Education Corner
Since the COVID-19 pandemic, people have been wearing masks for long periods, which can increase facial oil secretion and lead to skin breakouts. Many assume it is acne or an allergic reaction, but it might actually be rosacea. So, what exactly is rosacea?
What is rosacea?
Rosacea is a chronic skin condition caused by a combination of genetic and environmental factors. It occurs when the nervous system controlling facial blood vessels becomes dysregulated, leading to excessive facial flushing and visible redness. Common triggers include genetic predisposition and environmental influences.
Rosacea most often affects women over 30, but men and people of all ages can also develop it.
What are the symptoms of rosacea?
The symptoms of rosacea generally progress through four stages:
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Intermittent facial flushing: The face—especially the cheeks and nose—becomes red and feels warm or mildly stinging.
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Persistent redness and visible blood vessels: The redness becomes constant. On closer inspection, small, branching blood vessels (telangiectasia) can be seen on the cheeks and nose, affecting appearance.
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Papules and pustules: Small red bumps and pus-filled spots appear, resembling acne. However, unlike acne, rosacea typically does not cause clogged pores, blackheads, or whiteheads.
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Thickened skin and enlarged nose: Prolonged congestion may cause the skin to become thick and rough. In some cases, the nose becomes enlarged and red, a condition commonly called “rhinophyma” or “whiskey nose.”
How is rosacea different from acne?
Although rosacea and acne can look similar, they are distinct in cause and treatment:
| Skin Condition | Rosacea | Acne |
| Common patients | Women aged 20–40 | Teenagers (both male and female) |
| Main causes | Triggered by factors such as sunlight, diet, heat, or alcohol | Caused by clogged pores and bacterial growth |
| Treatment | Antibiotic creams, retinoid-based topical medications; moderate to severe cases may need oral antibiotics (e.g. erythromycin, tetracyclines) or laser/light therapy | Topical antibiotics or retinoids for moderate to severe cases |
| Prevention | Avoid triggers that dilate blood vessels – such as sun exposure, heat, alcohol, caffeine, spicy foods, chocolate, and cheese | Avoid oily, high-carb, and dairy-based foods that increase sebum production |
Why do I have rosacea?
Many factors can trigger rosacea, with diet being one of the most common. Alcohol, caffeinated drinks, and spicy foods often worsen the condition. Other triggers include:
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Sun exposure
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Hot environments
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Emotional stress
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New skincare or cosmetic products
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Chronic facial inflammation (such as eczema or contact dermatitis)
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Long-term use of steroid creams
How can rosacea be treated? Do I need to see a doctor?
Managing rosacea starts with lifestyle changes. Patients should avoid known triggers, manage stress, and reduce alcohol and caffeine intake. Daily prevention includes wearing sunscreen, avoiding spicy foods, and using gentle cleansers without exfoliating ingredients. Choose simple skincare products with minimal additives.
In terms of medication:
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Doctors may prescribe anti-inflammatory creams or retinoid-based topical medication.
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For more severe cases, oral antibiotics (such as tetracyclines or macrolides) may be prescribed to control inflammation. Treatment usually lasts 3 to 4 months, depending on the condition.
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For those taking antibiotics long term, doctors may order blood tests periodically to monitor for side effects.
Some patients, after diagnosis, may opt for laser or intense pulsed light (IPL) therapy. These treatments are typically performed once a month, and most patients notice improvement after 2 to 4 sessions. Before starting, the doctor will assess suitability, explain how the procedure works, and discuss potential risks.