About Rosacea - SkyArch Medical Clinic Brisbane

Rosacea is a chronic inflammatory skin condition that most commonly affects the central part of the face (cheeks, nose, forehead, and chin).
Typical symptoms include persistent redness, visible small blood vessels (telangiectasia), acne-like bumps (but no blackheads), a burning or hot sensation, and sometimes eye problems (ocular rosacea).

Rosacea is not an infection and is not contagious. However, because of the visible changes, it can affect confidence and social life. It usually appears between the ages of 30 and 60, and is more common in fair-skinned people, but it can occur in all skin types.

The exact cause is not fully understood. Genetic factors, immune system overreactivity, skin microbes (such as Demodex mites), and environmental triggers like sunlight or irritants are believed to play a role.

Early diagnosis and treatment can prevent progression and worsening, and improve not only appearance but also quality of life.

Main Symptoms

Persistent redness in the center of the face (similar to sunburn)
Small visible blood vessels (telangiectasia)
Red bumps resembling acne
Flushing triggered by hot drinks, spicy food, alcohol, sunlight, or stress
Eye symptoms (ocular rosacea): redness, dryness, gritty sensation, eyelid inflammation
Thickening of the skin on the nose (rhinophyma) — especially in men or when untreated for years

Who Gets Rosacea?

Most common between ages 30–60
Slightly more frequent in fair-skinned people, but possible in any skin type
Associated with genetics, vascular and immune over-reactivity, environmental factors, and Demodex mites

Triggers (Factors That Worsen Symptoms)

Sunlight, heat, or cold weather
Hot drinks, spicy foods, alcohol, caffeine
Emotional stress or sudden temperature changes
Harsh skin care: alcohol-containing cosmetics, strong peels

Treatment and Management

1. Lifestyle and Skin Care

Keep a diary to identify your personal triggers
Use gentle, fragrance-free cleansers and moisturisers
Apply sunscreen daily (SPF 30 or higher)

2. Medical Treatments

Topical treatments (creams/gels) — chosen based on whether redness or bumps are the main problem:

1. Metronidazole (0.75–1% cream/gel)

How it works: Reduces inflammation by scavenging reactive oxygen species and calming overactive immune cells.
Use: Apply thinly once or twice daily.
Course: Takes 8–12 weeks for improvement. Safe for long-term and maintenance therapy.

2. Azelaic Acid (15–20% cream/gel)

How it works: Anti-inflammatory (suppresses cytokines), antibacterial, normalises skin cell turnover to reduce roughness and blocked pores.
Use: Apply twice daily (start with once daily for sensitive skin).
Course: Improvement usually seen in 4–8 weeks. Long-term use possible.

3. Ivermectin (1% cream)