Symptoms of rosacea
Flushing and redness
Warm, flushed cheeks, nose, forehead or chin. Redness may become persistent, with tiny visible blood vessels.
Spots and bumps
Small inflamed or pus-filled spots, usually without the blackheads seen in acne.
Sensitive skin
Burning, stinging, dryness or swelling. On brown and black skin, redness may be less visible.
Eye and eyelid symptoms
Dry or gritty eyes and crusty eyelids. Eye pain, blurred vision or light sensitivity need urgent advice.
What causes rosacea?
The cause is not fully understood. Genes, the immune system and facial blood vessels may play a part. Sunlight, alcohol, spicy food, hot drinks, temperature changes, exercise and stress can trigger flares. A trigger diary can help. Rosacea is not contagious or caused by poor hygiene.
Management and treatment
Your doctor chooses treatment for your main symptoms. Spots, persistent redness and eye symptoms may need different approaches.
Everyday skin care
- Wear SPF 30 or higher daily and reapply when outdoors. Avoid your known triggers where possible.
- Wash gently with lukewarm water and an unperfumed cleanser or soap substitute. Moisturise dry skin; avoid scrubbing.
- Do not use steroid creams on your face unless advised. Check before using acne products, which may irritate rosacea.
Doctor-reviewed treatment
Prescription treatment options
Creams and gels for spots
Ivermectin, metronidazole and azelaic acid are equal first-line options. Your doctor selects one for your skin and previous treatment.
Antibiotic tablets
Doxycycline or lymecycline may help more troublesome spots, often alongside a cream. Erythromycin or clarithromycin are alternatives when suitable.
Persistent redness
Brimonidine gel can reduce redness for a few hours, but does not treat spots or visible blood vessels. Test a small area first, including after a break, and use no more than once daily. Redness can rebound or worsen; stop and contact your doctor if redness or burning gets worse.
Mild eye involvement
Warm compresses, daily eyelid cleaning and lubricating eye drops may help mild dryness or crusting. Worsening grittiness, eye pain, light sensitivity or blurred vision need same-day NHS 111 advice.
Perioral dermatitis and steroid-related rashes
Small similar spots around the mouth, nose or eyes may be perioral dermatitis rather than rosacea. Face steroids can cause or worsen it. Your doctor may advise reducing them over 1–2 weeks before stopping, simpler skin care, and topical clindamycin or erythromycin. Tablets may be used when needed.
Using treatment safely
- Apply creams thinly as directed, away from eyes, lips and inside the nose. Contact your doctor if irritation is troublesome.
- Tell us about pregnancy, breastfeeding, medicines and supplements. Doxycycline and lymecycline are not usually used during pregnancy.
- Take doxycycline with water while sitting or standing; do not lie down for at least 30 minutes. Use sun protection.
- With brimonidine, start with a small amount as directed, avoid eyelids and broken skin, and tell your doctor about antidepressants or heart and circulation problems.
Your online rosacea assessment
- 1
Tell us about your skin
Share symptoms, triggers, eye symptoms, past treatments, medicines and allergies.
- 2
Upload clear photos
Show the front and both sides of your face in good light, without filters.
- 3
Doctor reviews your case
Technology helps organise your answers, but every assessment and prescription decision is made by a doctor, who may message you if they need more information.
- 4
Get your personalised plan
Skin care advice and a personalised prescription if clinically appropriate.
Complete care. One simple price.
£24.99
Includes clinician review, live doctor chat & prescription
One payment. No subscription. Any prescription depends on clinical suitability.
Start your consultationYour treatment plan and follow-up
- Creams may start helping after about 4 weeks; fuller improvement can take 8 weeks or more.
- Your doctor sets a review plan and the shortest suitable antibiotic course. Contact them sooner if symptoms worsen.
- Rosacea can return. Keep up gentle skin care and review treatment before repeat prescriptions.
Frequently asked questions
Can I get rosacea treatment online in the UK and EU?
Yes. A doctor reviews your symptoms and photos, then provides a personalised plan and a prescription if suitable. Urgent eye symptoms need same-day care, not an online reply.
Which creams and gels treat rosacea?
Ivermectin, metronidazole and azelaic acid are equal first-line options for spots and bumps. Brimonidine may help persistent redness. Your doctor chooses according to your symptoms and skin sensitivity.
How long does rosacea treatment take to work?
You may notice improvement after about 4 weeks, but fuller benefit can take 8 weeks or more. Rosacea can recur, so your doctor will advise how to maintain control.
Will I need antibiotic tablets?
Not always. Tablets may help if there are many inflamed spots or creams have not helped enough. They do not treat flushing or persistent redness and should be reviewed rather than continued indefinitely.
Is it rosacea or acne?
Both can cause spots, but rosacea often causes flushing and stinging without blackheads. Photos and your history help your doctor distinguish them.
Can steroid creams cause a rosacea-like rash?
Yes. Facial steroids can cause rosacea-like redness or perioral dermatitis. Ask for advice before stopping: your doctor may recommend a gradual reduction to limit a flare.
Will my GP be told about my consultation?
With your consent, we can share a consultation summary and any prescription with your NHS GP to help keep your medical record complete.
Related conditions
Get urgent help if…
Call 999 or go to A&E
Sudden swelling of the lips, mouth, tongue or throat, or difficulty breathing or swallowing after treatment may be a serious allergic reaction.
Call NHS 111 the same day
Eye pain, blurred vision, sensitivity to light or increasingly gritty eyes may be signs of keratitis — inflammation at the front of the eye that needs urgent treatment.
Do not wait for an online reply. ChatDoc is not an emergency service.
General medical information, not a substitute for individual medical advice.