of rosacea permanently?

Unfortunately, there is no permanent cure for rosacea. We can only help patients to ease their symptoms. We can advise them which products to use, such as sunscreens, and common triggers which they can avoid.


What products should you avoid if you have rosacea?

My simple advice to patients is to avoid any product that causes redness, stinging, burning or itchiness. Unfortunately, there is no one-size-fits-all solution for rosacea, but people suffering from rosacea should always avoid exfoliators and any aggressive skincare products.


Can rosacea go away on its own?

Usually, rosacea does not go away on its own, but it can become very controllable. It may go into remission and stay in remission for a long time.


If you have concerns about rosacea or any other skin condition, please don't hesitate to arrange an appointment with Dr Aleksandar Godic via his Top Doctor profile.


By Dr Aleksandar Godic

Dr Aleksandar Godic is a leading consultant dermatologist based in London. Dr Godic graduated in 1996 from the Faculty of Medicine, University of Ljubljana, Slovenia. He finished his Master of Science in 1997 (Thesis: Analysis of Hair Surface in Patients with Ichthyosis Vulgaris, University of Ljubljana, Slovenia), and training in dermatovenereology in 2001. In 2004 he finished his PhD (Thesis: Molecular and Genetic Analysis of Darier Disease in Slovenian Population, University of Ljubljana, Slovenia).  He spent a year of postdoctoral fellowship in dermatopathology at the University of California, San Francisco, USA (UCSF), had additional training in dermatology at the Department of Dermatology, Yale University, USA (in 2005 and 2006), and was awarded the European Board Certificate in Dermatopathology (2006).

In 2005, Dr Godic was appointed as an Assistant Professor for Dermatovenereology at the Faculty of Medicine, University of Ljubljana, Slovenia. He is a regular invited lecturer at the European and world anti-aging congresses in Paris, and in Monte Carlo, respectively. In 2014 he became a board member of the World Council for Preventive Regenerative and Anti-Ageing Medicine (WOCPM). Recently he became a Scientific Board Member of BHI Therapeutic Sciences and will start seeing patients in Slovakia who are interested in autologous (self) fat transfer supplemented with stem cells into the face, V neck, hands, scalp and earlobes. He has numerous publications in high impact factor journals and has written a chapter on hair and scalp diseases in a textbook for medical and dental students. He contributed to the monographs on psoriasis and on skin aging and skin disorders.

With more than 20 years of experience, he is a at the cutting-edge of dermatology, constantly looking for new and innovative treatments. His special interests include general dermatology, hair and scalp disorders, skin cancer, pigmented lesions, inflammatory dermatoses (acne, psoriasis, rosacea, vitiligo, etc.), skin surgery, dermatopathology, anti-aging, and cosmetic dermatology.

Further to this, Dr Godic offers a revolutionary fat transfer treatment that uses patients' own stem cells to achieve lasting, transformational results.

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