Rudolph, ruby cheeks or just plain red all over: Rosacea and how to treat it.

Dr Helena Torpinski|Skin care and sun protection
2 October 2018

Do you feel like you’re looking at Rudolph in the mirror?

Do your cheeks look so red they’re like bright rubies on your face?

Do you suffer facial skin redness from sensitivity, acne or in response to heat?

These embarrassing skin conditions and reactions are the result of an underlying condition called Rosacea.

What is Rosacea? 

Rosacea is a challenging skin condition, for both the sufferer and the treating medical professionals. It causes flushing (like blushing or over-heating) on the face, ears, neck and upper chest.

When left untreated it can result in spider veins called telangiectasia, most commonly across the nose and cheeks, which create permanent redness on the skin.

Rosacea can also cause pustules and an acne-like rash on the face. This can look inflamed and sore, and is very difficult to hide with cosmetics, which can actually aggravate the skin further.

Rosacea has traditionally been wrongly associated with alcoholism, as it produces a similar flushed facial appearance and watery, blood shot eyes. This doubles up the potential for social shame and lack of confidence in those suffering with the condition.

Different Types of Rosacea?

Rosacea comes in a range of forms and types.

  • Generalised Redness (Erythematotelangiactatic rosacea). The redness of rosacea mostly involves the cheeks and nose but can also spread to the chin, forehead and down the neck. It has a genetic component and can be worsened by spicy food, alcohol and over heating. It carries a common skin sensitivity to cosmetic and skin care products and can be made worse by hormonal changes such as menopause. The result of untreated rosacea of this kind is broken capillaries, and the affected area will grow with continued flare ups.
  • Acne Rosacea Defined from regular rosacea by papules and pustules (red bumbps) above the level of the skin, which may be filled with pus. Can often be mistaken for acne, as it looks similar, which can be frustrating when the sufferer is of an age where acne should no longer be occurring. As acne rosacea is more permanent and disfiguring than regular acne, it can cause distress and social confidence issues. It can also be painful, itchy and irritating and can often be inflamed or exacerbated by standard acne treatments.
  • Ocular Rosacea. In this form of rosacea, the redness is experienced in the eye area, with red, gritty, sore eyes, inflamed eye lid margins (called blepharitis), which can leave the patient looking like they’ve had a really big night on the town! Ocular rosacea has the feeling of having a foreign body in your eyes which you can’t remove. It can produce styes on the eyelids, produce rough, dry, flaky skin on the eye lids, which can spread elsewhere on the face and can burn or sting.
  • Phymatous Rosacea. Also known as Rhinophyma, this form of rosacea creates thickened skin, starting on the nose, making it red, bulbous and with prominent pores and capillaries. The nose can become asymmetrical, and develop cysts and nodules. Those suffering with this condition are more likely to be men than women and can often be wrongly thought to be alcoholics as it has been traditionally (but incorrectly) associated with “disreputable drinking”.

Treating Rosacea

There are several common recommendations given to people living with rosacea.

Firstly, we want to remove those things that can trigger flare ups. This can include alcohol, certain foods, activities that overheat the body (such as rigorous exercise – stick to walking and activities that might cool the skin, such as swimming), avoid sun exposure and burning in particular, and remove all skin products that could aggravate the skin (at our clinic, Sr Luise Lentell is a skin care specialist and can help advise you of appropriate products).

We can also prescribe topical and oral medication to help calm the skin.

We use vascular lasers to reduce the burden of redness and stinging from the skin. This can produce a notable reduction in permanent redness and many ocular rosacea patients report the redness and stinging of their eyes is reduced when they have their facial rosacea treated this way.

For those suffering phymatous rosacea, or rhinophyma, ablative lasers can be used to resurface the unsightly skin enlargement around the nose and the shape distortion can be corrected in this manner.

Preventing Rosacea

The true cause of rosacea is unknown, though we know there is a strong genetic component. Take a look at family members or photos of parents and grand parents. If you notice signs that older family members may have the tell tale redness and other symptoms of rosacea, it’s a good idea to visit a dermatologist and discuss your concern about developing the condition. Your dermatologist can determine if you have the early signs of the condition and advise you on how to best care for your skin, to lessen the severity of symptoms in the future.


All dermatologists are trained in identifying rosacea and the common forms of treatment for this condition. But not all dermatologists may be aware of the success and range of treatments available using lasers. At our clinic, our expansive range of lasers and decades of experience at treating dermatological conditions with lasers, mean we can offer the most tailored and effective treatments. So if your dermatologist doesn’t mention laser treatment, make sure to ask and get the information to make your treatment decisions.

Got more questions?

Why not make an appointment with our dermatologist, Dr Terence Poon, to have your skin reviewed and your questions answered. Call our friendly receptionists today to make your appointment on (02) 9953 9522.


Written by Dr Helena Torpinski.
Dr Helena is a skin laser specialist and a GP when she’s not working in our clinic. She is popular with our patients and loves to help them feel great in the skin they’re in.