How to Identify and Treat Rosacea: A Practical Guide
Everything you need to know about this common skin condition and how to care for your sensitive skin
Updated: December 2025 | By: Perfumería Hortensia Advisory Team | Reading time: 8-10 minutes
What Is Rosacea?
Rosacea is a chronic dermatological condition of inflammatory nature that mainly affects the face. It is characterized by persistent redness, visible blood vessels and, in some cases, small pustules or bumps on the skin. Although the exact cause is still under investigation, experts suggest it involves a combination of genetic, vascular and immunological factors.
Epidemiological Data: Rosacea affects approximately 2-3% of the world’s population, with higher prevalence in fair-skinned individuals between 30 and 60 years of age. Women are more frequently affected than men, although in men it tends to present with greater severity.
Main Symptoms of Rosacea
The symptomatology of rosacea is variable and progressive. Initial symptoms are usually mild and can be confused with general skin sensitivity:
Characteristic Symptoms:
- Persistent facial redness: Mainly on the cheeks, nose, forehead and chin
- Visible blood vessels: Telangiectasias or small dilated capillaries visible to the naked eye
- Burning sensation: Itching, burning or stinging of the affected skin
- Pustules and papules: Small red bumps that may resemble acne but do not have blackheads
- Skin thickening: Especially in the nasal area (rhinophyma) in advanced cases
- Ocular symptoms: Red eyes, irritation, gritty sensation (occurs in around 50% of cases)
- Dryness and irritation: Rough, flaky and highly reactive skin
Rosacea Types: Updated Classification
Rosacea is classified into four main subtypes according to the criteria established by the American Academy of Dermatology (AAD):
Subtype I: Vascular
Characteristics: Persistent redness and flushing. Visible blood vessels but no pustules.
Manifestations: Continuous flushing, reactivity to thermal stimuli, moderate irritation.
Prevalence: The most common form, accounting for approximately 50% of cases.
Subtype II: Inflammatory-Papulopustular
Characteristics: In addition to redness, the presence of persistent papules and pustules.
Manifestations: Inflammatory lesions without comedones (blackheads), intense burning sensation.
Note: It can be mistaken for acne rosacea if not examined properly.
Subtype III: Phymatous
Characteristics: Thickening and deformation of the skin, mainly on the nose.
Manifestations: Rhinophyma (enlarged nose), enlarged pores, irregularly thick texture.
Progression: Advanced stage, requiring specialized dermatological intervention.
Subtype IV: Ocular
Characteristics: Primary involvement of the eyes and eyelids.
Manifestations: Ocular irritation, conjunctivitis, recurrent styes, blurred vision.
Relevance: May lead to visual complications if not treated appropriately.
⚠️ Important Note: The same person may present characteristics of multiple subtypes. Rosacea is progressive, so early diagnosis and treatment are essential to prevent progression to more severe stages.
Trigger Factors
Identifying and avoiding trigger factors is crucial to control rosacea. These vary between individuals, but the most common include:
| Category | Triggers | Mechanism |
| Climate Factors | Extreme temperatures, wind, low humidity, UV rays | Direct vasodilation and cutaneous oxidative stress |
| Food and Drinks | Alcohol, hot coffee, spicy foods, chocolate, citrus fruits | Capsaicin and other vasoactive compounds |
| Emotional | Stress, anxiety, embarrassment | Sympathetic nervous system response |
| Cosmetics | Irritating products, alcohol, fragrance, strong acids | Direct irritation of the skin barrier |
| Physical Activity | Intense exercise, heat exposure during exercise | Increase in core body temperature |
| Medications | Long-term topical corticosteroids, systemic vasodilators | Vasodilatory effect or inflammatory rebound |
| Skin Care | Over-cleansing, aggressive rubbing, harsh exfoliants | Barrier damage and inflammatory response |
Dermatological Treatment Options
Medical Treatments
The treatment of rosacea must be personalized and supervised by a dermatologist.
Cosmetological Treatments
Although they do not resolve rosacea on their own, these products are essential to improve skin tolerance:
- Gentle cleansers: Soap-free formulas, micellar waters, cleansing milks with neutral or slightly acidic pH (around 5.5)
- Repairing moisturizers: Creams with niacinamide, hyaluronic acid and ceramides to strengthen the skin barrier
- Sun protection: SPF 30+ minimum
- Soothing serums: Centella asiatica, allantoin, bisabolol, mallow extracts
- Specific masks: With soothing agents, no more than twice per week
Practical Skincare Routine for Rosacea-Prone Skin
Morning Routine
- Cleansing: Lukewarm water (never hot) + gentle cleanser without harsh soaps such as balms, milks or cleansing emulsions. The cleansing emulsion from BEAU DOMAINE or the cleansing cream from RANAVAT are two excellent morning options.
- Soothing toner: Apply with a soft cotton pad or fingertips without rubbing (optional but recommended), such as the toner from RIVOLI GENEVE. Another great option is a mist format, like the probiotic mist from ZELENS, which helps strengthen the skin barrier.
- Serum or essence: Niacinamide or centella extract (applied with gentle patting). There are many different options depending on which additional concerns you want to target.
- Moisturizer: Apply to face and neck with upward motions. With many possibilities to choose from, ZELENS Emulsion D or COSMETICS 27 Baume 27 are two options you are likely to love.
- Sun protection: Wait 5 minutes after your moisturizer, then apply generously (about 1 teaspoon for the entire face).
Evening Routine
- Makeup remover: Micellar water or a gentle oil/balm cleanser. The Moringa Cleansing Balm from EMMA HARDIE is our bestseller, but do not overlook U BEAUTY or the Shiso Balm from ZELENS.
- Cleansing: For a double cleanse, use your morning cleanser. Gentle cleanser + lukewarm water, then pat dry.
- Soothing toner: Ingredients such as centella asiatica, rose water or diluted witch hazel will work wonderfully on your skin.
- Targeted treatment: Once or twice a week, apply a hydrating/soothing mask.
- Repairing night cream: Richer than your day cream, with ceramides and peptides.
✅ Golden Rules for Applying Skincare
- Always use lukewarm, never hot water
- Never rub or massage with pressure; use only gentle pats and light strokes
- Wait 2–3 minutes between products to allow absorption
- Less is more: prioritize quality over quantity
- Patch test any new product (behind the ear, 24 hours)
Practical and Preventive Tips
Lifestyle Modifications
- Stress management: Meditation, yoga, breathing techniques. Stress is a major trigger.
- Trigger diary: Record foods, situations and products that worsen your rosacea.
- Environmental protection: Use a scarf in winter, sunglasses in summer (UV), and avoid direct fans.
- Water temperature: Showers and face washing with lukewarm water (ideally between 20–35°C).
- Breathable clothing: Avoid synthetic fabrics that trap heat.
- Adapted exercise: Regular physical activity in cool environments (swimming, yoga, Pilates).
Nutrition and Systemic Inflammation
- Anti-inflammatory foods: Oily fish rich in omega-3, leafy green vegetables, red and purple berries
- Probiotics: Growing evidence suggests that gut health influences rosacea (skin–gut axis)
- Antioxidants: Green tea, oral vitamin C, resveratrol may help at systemic level
- Avoid processed foods: Ultra-processed foods and refined sugars increase inflammation
Controllable Environmental Factors
- Keep your home at a cool, stable temperature (ideally 18–22°C)
- Use a humidifier in very dry environments (especially in winter)
- Avoid abrupt temperature changes (saunas, contrast showers)
- Protect your skin from pollution (environmental particles)
- Get enough sleep: lack of sleep increases systemic inflammation
When to See a Dermatologist
You should see a specialist if:
- You suspect you have rosacea (a clinical diagnosis is essential)
- Your symptoms worsen despite appropriate daily skincare
- You experience ocular symptoms (persistent eye irritation)
- You notice changes in nasal skin texture (early rhinophyma)
- Rosacea impacts your emotional or social quality of life
- You need to consider laser procedures or advanced treatments
Conclusion
Rosacea is a chronic condition but can be controlled and managed with a comprehensive approach that combines personalized dermatological treatment, appropriate cosmetic routines and lifestyle adjustments. Early diagnosis and treatment adherence are key to preventing progression. Remember that every person is unique, so patience and individualized care are essential. Do not hesitate to consult certified professionals to obtain the maximum benefit.
Discover our products for sensitive skin at Perfumería Hortensia and enjoy expert care tailored to your skin.
Disclaimer: This content is intended for informational and educational purposes only and does not constitute medical advice. Always consult a certified dermatologist before starting any treatment. The products mentioned are examples of pharmacological or cosmetic categories and may vary in name depending on the country.
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