Rosacea Explained (Part 1): Symptoms, Triggers and What You Need to Know
Written by Dr. Maha Shariff · September 28, 2026 · Rosacea
Rosacea is a common, chronic skin condition causing facial redness, flushing, sensitivity and sometimes spots, yet it is often mistaken for acne or sensitive skin. Symptoms, triggers, how it differs from acne, and when to seek medical advice.
“Why is my face always red?”
“I feel awkward leaving the house without make-up or concealer.”
“Why does my skin sting when I use skincare?”
“Why do I keep getting spots if it isn't acne?”
These are some of the questions I hear from both men and women during consultations.
Rosacea is a common, chronic (long-term) skin condition that can cause facial redness, flushing, sensitivity and in some cases, spots. Yet it is often mistaken for acne, sensitive skin or simply being prone to blushing.
If your skin seems persistently red, easily irritated or increasingly difficult to manage, understanding whether rosacea could be contributing is an important first step.
Whilst rosacea cannot currently be cured, symptoms can often be controlled. In my experience, this usually starts with getting the diagnosis right, settling any active flare and then moving towards a longer-term maintenance approach. This is something I work through with my patients as part of an individual treatment plan.
What is rosacea?
It is an inflammatory skin condition that most commonly affects the central face, particularly the cheeks, nose, forehead and chin.
Rosacea tends to fluctuate. You may have periods when your skin is relatively calm, followed by flare-ups when redness, flushing, sensitivity or spots become more noticeable.
It doesn't look the same in everyone and you don't need to have every symptom.
Common symptoms of rosacea include:
- Persistent facial redness
- Flushing or blushing more easily than usual
- Burning, stinging or increased sensitivity
- Dryness or a feeling of tightness
- Small red bumps or spots that appear to be pus-filled, like whiteheads
- Visible thread veins or small blood vessels
- In some people, thickening of the skin, particularly around the nose
Rosacea can also affect the eyes, which is known as ocular rosacea.
Rosacea or acne? Why they are often confused
Because rosacea may be associated with red bumps and pus-filled spots, it can be mistaken for acne. I see many patients who have treated their skin with products designed for acne-prone skin, only to find that their skin becomes increasingly sensitive, reactive or irritated.
There are some important differences:
Rosacea
- Persistent background redness is common
- Flushing is common
- Blackheads are not typical
- Burning or stinging can occur
- Often affects the central face
- Skin may be particularly sensitive
Acne
- Background redness is usually less prominent
- Flushing is uncommon
- Blackheads are common
- Burning and stinging are less typical
- Can affect the face, neck, chest and back
- Skin may be more tolerant of active skincare
This distinction matters because rosacea and acne are managed differently.
When should you seek medical advice for rosacea?
It may be worth having your skin assessed if:
- Your symptoms are persistent or getting worse
- Your skin isn't improving with what you're currently using
- You're unsure whether you're dealing with rosacea or another skin condition
- You're finding it difficult to work out what your skin needs and would benefit from personalised advice and a tailored plan
- Your symptoms are affecting your confidence or quality of life
If you are pregnant, planning a pregnancy or breastfeeding, it's also important to seek appropriate medical advice before starting or continuing certain treatments for rosacea, as some options may not be suitable.
What about your eyes?
Rosacea can affect the eyes as well as the skin.
If you experience persistent dryness, grittiness, irritation, redness or increased sensitivity to light, don't assume it's part of having sensitive skin. Eye symptoms can occur with ocular rosacea and may need specific assessment.
If you develop significant eye symptoms, particularly pain or changes in vision, seek prompt medical attention.
What causes rosacea?
There isn't one single known cause of rosacea.
Current evidence suggests that several factors may interact, including genetic susceptibility, changes in the immune response, blood-vessel sensitivity and environmental factors. The exact mechanisms are still being studied.
Rosacea is not caused by poor hygiene or by simply choosing the wrong skincare products. You haven't caused it.
However, certain factors can trigger or worsen symptoms in people who are susceptible to rosacea.
What triggers rosacea?
Rosacea triggers are highly individual.
Commonly reported triggers include:
- Sun exposure
- Hot weather
- Cold or windy weather
- Sudden changes in temperature
- Alcohol
- Hot drinks
- Spicy foods
- Emotional stress
- Vigorous exercise
- Certain skincare products or irritating ingredients
Importantly, you don't necessarily need to avoid all of these.
A trigger for one person may have no noticeable effect on someone else. Rather than excluding everything automatically, it can be much more useful to notice what actually affects your own skin.
Keeping a diary of flare-ups alongside things such as weather, exercise, food, stress and skincare can sometimes help you identify patterns.
A lesson from my consulting room
I saw a young patient some months ago wanting to explore stronger skin peels to address concerns including spots, redness and skin texture.
When I took a detailed history and assessed her skin, I felt that what I was seeing was more in keeping with rosacea, alongside a compromised skin barrier.
That changed our approach completely.
Rather than discussing peels, we focused on treating the flare and supporting her skin. Once things had settled, we moved towards a maintenance approach.
Depending on how her skin evolves, we may consider other options in the future.
When skin is inflamed and reactive, doing more isn't necessarily the answer. Skin responds differently from person to person, so the approach may need to be adjusted depending on how an individual's skin responds.
So what happens next?
Once you recognise and understand what rosacea is and what may be triggering your symptoms, the next question is naturally:
What can you do about it?
In Part 2, I'll look at the practical side of rosacea management, including how I approach skincare, which ingredients may be helpful, what may need more caution and when treatments may have a role.
Rosacea Assessment
If you are unsure whether rosacea is contributing to your symptoms, a consultation can help establish the diagnosis and set out a plan suited to your skin.
- Clinician-led assessment to confirm the diagnosis
- A plan to settle an active flare
- Longer-term maintenance and trigger review
Medical note
This article is intended for general information and education and does not replace an individual medical assessment. Rosacea can look similar to other skin conditions, so if you're unsure what's causing your symptoms, seek advice from a suitably qualified healthcare professional.
References
- National Institute for Health and Care Excellence (NICE), Clinical Knowledge Summary: Rosacea
- British Association of Dermatologists, Rosacea Patient Information Leaflet
- Hampton PJ, Berth-Jones J, Duarte Williamson CE, et al. British Association of Dermatologists guidelines for the management of people with rosacea 2021.
- Schaller M, Almeida LMC, Bewley A, et al. Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019 panel.