Redness and rosacea
Redness that comes and goes, then stays. Here is what controls it and what makes it worse.
Redness across the nose and cheeks that flushes with heat, wine or a hot drink, then settles, then over the years stops settling, is usually rosacea. Small visible vessels, a burning or stinging feeling with skincare, and in some people red bumps that look like acne without the blackheads are part of the same condition. It is long term, it flares and fades, and it is managed rather than cleared.
What treats it depends on which part you have. The bumps need prescription creams or tablets, from your GP or discussed at a consultation. The persistent redness and visible vessels respond to light: at Nova that is IPL, our first-line clinic treatment for rosacea redness. Flushing itself is the hardest part, and we will tell you so.
What causes it
Nobody has one answer. The blood vessels in the central face react too readily and over time stay dilated, the skin's immune response is overactive, and a tiny mite that lives in everyone's pores is found in larger numbers in rosacea skin. It runs in families and is commoner in fair skin, though it exists in every skin tone, where the redness shows as a dusky or darker patch.
The triggers are the part you can act on. The NHS (2023) lists alcohol, spicy food, hot drinks, sunlight, hot or cold weather, hard exercise and stress. Many people add hot showers, saunas, perfumed skincare and steroid creams to that list. Steroid creams deserve a mention of their own: used on the face for a rash they calm things for a while and then cause a rosacea-like eruption that flares when they stop.
What actually treats it
For the bumps and pus spots, the first-line treatment is a prescription cream applied once a day for around three months. If that is not enough, a course of prescription tablets, taken for 6 to 16 weeks according to the NHS, settles a flare, and a low dose can be continued for people who keep relapsing. For redness, a prescription gel exists that constricts the vessels for a few hours, useful for an occasion and not a daily fix, because the redness can rebound. For flushing, some blood pressure tablets are used off-label with modest results. We cannot name any of these on a website. Where one is right for you we say so and discuss it at a face-to-face consultation; your GP can prescribe the same.
For the redness that stays and the visible vessels, in-clinic light treatment is the thing that works, and it is what we are for. At Nova the first-line treatment is IPL, which targets the red in the skin and the small vessels across the cheeks and nose. Most people have a course of three, around four weeks apart, then maintenance once or twice a year because new vessels form with the same triggers. We treat skin types I to IV; on darker skin IPL carries a real risk of burns and dark or pale marks, so we patch test type III and IV and do not use it on the darkest types. Individual larger vessels on the nose are covered on our thread vein page.
We treat the redness once the bumps are under control, not during a flare. If you use the vessel-constricting prescription gel, skip it on treatment day. LED red light is a gentle add-on for calming the skin, free with another treatment on request. Skin boosters can help the dryness and sensitivity that go with rosacea once the skin is calm, and we talk about them case by case.
When to see your GP
See your GP if you have the bumps and pus spots, because they need prescription treatment, or if the redness is spreading or burning. Ask for an urgent appointment, or call 111, if your eye is painful, red, gritty, blurred or sensitive to light: rosacea affects the eyes in a large share of people and this can be keratitis, which the NHS says can be serious if not treated quickly. Thickening of the nose skin, persistent facial swelling, or flushing with sweats, diarrhoea or palpitations also need a medical look before any cosmetic treatment.
What we will not do
We will not peel, microneedle or use strong acids on rosacea skin while it is flaring; it makes the redness worse. We will not use IPL over active pus spots, on tanned skin or on the darkest skin types. We will not promise that light stops flushing: it reduces the standing redness and the visible vessels, and the flushing reflex stays. Results vary and cannot be guaranteed; plan on maintenance.
Skincare at home
Less is more. A gentle, non-foaming cleanser with lukewarm water, a plain moisturiser to repair the barrier, and a mineral sunscreen every morning, because sun is the most common trigger and the one you can block. Avoid alcohol-based toners, scrubs, fragrance, menthol and anything that tingles.
Ingredients that help: niacinamide to calm redness and strengthen the barrier; azelaic acid at the lower, non-prescription strength (higher strengths are prescription); ceramides. Retinol is possible once the skin is calm, introduced slowly, and paused during a course of IPL. Do not use retinol or any retinoid if you are pregnant, planning a pregnancy or breastfeeding.
From the Obagi range we stock: Obagi Nu-Derm 1 Gentle Cleanser 200ml; Obagi Rebalance Skin Barrier Cream 48g; Obagi Hydrate 48g; Obagi Sun Shield Mineral SPF50 85g, with the tinted versions Obagi Sun Shield Tint Warm SPF50 85g and Obagi Sun Shield Tint Cool SPF50 85g for people who want some cover.
Common questions
Can rosacea be cleared for good?
No. It is a long-term condition that flares and settles. Prescription treatment controls the bumps, light treatment reduces the redness and vessels, and avoiding triggers keeps it quieter. Expect maintenance.
Is IPL good for rosacea?
For the persistent redness and the small visible vessels, yes, in lighter skin types, and it is our first-line clinic treatment for that part. It does not treat the bumps, which need prescription medicine first, and it does not stop flushing.
How many IPL sessions for redness?
Usually a course of three, about four weeks apart, then a review. New vessels form over time with the same triggers, so most people come back once or twice a year. Results vary and cannot be guaranteed.
Is there a prescription treatment for rosacea?
Yes, several: creams for the bumps, a short course of tablets for flares, a gel that reduces redness for a few hours. We cannot name them online. They are discussed at a face-to-face consultation, or your GP can prescribe them.
Can I have a peel or microneedling with rosacea?
Not while it is active. Both inflame the skin and make the redness worse. Once the rosacea is controlled, a very gentle peel may be possible, decided face to face.
Does rosacea affect dark skin?
Yes. It is under-recognised because the redness shows as a darker or dusky patch rather than pink. The bumps, stinging and eye symptoms are the same. IPL is higher risk on darker skin, so the plan leans on prescription treatment and skincare.
Why do my eyes feel gritty?
Rosacea can involve the eyelids and the surface of the eye. Lid hygiene and warm compresses help the mild form. A painful, red or light-sensitive eye needs an urgent GP appointment or 111 the same day.
Will my redness come back after treatment?
Some of it, over time. Sun, heat, alcohol and hot drinks keep opening new vessels. Daily sunscreen and trigger control slow that down, and a maintenance session deals with what returns.
Book a free consultation. Or message us on WhatsApp: 077 21 400 600.
The clinic is in East Finchley, three minutes on foot from East Finchley station on the Northern line, with a car park next door. Most of our rosacea clients come from Hampstead, Highgate, Muswell Hill and Finchley, with others from Hampstead Garden Suburb, Golders Green, Crouch End and Barnet.
This page is general information, not medical advice. What suits you depends on your own skin, health and history, which we go through at a free consultation before anything is booked.