Facial flushing and rosacea - what's the difference?

Facial flushing can be embarrassing. It’s a tell-tale sign of anger, stress, anxiety, or indeed embarrassment itself – but for some people, redness in the face can be more than that. Dr Nisith Sheth, leading London dermatologist, explains more about the skin condition rosacea.

What is rosacea?

Rosacea is much more than simply red skin. Many people detect a natural amount of redness in their skin. Rosacea often starts with flushing in the face, for short periods of time, but can develop further and display other symptoms as the condition progresses. Some symptoms to look out for are:

Redness becoming more permanent
Small blood vessels visible in the skin
Pustules and papules (elevated patches of skin, with or without pus)
A burning sensation in the face, or stinging

If symptoms are persistent and affect your daily life – redness in the face can cause sufferers to become extremely self-conscious – then you should make an appointment to see a specialist. Bear in mind that the symptoms come and go, and there may be some times the rosacea is particularly bad.

What causes rosacea?

The causes of rosacea are still not really known. Many think the problem is caused by a defect in the blood vessels in the face. Things like spicy food, alcohol, stress, and sunlight can affect existing rosacea, but are not direct causes of the condition. Rosacea is more common in those with fair skin, particularly those that flush easily. It is also more common in women than in men.

What treatments are there for rosacea?

Rosacea cannot be cured, but it can be controlled. There are various ways this can be achieved, and many treatments are prescribed in the long-term. Self-care can be the first step a doctor or dermatologist may recommend, avoiding certain triggers as mentioned before, like alcohol, spicy food, or even caffeine. Some oral medications can help, and topical creams and gels (applied directly to the skin) can reduce redness or spots caused by rosacea.

Patients will often be referred to dermatologists for problems with severe redness and thickened skin, which can happen on the nose. When the skin of the nose becomes thickened, this is called rhinophyma. A specialist can remove excess tissue and reshape the nose, using either specially designed instruments, or a laser.

Laser treatment, and intense pulsed light treatment, can also be used to reduce the redness in the skin through aiming beams of light at the blood vessels in the skin. The laser heat shrinks the veins, which means they are no longer visible. Laser treatment is targeted, so there is minimal risk of damage to the area surrounding the vessels.

Living with rosacea

Rosacea can be problematic for sufferers, as it causes embarrassment and in some cases, social anxiety. Making sure you have the right treatment plan is essential, and sticking to this can help with your emotional wellbeing as physical symptoms improve.