Conditions We Treat

Rosacea

At Livingstone Dermatology, we understand that your skin is a reflection of your health and well-being. We are committed to the latest advancements in dermatological science, and dedicated to providing you with quality care.

Rosacea is a long-term skin condition that causes persistent redness, visible blood vessels, and sometimes acne-like bumps on the face. Although it is often mistaken for common skin sensitivities or acne, rosacea is a distinct dermatological concern that requires proper management.

While the exact number of people affected in Singapore is unknown, rosacea is more prevalent among adults aged 30 to 50 years old, particularly those with fair skin. If the condition is left untreated, symptoms can worsen over time, leading to increased discomfort, and self-consciousness.

What is Rosacea?

Rosacea is an inflammatory skin disorder that primarily affects the central face, including the cheeks, nose, forehead, and chin. It often begins with episodes of flushing, where the skin temporarily turns red before returning to normal.

Over time, this redness can become persistent, and small, dilated blood vessels, known as telangiectasia, may appear. Some individuals also develop bumps or pimples that resemble acne, while others experience eye irritation, known as ocular rosacea.

Although rosacea is not contagious, it can significantly impact daily life by causing discomfort, and emotional distress.

What are the types of Rosacea?

Rosacea presents in different forms, each with unique characteristics, such as:

Erythematotelangiectatic Rosacea (ETR) – ETR is characterised by persistent redness, visible blood vessels, and a tendency for the skin to flush easily. It is often accompanied by a sensation of warmth or burning.
Papulopustular Rosacea – sometimes mistaken for acne, papulopustular rosacea features red bumps (papules), and pus-filled pimples (pustules). It often occurs alongside persistent redness, and sensitivity.
Phymatous Rosacea – phymatous rosacea often leads to thickened skin, and irregular surface texture, most commonly affecting the nose (rhinophyma). Over time, the affected areas may become swollen or enlarged.
Ocular Rosacea – ocular rosacea affects the eyes, causing redness, irritation, dryness, and in severe cases, blurred vision. When it is left untreated, ocular rosacea can lead to complications affecting eye health.

What causes Rosacea?

The exact cause of rosacea is not fully understood, but it is believed to result from a combination of genetic, environmental, and immune system factors. Some of the key triggers, and risk factors include:

Abnormal Blood Vessel Function – dysfunction in facial blood vessels can lead to increased redness, flushing, and visible capillaries.
Genetics – individuals with a family history of rosacea may be more prone to developing the condition.
Demodex Mites – these microscopic mites naturally reside on the skin, but in higher numbers, they may contribute to rosacea symptoms.
Overactive Immune Response – the immune system may overreact to certain triggers, leading to chronic inflammation in the skin.
Triggers that Worsen Symptoms – several external factors can exacerbate rosacea flare-ups, including:
— Alcohol Consumption – red wine and other alcoholic beverages may worsen symptoms.
— Extreme Temperatures – hot, and cold weather, as well as sudden temperature changes, can aggravate rosacea.
— Sun Exposure – ultraviolet (UV) rays are a common trigger for rosacea.
— Spicy Foods – hot, and spicy meals can increase facial redness.
— Stress – emotional stress is known to trigger and intensify flare-ups.
— Certain Skincare Products – harsh cleansers, exfoliants, and alcohol-based products can irritate sensitive skin.

What are the signs and symptoms of Rosacea?

While symptoms vary from person to person, some of the most common signs include:

Bumps and Pimples – small, red bumps, and pus-filled pimples may develop on the affected areas. These lesions can resemble acne, but unlike acne, rosacea does not cause blackheads. Some individuals may also experience a burning or stinging sensation in these areas.
Burning, Stinging, or Itching – many people with rosacea report a sensation of heat, burning or stinging on their face. The skin may also feel itchy or overly sensitive to certain skincare products or environmental triggers.
Dry and Rough Skin – the affected areas of skin may become rough, flaky, and excessively dry. Some individuals notice a tight or irritated feeling, especially after washing their face or being exposed to extreme weather conditions.
Eye Irritation (Ocular Rosacea) – some people with rosacea experience irritation in their eyes, leading to redness, dryness, and a gritty feeling. The eyelids may become swollen, and in severe cases, untreated ocular rosacea can impact vision.
Flushing and Facial Redness – many people with rosacea experience frequent flushing, where the face turns red due to increased blood flow. In the early stages, this redness may fade after a short period, but over time, it can become more persistent, resembling a constant blush or mild sunburn.
Plaques – some forms of rosacea lead to raised, red patches that look like a rash. These plaques can develop without affecting the surrounding skin.
Skin Thickening – in more advanced cases, particularly in men, the skin may gradually thicken and develop a bumpy texture. This condition, known as rhinophyma, most commonly affects the nose, causing it to appear enlarged or bulbous.
Swelling (Facial Edema) – swelling can accompany other rosacea symptoms or occur independently. The face, particularly around the cheeks and eyes, may appear puffy due to inflammation and fluid retention.
Visible Blood Vessels – tiny, dilated blood vessels can become visible under the skin, particularly on the nose and cheeks. These thin, red lines are more noticeable in fair-skinned individuals.

Where does Rosacea normally develop?

Although rosacea primarily affects the face, it can affect different parts of the face, and body, including:

Cheeks
Chest
Chin
Ears
Eyes (ocular rosacea)
Forehead
Neck
Nose
Scalp

How is Rosacea diagnosed in Singapore?

Diagnosing rosacea involves a thorough assessment of your skin, symptoms, and medical history. At Livingstone Dermatology a thorough assessment of your skin condition will be made, and you may expect the following:

Medical History Review – our dermatologist will begin by discussing your symptoms, potential triggers, and whether rosacea runs in your family. By understanding your personal triggers, it will help in both diagnosis, and long-term management.
Skin Examination – after reviewing your medical history, our dermatologist will proceed with a detailed visual inspection of your skin. This step focuses on the central face, where rosacea typically appears. Aside from identifying the common symptoms, our dermatologist may also consider ocular rosacea if you experience eye-related symptoms such as dryness, irritation or swollen eyelids.
Skin Biopsy (if necessary) – in cases where symptoms overlap with other skin conditions, a skin biopsy may be performed to rule out similar concerns, such as seborrheic dermatitis or lupus. This involves taking a small sample of skin under local anaesthesia for microscopic examination. However, most cases of rosacea can be diagnosed through clinical evaluation alone.

How is Rosacea treated in Singapore?

When it comes to the effective management of Rosacea, the treatment plan generally focuses on reducing symptoms, preventing flare-ups, and improving skin health. While there is no cure, personalised treatments at Livingstone Dermatology can help control the condition and minimise discomfort.

Topical Treatments

Azelaic Acid – azelaic acid helps control inflammation, and improve uneven skin texture.
Brimonidine Gel – brimonidine gel is a prescription treatment that temporarily constricts blood vessels to reduce visible redness.
Ivermectin – ivermectin targets the skin’s inflammatory response, and helps reduce papules, and pustules.
Metronidazole – metronidazole is an anti-inflammatory gel or cream that reduces redness, and swelling.

Oral Medications

Antibiotics – antibiotics such as Doxycycline, Minocycline, are used for moderate to severe rosacea, to help manage inflammation, and prevent flare-ups.
Isotretinoin – Isotretinoin is a vitamin A-derived medication that can be prescribed for resistant cases, particularly when there are persistent breakouts.

Laser and Light Therapies

Intense Pulsed Light (IPL) Therapy – IPL therapy targets visible blood vessels, and reduces persistent redness.
Vascular Laser Therapy – vascular laser therapy is designed to shrink dilated blood vessels, and improve skin appearance.

Lifestyle and Skin Care Tips

Gentle Skin Care – avoid harsh exfoliants, and use fragrance-free, soothing skincare products.
Stress Management – practising mindfulness, yoga or relaxation techniques can help reduce stress-induced flare-ups.
Sun Protection – daily application of a broad-spectrum SPF is essential to prevent flare-ups.
Trigger Management – identifying, and avoiding common triggers like alcohol, heat, and spicy foods can help prevent worsening of symptoms.

Conclusion

In conclusion, rosacea is a long-term skin condition that causes redness, visible blood vessels, and sensitivity, often triggered by environmental, and lifestyle factors. Although it is not contagious, it can worsen over time if left untreated, leading to persistent discomfort and, in some cases, complications such as thickened skin or eye irritation.

Early intervention is key to keeping rosacea under control. Our skilled, and experienced dermatologist can diagnose your specific type of rosacea, and create a personalised treatment plan to manage symptoms, and prevent flare-ups. If you are experiencing ongoing redness, sensitivity or unexplained skin changes, do not wait for them to intensify. Schedule a consultation with us today, and take the first step towards clearer, healthier skin.

Frequently Asked Questions

Is rosacea painful?

Rosacea itself is not typically painful, but it can cause discomfort such as burning, stinging or tightness, especially when the skin is irritated or during flare-ups. Some people with rosacea also experience sensitivity to skincare products, heat or environmental triggers. If rosacea affects the eyes, ocular rosacea, it may lead to dryness, irritation or a gritty sensation. As such, managing triggers, and using soothing, dermatologist-recommended treatments can help keep discomfort at bay.

Is rosacea an autoimmune disease?

Rosacea is not classified as an autoimmune disease, but it does involve an abnormal immune response. The condition is thought to be linked to an overactive inflammatory reaction in the skin, as well as increased sensitivity to environmental factors, and microorganisms like Demodex mites.

While the exact cause is still being researched, rosacea shares some similarities with autoimmune, and inflammatory conditions in terms of immune system involvement.

How can I differentiate a rosacea rash from a lupus rash?

Both rosacea, and lupus can cause facial redness, but there are key differences:

Rosacea usually presents as persistent redness, visible blood vessels, and acne-like bumps, mainly on the cheeks, nose, chin, and forehead. It often worsens with triggers such as heat, spicy foods, or alcohol.
Lupus rash, also known as a “butterfly rash,” appears as a red, flat or slightly raised rash across the nose, and cheeks in a butterfly-shaped pattern. Unlike rosacea, lupus rashes do not typically include acne-like bumps, and may be more photosensitive.

Can rosacea be cured permanently?

Currently, there is no permanent cure for rosacea, but the condition can be effectively managed with proper treatment, and lifestyle adjustments. Many people with rosacea see significant improvements by following a personalised treatment plan that includes topical or oral medications, laser therapy, and trigger avoidance. Early diagnosis, and treatment can help prevent symptoms from worsening over time.

Can rosacea be prevented?

Since rosacea has a genetic and environmental component, it cannot always be entirely prevented. However, flare-ups can be minimised by identifying, and avoiding triggers such as excessive sun exposure, alcohol, spicy foods, and stress. Consistently using gentle skincare products, wearing daily sun protection, and following a dermatologist-recommended treatment plan can help keep rosacea symptoms under control.

If I have rosacea, does that mean I cannot wear makeup?

You can still wear makeup if you have rosacea, but it is important to choose products that are gentle, non-comedogenic, and free from irritating ingredients such as alcohol, fragrance, and harsh preservatives.

Additionally, look for mineral-based foundations, green-tinted primers to neutralise redness, and hydrating formulas that support skin health. On top of that, always remove makeup with a gentle, non-stripping cleanser to avoid aggravating your skin.

If you are unsure of the type of makeup or skincare products you should use, our dermatologist can recommend suitable makeup, and skincare options tailored to your skin’s needs.

Ready to take the first step towards rosacea relief?

Schedule a consultation with Livingstone Dermatology today.

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