Description

Rosacea is a chronic inflammatory skin condition primarily affecting the central face. It presents with persistent erythema, telangiectasia, papules, and pustules. It most commonly affects fair-skinned adults aged 30–50 and can significantly impact quality of life.

Symptoms

Persistent facial erythema (flushing)
Telangiectasia (visible blood vessels)
Papules and pustules (papulopustular subtype)
Burning or stinging sensation
Ocular involvement (dryness, irritation)
Rhinophyma (thickened nasal skin — advanced)

Causes & Triggers

Dysregulated innate immune response
Neurovascular dysfunction
Demodex folliculorum overpopulation
Genetic predisposition
Triggers: UV, heat, alcohol, spicy food, stress

Severity Classification

Mild Intermittent flushing and mild erythema

Moderate Persistent erythema with papules and pustules

Severe Widespread inflammation, phymatous changes, ocular involvement

Treatment Ladder

1 Mild (erythema): Trigger avoidance + gentle skincare + topical brimonidine
2 Papulopustular: Topical azelaic acid or metronidazole
3 Moderate: Oral low-dose doxycycline (anti-inflammatory dose)
4 Severe / Refractory: Oral isotretinoin at low dose
5 Telangiectasia: Laser/IPL therapy

Relevant Compounds

Allantoin

Calming and skin-soothing agent

Allantoin is a naturally occurring nitrogenous compound found in botanical extracts (particularly co…

Aloe Vera

Soothing and anti-inflammatory botanical

Aloe vera is derived from the inner gel of Aloe barbadensis miller leaves. It contains over 75 activ…

Azelaic Acid

First-line topical — anti-inflammatory and anti-microbial

Azelaic acid is a naturally occurring dicarboxylic acid produced by Malassezia furfur. It has antiba…

Ceramides

Barrier repair — critical in rosacea-impaired skin

Ceramides are a family of waxy lipid molecules that make up approximately 50% of the lipids in the s…

Green Tea Extract

Antioxidant — reduces UV-triggered flares

Green tea extract is derived from the leaves of Camellia sinensis. It is rich in polyphenols called …

Niacinamide

Barrier repair and anti-inflammatory adjunct

Niacinamide is the physiologically active amide form of vitamin B3. It is a versatile, well-tolerate…

Panthenol

Barrier support and irritation relief

Panthenol (D-panthenol or dexpanthenol) is the alcohol analogue of pantothenic acid (vitamin B5). Up…

Vitamin C

Anti-inflammatory antioxidant support (use stable derivatives)

Vitamin C is a potent water-soluble antioxidant essential for collagen synthesis. In topical skincar…

Recommended Drugs

Finacea Prescription azelaic acid 15% gel for papulopustular rosacea

Suggested Cosmetics

Cetaphil Gentle Skin Cleanser Non-irritating cleanser for rosacea-prone skin Cipla Excela Moisturiser Lightweight non-irritating moisturiser The Derma Co 5% Hyaluronic Acid Serum with Ceramides Hydrating serum for dehydrated rosacea-prone skin Dot & Key Ceramide & Hyaluronic Acid Moisturiser Barrier-repairing moisturiser for sensitised skin Dot & Key Vitamin C + E Sunscreen SPF 50 PA+++ Photoprotection is key in rosacea management Episoft AC Moisturiser with SPF 30 Lightweight photoprotective moisturiser La Shield Fisico Matte Sunscreen Gel SPF 50+ PA+++ Physical sunscreen — no chemical filter irritation for rosacea Physiogel AI Calming Relief Cream Calming cream for sensitised, redness-prone skin Re'equil Ceramide & Hyaluronic Acid Moisturiser Barrier-repairing moisturiser for sensitised skin Re'equil Ultra Matte Dry Touch Sunscreen Gel SPF 50 PA++++ High-protection sunscreen for UV-triggered rosacea

Lifestyle Tips

Identify and avoid personal triggers (food diary can help)
Use mineral sunscreen SPF 30+ daily — UV is a major trigger
Choose fragrance-free, gentle cleansers and moisturisers
Avoid alcohol-based skincare products
Green-tinted primers can help camouflage erythema

When to Refer

Ocular rosacea symptoms (refer to ophthalmology)
Rhinophyma requiring surgical intervention
Failure of topical therapy after 12 weeks
Diagnostic uncertainty (lupus, seborrheic dermatitis overlap)