Rosacea is a chronic inflammatory condition affecting the skin. It typically causes visible and enlarged blood vessels of the face, redness, and small pus-filled bumps.

Research estimates that around 5.46% of adults worldwide live with rosacea. Still, doctors may mistake its symptoms for acne or psoriasis.

People with rosacea may experience periods of remission from symptoms along with flare-ups, which are periods of worsening symptoms. Often, people can identify specific triggers that cause flare-ups. These may include certain foods, heat, weather, stress, and medications.

Although rosacea may be uncomfortable and there is no cure for the condition, people can manage their flare-ups with various treatments.

This article looks at rosacea flare-ups, their causes, treatment, and prevention.

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People with rosacea have extremely sensitive skin, meaning many factors can cause flare-ups. For example, spending time in the sun can cause skin redness and flushing that lasts for hours. Skin care products can also cause symptoms such as stinging, burning, and itching.

Doctors use the term “trigger” to refer to the things that cause rosacea flare-ups. Triggers vary between people, but they commonly include:

  • Foods: Dairy products, liver, citrus fruits, vinegar, chocolate, soy sauce, beans, and spicy foods.
  • Beverages: Alcohol, particularly red wine, beer, and spirits, and hot drinks, including tea and coffee.
  • Emotions: Stress and anxiety.
  • Cosmetics: Skin and hair products, including hairspray, witch hazel, acetone substances, and those containing alcohol.
  • Heat: Hot baths, saunas, and warm environments.
  • Weather: The sun, cold, humidity, and strong winds.
  • Physical exertion: Exercise, lifting and loading heavy items, or other strenuous activities.
  • Medications: Topical steroids and vasodilators.
  • Medical conditions: Chronic cough, menopause, and caffeine withdrawal syndrome.

People may find that their rosacea flare-up calms down somewhat when they avoid triggers.

The following tips may also help:

  • Soothe skin with a gentle, fragrance-free moisturizer.
  • Use a humidifier to prevent dry air from removing moisture from the skin.
  • Drink enough water to stay hydrated and prevent the skin from drying.
  • Dip a towel in cold water and drape it around the neck.
  • Try some stress relief techniques such as yoga and meditation.

It is not easy to specify how long a rosacea flare-up lasts as it varies from person to person. However, anecdotal evidence suggests it can be from days to months.

Rosacea is a chronic condition with periods of remission and relapses or flare-ups. In a retrospective study of 48 people diagnosed with rosacea, 52% of individuals had active rosacea, which had been ongoing for 13 years on average. The remaining 48% had cleared their rosacea, and the average duration of the condition was 9 years.

Research indicates that people who continue their rosacea treatments for the long term are less likely to experience a flare-up.

People can help prevent rosacea flare-ups by identifying and avoiding their triggers. Keeping a diary of what they eat and drink, activities they participate in, and locations they visit, alongside their rosacea symptoms, may help a person understand the factors that cause flare-ups.

The following tips may also help people avoid rosacea flare-ups:

  • Use sun protection: Apply a gentle broad-spectrum SPF 30 or higher sunscreen daily. Opt for fragrance-free sunscreens containing zinc oxide, titanium dioxide, or both, as these are less irritating. People should also wear a wide-brimmed hat and avoid the midday sun.
  • Reduce stress: People can find activities that reduce their stress levels, such as tai chi or meditation. In addition, stress management breathing techniques may help in stressful moments.
  • Avoid the heat: People should plan ahead to avoid overheating by dressing in layers, opting for warm or cool baths and showers, and sitting away from direct heat sources such as fireplaces. Air conditioning, fans, and sipping cool drinks can also help people stay cool.
  • Choose cold drinks: Opt for iced versions rather than hot tea or coffee.
  • Rethink alcohol choices: Choose white wine instead of red and dilute alcoholic beverages with soda or lemonade.
  • Select suitable cosmetic products: A dermatologist can recommend skin care products suitable for people with rosacea. Additionally, avoid astringents, toners, and products that contain menthol, camphor, or sodium laurel sulfate.
  • Check medications: If a person thinks that a medication is causing a rosacea flare, they should speak with their doctor about alternatives. However, it is essential not to stop taking the medication without discussing this first.

Doctors have no cure for rosacea, but the following treatments can help control a person’s symptoms:

Oral antibiotics

Doctors commonly recommend tetracycline antibiotics, including doxycycline and minocycline, for their anti-inflammatory effects and to kill bacteria on the skin. A course lasts for 6–12 weeks, depending on a person’s symptoms. People may require further courses from time to time.

Topical medications

People can use metronidazole cream or gel independently or alongside oral antibiotics. Doctors may also suggest azelaic acid, brimonidine gel, sulfacetamide sodium, sulfacetamide sulfur, or topical ivermectin to clear up swelling and redness.

A person may need to take medications for several months before noticing improvements in their rosacea symptoms.

Procedures

Doctors may also recommend the following procedures to help treat rosacea:

  • lasers and intense pulsed light treatments to remove enlarged blood vessels
  • electrocautery that uses an electrical current to remove damaged blood vessels
  • dermabrasion to remove the top layer of skin

Rosacea is an inflammatory skin disorder that causes enlarged blood vessels and skin reddening, usually of the face.

People living with rosacea generally have periods of no symptoms followed by flare-ups. Food, medications, heat, or stress tend to trigger these.

People can try to manage their flare-ups by learning their triggers and avoiding them. In addition, keeping the skin moisturized and cool during a flare-up can help calm symptoms.

Typically, people that adhere to long-term rosacea treatment strategies are less likely to experience uncomfortable flare-ups.