Home Treatments Skin Treatments Rosacea Treatment London: Solutions for Redness & Flare-Ups

Rosacea Treatment: Solutions for Redness & Flare-Ups

Doctor hands in gloves examining red rash on patient skin closeup. Diagnosis and treatment of allergic urticaria concept

The signs of rosacea can take many forms. Flushing may turn into permanent redness. Breakouts appear, though not in a usual acne pattern. A rough patch near your nose might thicken; your eyes might burn by evening and look red, rimmed. In some cases, symptoms settle for a while. In others, they return to new places, or with higher intensity. Rosacea’s effects seep into daily routines, confidence, and quality of life.

Most cases are reported in fair-skinned adults, although people of all skin tones and backgrounds can be affected by rosacea. It may just be more difficult to spot in darker skin tones. Rosacea doesn’t draw a hard line by age or gender. According to clinical records, women are more likely to experience it. Men, when they develop it, may experience thicker skin changes or more pronounced symptoms.

Rosacea doesn’t settle into a single pattern, and treatments in the UK don’t rely on guesswork. You may have a flare-up after a glass of wine, heat, stress, or nothing obvious at all. This erratic cycle wears people down physically and mentally.
Real care starts when the plan fits the person, not just the skin.

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Our clinic operates as a private surgery and is not affiliated with the NHS (National Health Service)

Understanding Rosacea: Symptoms and Types

Rosacea takes several forms, each with its own pattern. Although it has been classified into four types, in practice, symptoms often blend or evolve over time.

ETR, or erythematotelangiectatic rosacea, manifests as persistent redness. Flushing occurs often, and tiny blood vessels may become visible. The cheeks and nose may feel sore, tight, or hot to the touch. The cheeks and eyelids look pink or light red, due to increased vascularisation. This gives the “English Rose” a healthy look, but may not be that healthy.

Papulopustular rosacea brings breakouts resembling acne, but they don’t behave the same. It appears on the central face and is often accompanied by background redness. This type is common in middle-aged women.

In phymatous rosacea, the skin thickens. The tissue around the nose may grow dense or uneven, sometimes affecting other areas. The condition skews toward male patients and may take years to develop fully. The skin on the nose looks blue-purple coloured, and the veins and telangiectasia on the cheeks and upper nasolabial folds appear wider and blue. The nose, with thickened skin, can be quite pitted and scarred-looking.

Eye symptoms don’t always follow skin changes. In ocular rosacea, they may come first: dryness, burning, or that feeling of grit beneath the eyelid. Some patients don’t experience any redness on the face and eyelids at all.

Eye involvement in rosacea is often underestimated or goes untreated. It involves red rimming eyelids, like pink makeup, and can lead to seriously uncomfortable dry eyes from meibomian gland dysfunction (MGD). Even the eye itself can become inflamed, vision affected, and eyelids get loose and sagging.

What Causes Rosacea and What Triggers It?

Unfortunately, no single cause explains rosacea. In some families, the condition runs across generations. Researchers also point to immune overreaction and Demodex mites, tiny, normally harmless organisms that may disrupt the skin’s balance in certain people.

What’s clearer is what can make rosacea worse, though effects may vary among individuals:

Sunlight or wind;
Spicy foods;
Hot drinks (especially coffee or tea);
Alcohol, particularly red wine;
Stress or strong emotions;
Hot baths or saunas;
Intense exercise;
Cold weather or heat.

Personal Trigger Checklist

Do any of these apply to you?
Do you flush after sun exposure?
Does spicy food or alcohol trigger symptoms?
Do your cheeks flare during stressful moments?
Does heat or cold make things worse?
Have you noticed any reactions after using specific skincare products?

Diagnosing Rosacea: When to See a Specialist

Most rosacea diagnoses are made without additional tests and are based on the clinical history and appearance of the skin and eyes. The dermatologist will use a dermatoscope to help analyse the skin, and the ophthalmologist will use a slit lamp to view the eyelid and eye detail.

Flushing, discomfort, visible vessels, or eye involvement can point to rosacea, but not always. Many conditions cause redness, but they don’t follow the same course.

Reasons to see a specialist:

Your facial, nose and eyelid skin is getting worse quickly;
Bumps or swelling aren’t settling;
Your eyes feel gritty, sore, or dry;
Your eyes look constantly red;
Your eyelids are constantly red-rimmed;
You’ve tried over-the-counter (OTC) rosacea treatments, but nothing helps;
Scarring cheeks.

Medical Treatments for Rosacea

Treatment usually starts on the skin. Gels or creams are applied once or twice a day, depending on the product. Some reduce swelling, while others target microscopic triggers.

Ivermectin, for example, clears mites that live on the skin. Another substance known as azelaic acid works on blocked or easily irritated pores. Metronidazole is chosen for its calming effect on the surface layers. None of these work instantly, but with steady use, the skin often begins to settle within a month.

If breakouts continue or redness spreads, prescription oral medication may follow. Doxycycline is commonly prescribed, or Lymecycline tablets. These do not treat infection ; they are used for their ability to quieten inflammation from the inside out. In ocular rosacea, we typically use a low-dose Lymecycline for several months, which helps both facial and ocular rosacea become quiescent. For more difficult cases, isotretinoin tablets may be prescribed. It’s used in shorter courses and usually only when skin thickens or becomes resistant to other remedies. It must be used only under the direct management of the dermatologist, with all baseline tests done, especially in women of childbearing age.

Non-Medical Therapies: Laser and Light-Based Treatments

Some rosacea symptoms respond best to light, not creams or pills. Visible veins, deep redness, and flushing that won’t settle often fall into this group.

Two main therapies are used. Light therapy with intense pulsed light (IPL) spreads its energy across several wavelengths, making it useful for broad redness and visible flushing, with fine blood vessels. Pulsed dye laser may be used for larger telangiectasia. A non-ablative laser such as ResurFX is used in combination with IPL. ResurFX is a non-ablative fractional laser which does not have a long downtime and is a light laser to help improve skin texture and quality, tone and reduce redness. ResurFX helps stimulate collagen production and improve skin texture.

These rosacea treatments are done in our clinic at Clinica London we offer a wide range of IPL treatments for skin conditions, including rosacea, using up to seven different wavelength filters, chosen individually for the patient. IPL is highly effective in reducing erythema and telangiectasia, whether superficial or medium depth, complemented by skin improvement with ResurFX.

A session lasts under half an hour, but they’re rarely one-offs. Most plans involve three to five visits, spaced across several weeks. The breaks aren’t just for scheduling; the skin needs time between sessions to calm, clear, and adapt.

The sensation felt during rosacea IPL treatment varies. Some describe a quick snap or flick—uncomfortable, but brief. It depends on the filter used and the severity of the rosacea. Cooling gels or air are often used to reduce heat and protect the skin. After IPL, mild swelling or redness may settle within a day or two. Makeup can usually be worn the next day.

When ResurFX is used, the skin is prepared with local anaesthetic cream beforehand to reduce treatment discomfort. Swelling is mild, but slight pinkness and swelling may last up to 4 to 5 days.

Results build over time. Once flushed after a few minutes outdoors, a face may now hold its tone. Veins that once stood out under harsh light begin to fade. Some patients repeat a session every year or two to maintain those gains, but many find relief without ongoing rosacea treatment.

Skincare for Rosacea-Prone Skin

Cleansers should rinse without friction and shouldn’t contain any perfumes, foam, or alcohol. Anything that strips or stings is doing too much. A bland, gel-based or milky cleanser usually does the job without irritating the skin.

Moisturisers work best when the formula stays simple—no irritants, no extras, just support where the skin needs it. Ceramides rebuild what rosacea breaks down. Glycerin holds water close to the surface. Niacinamide works for some, but not all. Most importantly, thick, perfumed, or greasy creams can irritate reactive skin and should be avoided.

Keep skin management simple, applying “less is more” principle. Many females try to hide their rosacea with makeup; the same principle applies: use light, non-fragrant products.

Sun protection adds another layer of defence. Zinc oxide and titanium dioxide protect by bouncing light off the skin, not absorbing it, making them less likely to provoke a reaction. Still, the formula around them matters. The base, such as the emollients, stabilisers, preservatives, often decides whether it helps or harms.

Morning:

Rinse with lukewarm water or a gentle cleanser;
Apply a barrier-supporting moisturiser;
Finish with mineral sunscreen.

Evening:

Cleanse gently, no scrubbing or double-cleansing;
Reapply moisturiser, either the same formula or one that’s slightly richer.

Apply a small amount of any new product behind the ear or along the jawline, and leave it for several days. Reactions can take time to appear, especially with rosacea.

Lifestyle Modifications That Support Treatment

Rosacea often reacts to what’s happening well beyond the skin. Flare-ups can follow a meal, a weather shift, a drink, or nothing obvious at all. A flare might follow heat one day and stress the next, then pause for weeks.

Keep a diary, noting what you ate, the weather conditions, and how your day went. Some use notebooks, and others rely on apps designed to track symptoms. The format doesn’t matter: consistency does.

Gentle exercise can support overall skin health without adding to inflammation. Long-distance running on a hot day may cause problems; walking in cooler air usually won’t.

Sleep has its own role in keeping flare-ups at bay. A regular schedule and enough rest make it easier for the skin to recover between episodes.

Case Study: Managing Rosacea at Clinical London

At Clinica London, we have both Dermatologists and Ophthalmologists managing patients with rosacea.

A patient came to see one of the Dermatologists at Clinical London after nearly a year of persistent facial redness. Flushing happened often—triggered by warmth, movement, and stress—and had become harder to control. Small papules had developed along the client’s nose and cheeks. Previous attempts at over-the-counter rosacea treatment had offered no real improvement and left the client’s skin more reactive.

A clinical diagnosis confirmed papulopustular rosacea with background erythema and visible capillaries (telangiectasia). Treatment began with a topical anti-inflammatory, paired with a simplified skincare plan to protect the barrier and reduce sensitivity. Once the initial flare-ups were under control, IPL and non-ablative laser (ResurFX) were introduced to target persistent redness and thread veins, and improve skin quality.

Skincare changed as the skin allowed. Rosacea IPL and laser treatment sessions were moved further apart. With time, the client’s flare-ups decreased, and redness became less prominent. No single intervention made the difference—it was the combination, applied with attention to how the skin behaved. Combining topical treatments and light treatments worked well.

This case reflects the core of Clinical London’s treatment approach: personalised care that adapts, layer by layer, as the skin recovers.

FAQs about Rosacea

What is the most effective treatment for rosacea?

Topical ivermectin and/or metronidazole are often used to calm surface-level inflammation. Treatments like doxycycline or lymecycline, and IPL may be introduced for deeper involvement or visible redness as part of a longer plan. Timing and skin behaviour shape the route forward.

Can rosacea be cured permanently?

There’s no permanent cure for rosacea, but with consistent care, both medical and personal, it can stay under control for long periods.

What triggers rosacea flare-ups?

Heat, alcohol, sun, and even certain skincare products can all provoke a reaction, but not always in the same way from one person to the next. The more clearly triggers are tracked, the more manageable the symptoms become.

Is rosacea caused by poor hygiene?

No, rosacea has nothing to do with being unclean. Internal factors like inflammation, genetics, and blood vessel activity drive it. Washing more doesn’t prevent it, and can sometimes make it worse.

How do I know if I have rosacea or just sensitive skin?

Rosacea causes steady redness, visible veins, and sometimes breakouts or eye symptoms; sensitive skin usually doesn’t. If it’s hard to tell, a consultation can help. Looking at the patient´s eyes for redness on the lid margins is often a giveaway that they have rosacea, even if the cheek pinkness is mild.

Is laser treatment safe for rosacea?

Used correctly by experts, rosacea laser treatments can reduce flushing and thread veins without harming the skin. The first line is IPL treatment, which strictly is broad light wavelengths, using special filters suitable for rosacea redness and blood vessels. IPL is not a laser. Laser can be Pulsed Dye for larger red blood vessels, or non-ablative resurfacing for general skin quality improvement by deep collagen stimulation. IPL is a gentle treatment and has to be a course of IPL, then maintenance.

What skincare products should I use for rosacea?

Rosacea responds best to simple formulas. Fragrance-free, non-irritating products are best. Look for ceramides or niacinamide and skip acids, menthol, or alcohol.

Does diet affect rosacea symptoms?

Yes. Spicy food, alcohol, and hot drinks can cause flares. A food diary might help spot what’s triggering yours.

Can stress make rosacea worse?

Yes. Stress is a recognised trigger. Calming routines, such as mindfulness and meditation, can help reduce flare frequency.

When should I see a specialist for rosacea?

If redness spreads, bumps worsen, or your eyes feel irritated, it’s time for a closer look. A dermatologist can tailor a plan that over-the-counter options can’t. If the eyes are gritty, red or dry, then the ophthalmologist will help manage your eyes.

At Clinica London, the Oculo-Facial or Oculoplastic Ophthalmologists do the IPL and laser treatments, plus associated IPL dry eye treatments.

Preventing Flare-Ups and Managing Long-Term Care

Skin that flared once tends to remain reactive. Without maintenance, the cycle often restarts. Long-term care isn’t complex, but it does need consistency.

Some patients stay on low-dose antibiotics between flares; others rotate a topical treatment to quiet inflammation. The skincare that follows avoids shortcuts: steady hydration, daily sun defence, and changes made slowly, one product at a time. Nothing harsh, nothing that stirs up the surface.

Relapses are part of the condition. What matters is how early they’re caught. Follow-up appointments allow for adjustments before flare-ups gain ground. Between visits, routines built around prevention keep the skin more stable.

What to Expect from a Rosacea Consultation at Clinical London

If your problem is primarily facial skin-related, then you should see the dermatologist. If the eyes are involved, you should certainly seek help from the Ophthalmologist, whether it be redness, irritation or discomfort.

A dermatology or ophthalmology consultation at Clinical London begins with a detailed review of symptoms and treatment history, which forms the basis for what follows.

Your clinician will review your symptoms, health history, and any previous treatments.

Some patients begin with medical therapy, or IPL as the best treatments for rosacea, while others focus first on rebuilding the skin barrier. Each plan is adjusted to suit the stage and subtype of rosacea, with room to evolve over time.

At Clinica London, the Dermatologists do the skin medical treatment and the Ophthalmologists do the eye medical treatment, plus face light and laser treatments.
You can book your appointment today through the website or by contacting our team.

The Rosacea team consist of the two Dermatologists, DR Jennifer Crawley and Dr Rebeca Calado. The Ophthalmologists include Ms Jane Olver and Mr Daniel Sibley, with Ms Jane Olver running the IPL and ResurFX light treatments.

Dr Jennifer Crawley

Consultant Dermatologist
Children & Adults

Dr Rebeca Calado

Consultant Dermatologist
Children & Adults
Specialist in Dermatovenereology

Miss Jane Olver

Consultant Ophthalmic Surgeon
Oculoplastic (Eyelid) & Lacrimal Specialist
Medical Director
A dedicated Oculoplastic Eyelid surgeon, blepharoplasty, ptosis and Adult strabismus (squint) specialist

Mr Daniel Sibley

Consultant Ophthalmic Surgeon
Cornea, External Eye Diseases, Cataract & Refractive Specialist