Rosacea and Skin Redness Treatment

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Rosacea

Dr.Henry Loh

Dermatologist and Chief Medical Advisor

Dr. Silver Chua

Medical Director and Consultant

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What is Rosacea?

Rosacea is a long-term inflammatory skin condition that most commonly affects the central area of the face, including the cheeks, nose, chin, and forehead. It often begins with frequent flushing or redness that may come and go but can gradually become more persistent over time. Common signs and symptoms include facial redness, visible blood vessels (telangiectasia), skin sensitivity, and occasional stinging or burning sensations. In some individuals, acne-like bumps or pustules may develop.

In more advanced cases, thickening of the skin—particularly around the nose (rhinophyma)—may occur, though this is less common. Rosacea can present differently in each individual, and its severity may fluctuate. While the condition is not contagious, it can significantly affect a person’s skin comfort and self-confidence. Understanding what contributes to rosacea and identifying potential triggers is an important first step in managing it effectively.

What causes Rosacea?

The exact cause of rosacea is not fully understood, but it is believed to result from a combination of genetic predisposition, immune responses, and environmental triggers. Common aggravating factors include spicy foods, alcohol, sun exposure, heat, and emotional stress. Skincare products and hormonal changes may also contribute to symptom flare-ups in sensitive individuals.

Although there is no known cure, rosacea can often be managed with a comprehensive approach under medical supervision. Treatment options may include prescription medication, laser-based therapies, and topical solutions to support symptom control. Lifestyle changes—such as avoiding personal triggers, using microbiome-friendly or gentle skincare, applying daily sun protection, and reducing stress—can also play a role. Consulting with a doctor is essential to develop a personalised plan tailored to your skin needs.

How is Rosacea related to
Microbiome health?

The skin microbiome refers to the community of microorganisms that naturally reside on the skin’s surface. A balanced microbiome is thought to support overall skin health, including barrier function and inflammatory regulation. In individuals with rosacea, research suggests that changes in microbiome composition may be associated with skin sensitivity, redness, or inflammation.

Disruptions in the skin microbiome—such as an overgrowth of certain bacteria—are believed to influence how the skin reacts to environmental or internal triggers. While the exact relationship between microbiome health and rosacea is still being studied, maintaining a healthy skin environment through microbiome-friendly skincare and medical guidance may help reduce flare-ups and support symptom management.

Several factors related to microbiome imbalance may influence rosacea symptoms. Below are some examples that may contribute to increased skin sensitivity or flare-ups.

1.Dysbiosis and Inflammation :

Research indicates that many individuals with rosacea may have a disrupted skin microbiome—a condition known as dysbiosis, which refers to an imbalance between good and harmful microorganisms on the skin. In such cases, there may be an increase in certain bacteria like Staphylococcus epidermidis and a reduction in beneficial microbes. This imbalance is believed to interfere with the skin’s natural defense system, leading to visible inflammation, redness, and sensitivity. Though still being studied, this connection suggests that restoring microbial balance may be a helpful part of rosacea management.

2.Involvement of Demodex Mites :

Demodex mites are tiny organisms that naturally live on human skin. While normally harmless, people with rosacea often show higher concentrations of these mites, particularly on the cheeks and nose. This overpopulation may trigger an immune reaction, resulting in inflammation and worsening symptoms. Some researchers believe that the mites themselves may not be harmful, but rather their waste or associated bacteria may provoke irritation. Understanding the role of Demodex in rosacea remains an area of ongoing study.

A female model with visible Rosacea symptoms, including redness and inflammation, highlighting the need for professional Rosacea treatment in Singapore.

3.Immune System Response :

The skin's immune system plays an important role in managing inflammation. In people with rosacea, the immune system may overreact to triggers due to changes in the microbiome. This response can lead to the release of inflammatory signals, causing facial redness, warmth, and swelling. Over time, repeated immune responses may lead to visible blood vessels on the skin. While these mechanisms are complex, they help explain why rosacea tends to flare in cycles and why managing inflammation is central to care.

4.Triggers and Flare-ups :

Certain everyday factors may disrupt the skin's microbial balance and contribute to flare-ups. Common triggers include spicy food, alcohol, UV exposure, hot weather, and stress. Harsh skincare products or frequent exfoliation can also affect skin sensitivity. These factors may cause an overgrowth of less beneficial bacteria, weaken the skin barrier, or increase inflammation. Identifying and avoiding personal triggers, while using gentle skincare, is often part of a well-rounded rosacea care plan.

5.Treatment Approaches :

Interest in the skin microbiome is driving new rosacea care strategies. Probiotic-based topical products are under research for their potential to support microbial balance. Meanwhile, microbiome-friendly skincare—like gentle cleansers and barrier-supporting moisturizers—is already in use. While not a cure, these approaches may complement medical treatment and help reduce irritation over time.

In summary, the skin microbiome is increasingly recognised as a factor in rosacea-related skin changes. Supporting microbial balance through personalised skincare, medical consultation, and avoidance of known triggers may contribute to more effective long-term management of rosacea.

Analysing your Rosacea Condition

Erythematotelangiectatic Rosacea (ETR)

Acne Rosacea

Ocular Rosacea

Rhinophyma

Clinical example of Erythematotelangiectatic Rosacea (ETR), showing redness and visible blood vessels, used for Rosacea condition analysis in Singapore.

A clinical example of Acne Rosacea, showing acne-like breakouts and redness, commonly treated with specialized therapies in Singapore.

Common Cases

Clinical example of Ocular Rosacea, showing eye irritation, redness, and swollen eyelids, commonly treated with specialized therapies in Singapore.

Clinical example of Rhinophyma, showing thickening of the skin on the nose with prominent redness, commonly treated with specialized therapies in Singapore.

Rare Cases

Unsure of your Rosacea condition?

Rosacea and acne can appear similar, but their underlying causes and treatments are different. If you're unsure, a consultation with a doctor can help assess your skin and guide you toward a care plan tailored to your needs.

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Difference between Rosacea and Acne

Rosacea and acne can sometimes look similar—both may involve redness, bumps, or irritation—but they are distinct skin conditions with different underlying causes.
Below are some general differences that may help you better understand the characteristics of each.

Differentiate	Rosacea	Acne
Location	Face, mostly on the cheeks	Various parts of the body, including the face, chest, shoulders, and back.
Age	Mainly Adults, aged 30-50 years old	Teens - Adults
Triggers	Spicy foods, alcohol, sunlight, stress, and hot beverages.	Fluctuations in hormonal changes
Type of bumps	Small, red, pus-filled bumps that resemble acne.	Blackheads, whiteheads, pustules, papules, nodules and cysts
Appearance	Redness and visible blood vessels on the face, especially on the cheeks, nose, forehead, and chin.	Visible Blackheads and Whiteheads

How to treat Rosacea

While there is currently no known cure for rosacea, there are effective ways to help manage the condition and reduce visible redness. Treatment often involves a combination of approaches tailored to the severity and type of rosacea. Consultation with a doctorl is recommended to determine the best plan for your skin needs. Treatment options may include:

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1. Topicals

Topical medications are often prescribed to help reduce inflammation or control symptoms. Common ingredients used in topical rosacea treatments include:

Azelaic acid
Ivermectin
Mentronidazole
Retinoids
Sodium Sulfacetamide

Note: These should only be used under medical supervision.

2. Oral Medication

In some cases, doctors may recommend oral medications to manage moderate to severe symptoms. Options may include:

Antibiotics
Isotretinoin

Note: These should only be used under medical supervision.

3. In-clinic Treatments

Medical treatments performed in a clinic setting may help address visible redness and vascular symptoms. One widely used option is:

• Vbeam Laser

How does these treatment help my Rosacea?

Azelaic acid is commonly used as a topical treatment option for individuals with rosacea and is often recommended by healthcare professionals. It may help improve the appearance of redness and support overall skin clarity. Some individuals may initially notice a mild tingling sensation, which often becomes less noticeable with continued use. In rare cases, slight changes in skin tone may occur. For best outcomes, consistent use under the guidance of a qualified healthcare provider is encouraged.

Metronidazole is commonly used for its anti-inflammatory and antibacterial properties, and may support improved skin appearance in individuals with rosacea. It is thought to help manage visible signs of inflammation, such as skin redness, when used regularly as directed by a healthcare professional. For those with sensitive or reactive skin, this treatment is often part of a comprehensive skincare approach recommended by medical experts.

Topical retinoids are sometimes included in skincare plans for individuals with rosacea, as they may support skin renewal and texture refinement. As retinoids can be potent, they are best used under the supervision of a qualified healthcare provider to ensure optimal results and skin tolerance. Individuals interested in incorporating retinoids into their rosacea care routine are encouraged to speak with a doctor for tailored advice.

Oral antibiotics are sometimes included in rosacea care plans due to their anti-inflammatory properties, and may assist with symptom control as part of a short-term strategy. Some studies suggest that they may help improve visible signs of rosacea, particularly in the early stages of treatment. In certain cases, healthcare providers may recommend a tailored maintenance plan using specific agents, such as low-dose doxycycline, to support long-term skin health under medical supervision.

Isotretinoin is sometimes considered in cases of severe or treatment-resistant rosacea, particularly when oil regulation may contribute to skin improvement. Due to its powerful effects, isotretinoin is prescribed only under close medical supervision, with careful consideration of individual health needs and circumstances. Its use is typically limited to specific cases where other treatment options have not provided sufficient benefit.

Vbeam laser therapy is a commonly used non-invasive option that may support the management of visible redness and blood vessels associated with rosacea. This technology uses pulsed-dye laser energy to selectively target skin areas affected by vascular changes, aiming to improve the appearance of facial redness and uneven tone. The procedure is generally well tolerated and often performed without the need for significant recovery time.

Under the guidance of a doctor, multiple sessions may be recommended to achieve the desired outcome. Vbeam therapy is considered one of several approaches that may be included in a personalized rosacea treatment plan, depending on individual skin type and treatment goals.

This page has been medically reviewed by Dr Henry Loh

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KINS Clinic DOCTOR'S PROFILE

Dr.Henry Loh

Dermatologist and Chief Medical Advisor

Fellows of the Academy of Medicine, Singapore (FAMS) / Membership of the Royal Colleges of Physicians (MRCP) / Bachelor of Medicine and Bachelor of Surgery (BMBS)

Prior to joining KINS Clinic, Dr. Henry Loh was a co- founding partner of Dermatology Associates, one of the largest private dermatology clinic groups in Singapore. He has also been instrumental in promoting the use of the latest treatments.

Dr. Silver Chua

Medical Director and Consultant

Post-graduate Diploma in Practical Dermatology (PgDip) / Doctor of Medicine (MD) / Bachelor of Medical Studies (BMed) / Bachelor of Science in Medicine (BSc (Med))

Dr Silver Chua specialises in the medical care of acne, rosacea, and other common skin concerns, complemented by a strong background in aesthetic treatments. She leads the fully integrated care pathway at KINS Clinic—ensuring patients receive cohesive, evidence-based care that bridges both medical and aesthetic needs. Her approach is grounded in safety, with a strong emphasis on achieving naturally balanced, lasting results.
Dr Silver is fluent in both English and Mandarin

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