Rosacea – Assessment and Treatment by a Dermatologist



A specialist in dermatology diagnoses rosacea and develops a treatment plan to reduce facial redness and spots.


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In brief

Rosacea is a chronic, non-contagious inflammatory skin condition affecting the face. It causes persistent redness in the central part of the face, episodes of flushing, visible small blood vessels and spots. It typically begins between the ages of 30 and 50, comes and goes in periods, and can also affect the eyes. At Charlottenlund Privathospital, rosacea is assessed and treated by Susanne Birkballe, specialist in dermatology, who develops a plan covering skincare, triggers and treatment. Topical and tablet treatment can be started at the private hospital.

Your consultation with the dermatologist
1
Consultation
When did the redness and spots begin, what triggers them, and are the eyes affected?
2
Examination of the skin
The face, eyelids and scalp are examined, including whether the condition could instead be acne, eczema or contact dermatitis.
3
Skincare and treatment plan
Gentle skincare, sun protection and topical or tablet treatment, depending on which symptoms are most prominent.
4
Follow-up
The effect is assessed after a couple of months, and the treatment plan is adjusted if needed.

What is rosacea?


Rosacea is a chronic inflammatory condition affecting the skin of the face. The blood vessels react more strongly than normal, and the skin becomes easily irritated. It typically begins between the ages of 30 and 50 and is more common in women, while men are more likely to develop thickened skin on the nose. Rosacea is not contagious and is not caused by poor hygiene. Around 5.5% of the population have rosacea.

5,5 %
of the population have rosacea according to a pooled analysis of 32 studies involving a total of 26.5 million people.
Source: Gether et al., Br J Dermatol 2018
Rodd naese med synlige blodkar og begyndende fortykket hud ved rosacea hos en mand

What does rosacea look like?


Rosacea is now classified according to the signs each person has, rather than into fixed types. Many people have several signs at once, and they can change over time. The skin often stings and burns and does not tolerate creams and makeup well.

Redness
Persistent redness on the cheeks, nose, chin and forehead – the most typical sign.
Flushing
Episodes of redness and warmth, for example triggered by heat, alcohol or stress.
Visible blood vessels
Small red blood vessels on the cheeks and nose.
Spots
Red spots and small pus-filled bumps, but no blackheads or whiteheads as seen with acne.
Thickened skin
Thickened, uneven skin, most often on the nose and more commonly in men.

What can trigger rosacea?


Rosacea triggers vary from person to person. In a survey of 1,066 people with rosacea, 81% cited sun, 79% stress and 75% hot weather as triggers. Many people find it helpful to identify and avoid their own triggers.

Common triggers
Sun Stress Hot weather Wind Strenuous exercise Alcohol Hot baths Cold weather Spicy food Hot drinks Skincare products

Rosacea or acne?


Rosacea and acne are often confused because both cause spots. The difference is easiest to see by looking at blackheads, age and redness.

Acne


  • Blackheads (black and white spots)
  • Usually starts in the teenage years
  • affects the face, chest and back
  • The skin is often oily.

Rosacea


  • No blackheads
  • Usually starts after the age of 30
  • Affects the middle of the face
  • Redness, flushing and stinging skin are typical.

When should you see a dermatologist about rosacea?


You should see a dermatologist if the redness does not go away, if spots appear in adulthood, or if the skin does not improve with gentle skincare and the treatment prescribed by your GP. This also applies if the skin on your nose becomes thickened, or if you are unsure what the rash is – rosacea can look like seborrhoeic dermatitis and contact dermatitis caused by creams and makeup.

!
Red, dry or stinging eyes?
Rosacea can cause dry, irritated eyes and inflammation of the eyelid margins. If you develop eye pain, sensitivity to light or reduced vision, you should contact your GP or the out-of-hours medical service the same day so that the eye can be examined.

How does a dermatologist examine rosacea?


The diagnosis is based on the consultation and the appearance of the skin – there is no blood test for rosacea. The dermatologist will ask about triggers, skincare and makeup, as well as any eye symptoms. It helps to bring along the products you use on your face. At Charlottenlund Privathospital, the examination is carried out by Susanne Birkballe, dermatologist in dermatology.

How is rosacea treated?


Rosacea cannot be cured, but it can usually be kept under control, leaving the skin calm for long periods. Treatment is chosen according to whether redness or spots are the main concern, and most treatments take around 8 weeks to work. Visible blood vessels and thickened skin on the nose require a different treatment, and patients are referred elsewhere for this.

Always
Skincare and triggers
Gentle, fragrance-free skincare, daily sun protection and reducing exposure to personal triggers.
For spots and redness
Topical treatment
Cream or gel that reduces inflammation. The effect is typically seen after around 8 weeks.
For more widespread rosacea
Tablet treatment
Can be started by the dermatologist for a period of time when topical treatment is not sufficient.
Kvinde i skygge smoerer solcreme paa kinderne som en del af den daglige hudpleje

What can you do yourself?


Daily skincare is very important for rosacea. The skin should be treated gently and protected from the sun, which also helps protect against sun damage such as actinic keratosis. Keeping a diary of triggers can help identify patterns.

Skin
✓ Mild, uparfumeret rens og creme
✓ Use high-factor sunscreen every day, including in winter
✓ Use lukewarm rather than hot water
✓ Avoid scrubs and harsh facial brushes
Everyday life
✓ Make a note of what triggers the redness
✓ Limit alcohol and spicy food if they trigger flushing
✓ Cool down in hot weather and during strenuous exercise
✓ Use a scarf to protect the face from wind and cold

Referrals and payment


Many health insurance policies cover a consultation with a dermatologist, but insurers typically require a referral from your GP and prior approval. No referral is needed if you are paying for the consultation yourself. Prices are listed in the price list. Consultations take place at the main clinic in Charlottenlund.

Frequently asked questions

  • Is rosacea contagious?

    No. Rosacea is not contagious and is not caused by poor hygiene.

  • Can rosacea go away?

    Rosacea is a chronic condition that comes and goes in flare-ups. With treatment and fewer triggers, the skin can usually be kept calm for long periods.

  • What is the difference between rosacea and acne?

    Acne causes blackheads and usually starts in the teenage years. Rosacea does not cause blackheads, usually starts after the age of 30, and causes redness and flushing in the middle of the face.

  • Can rosacea affect the eyes?

    Yes. Rosacea can cause dry, red and irritated eyes and inflamed eyelid margins. If you have eye pain, sensitivity to light or reduced vision, contact your GP or the out-of-hours medical service the same day.

  • What skincare is suitable for rosacea?

    Use a gentle, fragrance-free cleanser and moisturiser, and high-SPF sunscreen every day. Avoid exfoliating scrubs, harsh facial brushes and products that sting.

  • What makes rosacea worse?

    Sun, stress, hot weather, wind, alcohol, hot baths and spicy food are some of the most common triggers. Triggers vary from person to person.