Rosacea: Is It Really Rosacea?

Understanding Your Skin From the Outside In

One of the things I find myself talking about more and more in my treatment room is rosacea.

I have had quite a few clients come to me believing they have rosacea because their skin is red, flushed, warm, irritated or sometimes a little bumpy.

But one thing I always want to say is:

Not every red face is rosacea.

Rosacea is a genuine, chronic inflammatory skin condition. It can cause flushing, persistent redness, visible blood vessels, sensitivity, burning or stinging and, in some people, acne-like breakouts or eye symptoms.

It can be managed very successfully, but there isn't a simple cure. For most people, managing rosacea is about understanding their individual skin, recognising their triggers, protecting the skin barrier and choosing the right products and treatments.

So before we put a label on the skin, I think it is really important to ask a much bigger question:

Why is the skin behaving this way?

Your skin is communicating with you

I have always believed that skin health is about so much more than what we put on our face.

Your skin is an organ. It is constantly responding to what is happening around you and, to some extent, within you.

That doesn't mean I believe every skin problem comes down to diet, or that changing your diet will simply “cure” rosacea. Skin is far more complicated than that.

But I do believe there is a huge amount of value in learning to listen to your skin and your body.

When I see a client with a very flushed, reactive or irritated complexion, I want to know more.

Does your face become hot in the evening?

Do you flush after exercise?

Have you noticed certain foods seem to coincide with a flare?

Are you feeling stressed or run down?

Are you sleeping well?

Have you suddenly become much more sensitive to products you've used quite happily before?

Are you using lots of acids, exfoliants or active ingredients?

These questions don't diagnose rosacea — that needs proper medical assessment — but they can help us start to understand patterns.

Sometimes I will suggest keeping a very simple diary for a couple of weeks.

Nothing complicated. Just noticing:

What did I eat?How did I feel?Did I feel bloated?Did my skin feel hot?Did I flush?Did it feel itchy or irritated?What products did I use?Was I stressed, tired or particularly emotional?

You might begin to notice things you hadn't connected before.

And I think that awareness can be incredibly useful.

Looking at the whole picture

I've had clients referred to me by nutritionists, and I actually really like this approach.

Because skin health doesn't exist in isolation.

A nutritionist can look at nutrition and overall wellbeing, while I can concentrate on the skin itself — the barrier, hydration, sensitivity, inflammation, products and appropriate treatments.

It becomes much more of a team approach.

And that's how I like to work.

I don't want to simply look at your face, see redness and immediately decide what I think the answer is.

I want to understand you.

And then there is flushing...

This is something I understand personally because I flush very easily.

I can “pink up” when I exercise, get warm or when my body temperature rises.

That doesn't automatically mean I have rosacea.

Flushing is a normal response to heat and increased blood flow, and some people simply have a much more noticeable vascular response than others.

When we become warm, the blood vessels in our skin dilate — known as vasodilation — allowing more blood to reach the surface and helping the body release heat.

I see different reactions in my treatment room all the time.

I can perform the same treatment on two clients and see completely different responses.

One person might become very flushed after microneedling, while another barely changes colour.

That doesn't necessarily mean one person's skin is healthier than the other's.

Our skin is individual.

Our genetics are different.Our vascular response is different.Our skin barriers are different.Our sensitivity and inflammatory responses are different.

And that is exactly why I don't believe in treating every red or reactive face in exactly the same way.

And then there is skincare...

This is where I think things can sometimes go wrong.

Someone is told they have rosacea, becomes worried about their skin and then starts trying to “fix” it.

They may introduce strong acids, scrubs, exfoliants or lots of active ingredients in an attempt to clear the redness, congestion or bumps.

And before long, their skin barrier can become even more compromised.

More treatment isn't always better treatment.

Sometimes the most beneficial thing you can do is actually take a step back.

For rosacea-prone or very reactive skin, I generally want to see a simple, supportive routine — gentle cleansing, good moisturisation, barrier support and daily SPF — while avoiding unnecessary irritation.

And this is also why I would never advise someone to simply start using strong active ingredients such as tretinoin because they feel they need to “treat” their redness. Tretinoin can be an excellent prescription treatment for certain skin concerns, but it can also cause significant irritation, particularly in sensitive or rosacea-prone skin, so it needs to be used appropriately and under suitable professional guidance.

Sometimes your skin doesn't need more.

It needs less, but better.

Rosacea is about management, not perfection

If you have genuinely been diagnosed with rosacea, I don't want you to feel that your skin is something you have to fight against forever.

There is a lot that can be done to manage it.

A personalised skin health plan might include:

• A simple, appropriate skincare routine

• Identifying and managing individual triggers

• Supporting and protecting the skin barrier

• Daily SPF and sensible sun protection

• Appropriate professional skin treatments

• Medical treatment where necessary

For persistent redness or visible blood vessels, a medical professional may also recommend treatments such as prescription medication, laser or light-based therapies where appropriate.

But I think the word management is really important.

You learn your skin.

You learn what it likes.

You learn what it doesn't like.

You learn what triggers it.

And then you become consistent.

Because good skin health isn't usually created by one miracle treatment.

It is created by what you do repeatedly.

So, do you really have rosacea?

If you have facial redness, flushing, sensitivity or irritation, don't automatically diagnose yourself.

It could be rosacea.

But it could also be another skin condition, irritation, sensitivity, environmental exposure — or simply a tendency to flush easily.

Rosacea can look similar to other conditions, which is why professional assessment is important if you're unsure about what is happening with your skin.

For me, everything starts with understanding the skin in front of me.

I want to know what it looks like.

How it behaves.

What you're experiencing.

What products you're using.

What you've already tried.

And, where appropriate, I want to understand a little more about the bigger picture too.

Because your skin doesn't exist separately from you.

It is part of you.

And sometimes, rather than asking:

“What product will get rid of this?”

I think the better question is:

“What is my skin trying to tell me?”

Your face can tell us a great deal about what is happening with your skin — and sometimes, it is worth slowing down enough to listen.

If you're concerned about redness, sensitivity, flushing or changes in your skin and you're not sure where to start, please get in touch.

I'd much rather take the time to understand your skin properly than simply put a label on it.