“Ask Dr. HKSH” - My Face can’t Help Flushing - Rosacea


Q1. What is rosacea?
Rosacea is a common, chronic skin condition. Currently, nearly 1 out of every 10 people is likely to have rosacea.  It usually affects women aged 20 to 50 and with fair skin complexion. Rosacea tends to be less common but more severe in men. It has to do with neural dysfunction of facial blood vessels, which become more likely to dilate and cause facial flushing.

People with mild rosacea usually have no symptom. However, environmental triggers such as alcohol and sunlight exposure may cause flushing in the cheeks, nose tip and jaw. The face may also feel a hot, burning and stinging sensation.

Q2. What are the symptoms of rosacea?
If the face flushes more often and for a longer period, the blood vessels may stay dilated. It can result in persistent redness or dilated capillaries in the skin, being visible as blood streaks on the face. Inflammation may occur if severe, causing acne-like papules and pustules. Without proper treatment, the skin will thicken and nose pores will enlarge, especially at the nose tip, causing rhinophyma.

Q3. How can I prevent rosacea in daily life?
Many things can trigger rosacea in daily life. Patients should pay close attention and avoid them as best as they can. One of them is ultraviolet. Better use sunscreen and avoid direct, excessive exposure to sunlight.  Another is hot and stuffy environment, e.g. while in sauna or hot spring, and bathing or washing face with water that is too hot. Emotional management also matters, as the condition may worsen if patients have mood swings or get too emotional. Finally, diet. Chemical substances may build up inside the body after consumption of high-alcohol or high-caffeine beverages, sour fruits, spicy food, chocolate and cheese, causing dilation of blood vessels. You need not avoid all these food at all cost; just try to eat in moderation.   

Q4. How should I choose skincare products?
Rosacea can be mitigated with simple, proper skincare, which includes cleaning, moisturising, and most importantly, sun protection. Non-soap, mild and non-exfoliating face washes are recommended.  Choose skincare products that contain fewer additives, especially fragrance, menthol and alcohol. Sun protection is essential to rosacea patients. Use sunscreens with SPF 30 to 50 for UVB protection, and PA+++ or PA ++++ for UVA protection. Apply about one teaspoon of sunscreen to both the face and the neck, preferably once in the morning and once in the afternoon. 

Q5. What are the treatments for rosacea? 
Besides lifestyle changes and proper skincare, topical creams, oral medications or laser therapy are recommended.  For mild rosacea, topical creams can be effective. Non-steroidal, anti-inflammatory ointments, topical antibiotics or azelaic acid-containing creams can be considered. Severe rosacea patients can take oral medications to control the condition, thereby reducing the risk of skin thickening or scar formation. Oral medications include antibiotics, such as Tetracycline and Erythromycin. If to no avail, patients may consider oral Isotretinoin. Laser therapy is also a good option to treat facial flushing and blood capillary problems.

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