How to Prevent Rosacea Flare-Ups

Rosacea is a long-term condition, and it is important for patients to work closely with their dermatologists to make sure their symptoms are controlled. Keeping track of what triggers flare-ups, such as foods, drinks and skincare products, can help reduce the frequency of these episodes.


People with rosacea might notice flushing of the nose and cheeks that comes and goes. They may also have visible small blood vessels on the skin (telangiectasia).


Rosacea is a chronic skin condition that causes blushing or flushing in the central part of your face. Visible blood vessels and small pus-filled bumps may also appear. This can make your face look red or swollen, and it can be mistaken for acne or other skin problems or natural ruddiness. The signs and symptoms can flare up for weeks to months, then fade away for a while. The condition is more common in middle-aged white women, but it can affect people of any race. It can be harder to diagnose in people with brown or Black skin, because the blushing and flushing are more difficult to see on those skin types.

Symptoms are most often centered around the nose and cheeks, but they can affect other parts of the face and neck, as well as the scalp, chest or ears. The most common type, called erythematotelangiectatic rosacea (er-uh-THEE-mă-TOH-tel-AN-jeek-TAY-tik) has a long-lasting redness with visible blood vessels, and the skin may become thickened or scaly. You may also have enlarged or bulbous nose, a condition known as rhinophyma [rih-NOFEE-mă].

Another subtype, papulopustular rosacea (pah-PUL-o-PUS-tuh-lar ros-ACE-a) has pus-filled bumps that resemble acne and makes your face look swollen and red. It can also cause your eyes to get irritated and watery, causing them to appear red at the base of the eyelashes. It can lead to styes, a cyst that develops near the eyelid.


The signs and symptoms of rosacea can look like other health conditions. Your healthcare provider will diagnose rosacea based on your history and physical examination. They will examine the skin on your face and, if necessary, your neck, scalp, chest, or ears. They will look for areas of redness and spots that resemble pimples. They will also watch for eye irritation (which can be very serious and lead to problems with your vision).

Your doctor may recommend skin creams that reduce inflammation and discoloration. They might also prescribe medications that help control the blemishes, such as azelaic acid or benzoyl peroxide. They may give you camouflage creams to cover the blemishes. They may also give you eye drops to relieve ocular rosacea symptoms, such as itching, burning, tearing, and a feeling that there is grit or sand in the eyes.

Your doctor might do skin prick testing to check for allergies. You might also need a skin biopsy, but this is not routine. They might need a biopsy if they think you have a very rare form of rosacea called rosacea fulminans, which involves an extremely painful rash with pus-filled bumps and enlarged pores, especially around the nose, that can cause your face to bulge and look like a butterfly’s wings. This is usually seen in men of Northern European descent.


Rosacea doesn’t have a cure, but treatments can help. The goal is to control symptoms so they don’t interfere with daily life. A doctor can recommend prescription skin creams, washes or lotions, such as azelaic acid, benzoyl peroxide, or metronidazole. They may also prescribe camouflage creams to hide blemishes or redness. They might also recommend oral medications, such as tetracycline, minocycline, or isotretinoin (Amnesteem and Claravis). Oral antibiotics can treat inflammation and kill bacteria that cause rosacea. It can take a few weeks or months for these medicines to work.

They can also recommend topical ointments to reduce the look of large blood vessels in the face. They might advise you to avoid hot and cold temperatures, spicy foods, and alcohol. They might suggest a diet low in yeast and dairy to improve gut health and eliminate inflammation.

They can also advise you to use a gentle cleanser and warm water or a mild face mask, and apply a moisturizer with sunscreen if needed. They can also recommend tea tree oil, which has been shown to reduce rosacea symptoms such as itching and redness. They might also suggest using a watered down baby shampoo or eyelid cleaner to remove excess oil around the eyes. They can also recommend putting a warm, damp cloth on your face for 10 to 15 minutes every day to relieve dryness and itching.


The best way to prevent rosacea flare-ups is to avoid things that make them worse. This includes spicy foods, hot beverages, alcohol, certain cosmetics and soaps, and medicines that dilate blood vessels (such as tetracycline, isotretinoin and ivermectin). Some people have their symptoms made worse by sunlight or extreme heat and cold. Others may have a specific trigger such as stress or anxiety. Keeping a diary of what makes your symptoms better or worse can help you and your doctor find possible triggers.

Treatment of rosacea includes using gentle, nonsoap cleansers twice daily and moisturizers that are free of fragrance and other skin irritants. You can also use green-tinted makeup to hide redness and blotchy spots. Using a soft, wide-brimmed hat and staying out of the midday sun is helpful as well. You can also take steps to reduce your stress levels and learn techniques to deal with emotional upsets.

Doctors also may recommend tetracycline antibiotics, such as doxycycline and minocycline. These are a class of antibiotics that kill bacteria on the surface of your skin. They also reduce inflammation and decrease the swelling of enlarged blood vessels. They may also prescribe topical medications that help with rosacea, such as creams containing metronidazole (Flagyl), azelaic acid, sodium sulfacetamide and sulfur (Avar, Sulfacet, Clenia, Plexion) or brimonidine gel to decrease redness by temporarily constricting blood vessels.