Rosacea: symptoms, photos and treatment — skincare, medicines, laser and IPL
Updated: Oct 13
Rosacea is a chronic inflammatory skin condition that can cause persistent facial redness, flushing, visible vessels, breakouts and sensitivity. Some people also develop eye symptoms. Treatment therefore follows the pattern of symptoms, rather than the colour of the cheeks alone.
At Dr USKOV Kliinik in Tallinn, laser treatment mainly addresses the vascular component. Skincare, medication and follow-up have separate roles in controlling symptoms and maintaining improvement.
What does rosacea look like?
Redness often affects the cheeks, nose, chin and forehead. It may initially come and go before becoming persistent. Burning, stinging, warmth, dryness and visible small blood vessels can occur.
Red bumps and pustules sometimes resemble acne, but treatment differs. Phymatous changes cause skin thickening, particularly on the nose. Not every sign occurs in every patient, and redness may be harder to recognise in darker skin.
Causes and triggers
Rosacea is not contagious and is not caused by poor hygiene. Inflammatory and vascular mechanisms interact with individual susceptibility. Finding Demodex mites alone does not explain every case or mean that everyone needs the same test or treatment.
Sunlight, overheating, cold wind, hot drinks, alcohol, spicy food or stress may trigger flares. Triggers vary: observing your own pattern is more useful than automatically excluding every possible food or giving up exercise.
How is the diagnosis made?
The doctor examines the skin, asks about flare-ups, skincare and medicines, and checks for eye symptoms. Rosacea can coexist with acne or seborrhoeic dermatitis. Contact dermatitis and other conditions can also resemble it.
Diagnosis is usually clinical. Dermoscopy or further investigations are used when indicated, rather than as a compulsory package. Using steroid creams on the face without medical advice can worsen the problem.
When do the eyes need attention?
Dryness, grittiness, redness and inflamed eyelid margins need medical assessment. Eye pain, light sensitivity or deteriorating vision require urgent care. Laser treatment of facial vessels does not replace treatment of ocular rosacea.
Everyday skincare
Basic care usually includes gentle cleansing, moisturising and a well-tolerated broad-spectrum sunscreen of at least SPF 30. Avoid rubbing, harsh scrubs and products that cause persistent burning. Introduce new products gradually.
Protect the skin from wind and abrupt temperature changes in winter. Adjusting habits should help control symptoms while preserving everyday activities as far as possible.
Medicines and procedures address different problems
For inflammatory breakouts, a doctor may select a topical medicine such as azelaic acid, ivermectin or metronidazole, or systemic treatment when needed. The choice depends on symptoms, contraindications and local availability. Do not start antibiotics on your own.
Some prescription products temporarily reduce persistent redness. Visible dilated vessels and background vascular redness may respond better to a vascular laser or IPL. IPL means intense pulsed light; it is not a laser.
Laser and IPL at Dr USKOV Kliinik
Dr Alexander Uskov's individual protocols consider the vessels, skin phototype, sensitivity and activity of inflammation. The clinic's range of lasers and other medical technologies can be combined with skincare and medication when appropriate.
A 2019 systematic review found that lasers and IPL could reduce rosacea redness, particularly visible vessels. The evidence was of low to moderate certainty; the outcome depends on the symptoms being treated and the chosen method. van Zuuren et al., 2019
Reducing vessels and redness does not remove every mechanism of rosacea. Flushing or sensitivity may persist, and new vessels may appear later. Session numbers and intervals are discussed after assessment and adjusted to the skin's response.
Risks and recovery
Redness, swelling, sensitivity, and sometimes bruising or crusting can follow vascular treatment. Burns, pigment changes and scarring are possible. Cooling and appropriate settings reduce risk but do not eliminate it.
Tell the clinician about tanning, medicines and previous adverse reactions. Suitable eye protection is necessary during treatment. Returning to makeup, exercise and sauna depends on the procedure and healing.
Clinical photographs
These photographs show individual cases. Lighting, follow-up time and the initial skin condition influence the visible result. Another patient's improvement is not a promise of the same outcome.
Frequently asked questions
Can rosacea be cured permanently?
Treatment generally aims to control a chronic condition. Maintenance skincare and, when appropriate, further treatment can help preserve improvement.
Does a laser replace medication?
Not always. Vessels and inflammatory breakouts need different approaches; mixed symptoms may require a combined plan.
When should the result be assessed?
After recovery, at the time agreed with the doctor. Immediate redness or swelling can temporarily obscure improvement.
