Rosacea – in brief
| Symptoms | Facial redness, flushing, visible capillaries, stinging and skin sensitivity, and in some forms red bumps and pus-filled blemishes |
|---|---|
| Triggers | Sun, heat, sudden temperature changes, stress, alcohol, hot drinks, spicy food |
| Examination | Discussion of symptoms and triggers, skin examination and assessment of the rosacea subtype |
| Treatment | Symptomatic treatment, sensitive skin care and daily sun protection |
| Laser treatment | Yellow laser and DYE VL light treatment for redness and dilated capillaries |
| Follow-up | Monitoring and adjustment of therapy according to skin response |
What is rosacea?
Rosacea is a chronic inflammatory skin condition, which most commonly affects the central part of the face – the cheeks, nose, chin and forehead. The course is individual: in many people, calmer periods and flare-ups alternate, and in some, the redness becomes more permanent over time.
Redness and flushing - the face flushes easily and quickly, accompanied by a feeling of warmth, and in some people the redness persists even between episodes.
Visible thread veins – thin, dilated blood vessels, most commonly on the cheeks and nose.
Inflammatory changes – red bumps (papules) and pus-filled lesions (pustules) on a red base.
Skin sensitivity – stinging, burning, dryness, and a reaction to cosmetics that were previously well-tolerated.
Skin thickening – rarer, most commonly on the nose, in long-standing rosacea.
Previously, rosacea was divided into four subtypes – erythematotelangiectatic, papulopustular, phymatous and ocular. Today, individual signs present on the skin are more commonly described, as signs of multiple forms can occur in the same person. Rosacea can also affect the eyes and eyelids, and a dermatologist's examination is required to make a diagnosis.
Laser treatment for rosacea
How does laser treatment for rosacea work?
Laser and light treatments work on dilated blood vessels: the energy is absorbed by haemoglobin, the blood vessel is closed, and the body gradually breaks it down. This is why they are most useful for persistent redness and visible capillaries, whereas inflammatory changes also require therapy. The treatments do not alter the predisposition to rosacea, so the redness may intensify again over time, and the result is maintained through skincare, avoiding triggers and, if necessary, repeated treatments. Most commonly, 2 to 3 treatments are needed, and the exact number and interval between them is planned by the doctor according to the findings and the skin's response. When visible blood vessels are a pronounced part of the problem, the doctor may also consider thread vein removal.
Yellow laser
Yellow laser uses yellow light with a wavelength of 577 nm, which is well absorbed by haemoglobin in blood vessels. It targets diffuse redness and tiny capillaries, while sparing the surrounding tissue. After the treatment, transient reactions are possible – redness, mild swelling or a sensation of warmth – which typically subside within a few hours to a few days.
DYE VL light treatment
DYE VL It is not a classical laser, but a light-based treatment relying on AFT technology, featuring a narrow spectrum of light tailored to blood vessels. It is used for redness and dilated capillaries associated with rosacea, and treatments are most commonly performed in a series. After the treatment, the skin may be transiently redder or slightly swollen.
Aftercare following treatment
Following the treatment, the skin is cooled and nourished with mild, soothing products. For a few days, heat, saunas, steam rooms, intense exercise and aggressive cosmetics are to be avoided. Sun protection is mandatory, and the doctor provides care instructions according to the type of treatment.
Causes and triggers of rosacea
Causes. The exact cause of rosacea is not known. It is believed to arise from a combination of hereditary predisposition, increased reactivity of the facial blood vessels, changes in the skin's immune response and a weakened protective barrier. It is more common in fair-skinned individuals and in families where rosacea already exists. Microscopic mites Demodex, which are naturally present on the skin, are often more numerous in people with rosacea and can contribute to inflammation.
Triggers they do not cause rosacea, but in people who have it, they can worsen symptoms. The most common are the sun, heat and sudden temperature changes, wind and cold, stress, physical exertion, alcohol, hot drinks and spicy food, as well as aggressive cosmetics. Triggers are not the same for everyone, so it is useful to monitor what causes flare-ups in each individual and discuss this with a doctor.
What does a dermatologist appointment involve?
The first step is dermatological examination, which assesses the cause of the redness and selects an appropriate treatment plan. The dermatologist discusses how long the symptoms have lasted, when they worsen, which preparations and cosmetics are used, and what therapy has been previously applied. It is also important to mention any eye symptoms, such as dryness, stinging, or a gritty sensation.
Then the skin of the face is examined, with the naked eye and a dermatoscope, and redness, capillaries, inflammatory changes and skin sensitivity are assessed. The diagnosis is most often made on the basis of the clinical picture, and in the case of an atypical finding, the doctor may recommend additional diagnostics, such as skin biopsies. At the end of the examination, you receive a treatment plan, care advice and a follow-up appointment.
How is rosacea treated?
Treatment is adapted to the dominant symptoms. Rosacea cannot be permanently cured, but with appropriate therapy and care, it can be kept under long-term control.
Topical therapy – in the case of inflammatory lesions and redness, a dermatologist may recommend preparations that soothe inflammation and reduce redness.
Oral therapy – it is introduced in cases of more pronounced inflammatory changes, eye discomfort, or when local therapy is not sufficient, for a duration determined by a doctor.
Skincare and sun protection – gentle cleansing, hydration and daily sun protection are part of every treatment plan.
Laser treatment For persistent redness and visible capillaries, the Yellow laser and DYE VL light treatment are used, acting directly on dilated blood vessels. Alongside therapy and care, laser treatment significantly reduces persistent redness and visible capillaries.
Therapy is neither started nor changed independently. Corticosteroid creams should not be used on the face without a doctor's recommendation, as they can worsen rosacea.
Daily skincare for rosacea
Skin with rosacea responds best to simple and gentle care. The face is washed with lukewarm water and a gentle cleanser, without rubbing, harsh scrubs and brushes. A moisturiser helps to strengthen the skin's protective barrier, and broad-spectrum sun protection, suited to sensitive skin, is used during the day. Products containing alcohol, menthol, strong fragrances and abrasive particles are best avoided, and it is useful to test a new product on a small patch of skin first.
In the video, Dr Ivica Jeremić explains which cosmetic preparations soothe skin with rosacea and how laser treatments work on redness and capillaries.
Check-ups and maintenance of results
At check-ups, we assess redness, the number of inflammatory lesions, stinging sensations and how well the treatment is tolerated. We adjust the treatment and skincare according to the skin's response. Once the condition calms down, we discuss how to maintain the results and the procedure to follow if symptoms flare up again.
Because rosacea is a chronic condition, flare-ups are possible even after successful treatment – due to the sun, stress, changes of season or hormonal changes. At that time, it is useful to consult a dermatologist earlier, so that the treatment can be adjusted in time.
Rosacea and eye problems
Rosacea can also affect the eyes and eyelids. Symptoms include dryness, burning and redness of the eyes, a gritty sensation, swollen and red eyelid margins, and sometimes recurrent styes. It is necessary to mention these symptoms to a dermatologist, who may also recommend an ophthalmological examination. Eye pain, marked sensitivity to light or changes in vision require prompt evaluation by an ophthalmologist.
Price of examination and rosacea treatment
The price depends on the required examinations and the selected treatment plan. The examination prices can be found in dermatology price list, and the prices of individual procedures in price list for laser treatments. During the examination, an explanation of the recommended steps and a rough cost estimate are provided.
Frequently asked questions about rosacea
Can rosacea be cured?
Rosacea is a chronic condition and cannot be permanently cured, but with therapy, skincare and the avoidance of triggers, symptoms can be significantly reduced and kept under control for a long time.
What does rosacea look like on the face and where does it most commonly appear?
Rosacea most commonly occurs on the central part of the face: the cheeks, nose, chin and forehead. It begins with redness that appears easily and fades slowly, and over time the redness can become permanent, accompanied by visible dilated capillaries. In some patients, reddish bumps and small pustular lesions also occur, along with a stinging, burning or tight sensation in the skin.
In some people, the skin of the nose gradually thickens, which is more commonly seen in men. Rosacea can also affect the eyes, resulting in redness, dryness or a gritty feeling in the eyes. Which symptoms predominate determines the treatment plan, which is why a consultation with a dermatologist is the first step.
Are rosacea blemishes the same as spots or acne?
No. With rosacea, red bumps and pus-filled lesions can appear that resemble spots, but they develop differently than acne – without blackheads and clogged pores, against a background of redness and dilated capillaries, accompanied by stinging and skin sensitivity. This is why they are treated differently, and products intended for acne can further irritate skin with rosacea. The difference is assessed by a dermatologist during an examination.
Is rosacea contagious?
No. Rosacea is not transmitted by touch, towels or cosmetics.
How quickly are the results of the therapy seen?
With inflammatory conditions, the first improvement is usually seen after a few weeks of regular therapy, while the redness subsides more slowly. With laser and light treatments, redness and capillaries decrease gradually over a series of treatments.
Are laser treatments necessary for everyone?
No. For many patients, therapy and appropriate care are sufficient. Laser and light treatments are considered when persistent redness and visible capillaries are a prominent part of the problem.
Does rosacea get worse in summer?
For many yes, as the sun and heat are frequent triggers. Sun protection, avoiding overheating and gentle skincare help summer pass more calmly. Laser treatments are most commonly planned outside the strong sun period, according to a doctor's assessment.
Can makeup be used during treatment?
That's fine, provided it's mild, fragrance-free and does not irritate the skin. Greenish-tinted concealers can cover redness. Makeup is removed gently in the evening, without rubbing.
Does diet affect rosacea?
In some people, symptoms are made worse by alcohol, hot drinks and spicy food. There is no one-size-fits-all diet, so it is helpful to track your own triggers.
What if the redness returns after the treatment?
Since rosacea is chronic, the redness may increase again over time. At that point, the dermatologist evaluates whether a correction to the therapy or a maintenance treatment is necessary.
Book treatment for rosacea in Belgrade
The Imedic Polyclinic is located at Kneza Miloša 23 street, 2nd floor, Belgrade. Opening hours: Monday–Sunday, 9:00–21:00.
Appointments are made by phone: 064 237 0707. If you contact us from abroad, we are also available via Viber and WhatsApp on the same number.
Author: Dr Ivica Jeremić
Doctor of Medical Sciences (Molecular Medicine and Immunology), subspecialist in rheumatology, dermatology resident.
Updated:
Expert sources
- Schaller M, Almeida LMC, Bewley A, et al. Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019 panel. British Journal of Dermatology, 2020. PMID: 31392722.
- American Academy of Dermatology Rosacea: Diagnosis and treatment.
- Rosacea. StatPearls, NCBI Bookshelf.
