From Flushed to Fresh: Modern Rosacea Treatments That Really Work

Photo source from: Cleveland Clinic

Rosacea is a chronic inflammatory skin condition that affects millions worldwide, yet it’s one of the most misunderstood dermatological concerns. While it may start as occasional flushing, it can progress to persistent redness, visible blood vessels, and even acne-like breakouts. As an aesthetic doctor, I’ve seen how rosacea can impact not just skin health, but self-esteem and quality of life. The good news? Modern aesthetic medicine offers highly effective treatment options that can significantly improve symptoms and skin appearance.

In this article, I’ll break down what rosacea really is, the different types, common triggers, and how we approach treatment using advanced, evidence-based aesthetic procedures.

What is Rosacea?

Rosacea is a long-term skin condition primarily affecting the face, characterized by periods of flare-ups and remission. It often starts with flushing (temporary redness) but can develop into more persistent symptoms such as:

• Redness across cheeks, nose, forehead, and chin

• Visible capillaries (telangiectasia)

• Pimples or pustules that resemble acne

• Thickened skin (especially on the nose—rhinophyma)

• Burning or stinging sensation

• Red, irritated eyes (ocular rosacea)

  
  

It typically affects individuals between 30 and 60 years old and is more common in fair-skinned individuals, but we see it frequently in Malaysians too, particularly among those with sensitive or reactive skin.

Types of Rosacea

Rosacea is classified into four main subtypes. Knowing your type is crucial to choosing the right treatment.

1. Erythematotelangiectatic Rosacea (ETR) - Vascular Rosacea 

   This type presents as persistent redness and flushing with visible blood vessels. It’s often mistaken for sensitive skin.

   Key Features:

   • Facial flushing

   • Telangiectasia (broken capillaries)

   • Sensitivity and dryness

     
     

2. Papulopustulat Rosacea - Inflammatory Rosacea

   Often confused with acne, this subtype includes red bumps and pus-filled lesions.

   Key Features:

   • Acne-like breakouts

   • Redness and swelling

   • Burning or stinging sensation

     
     

3. Phymatous Rosacea

   This form leads to thickened, bumpy skin, particularly on the nose (rhinophyma).

   Key Features:

   • Skin thickening

   • Irregular surface texture

   • Enlarged pores

   
   

4. Ocular Rosacea

   Affects the eyes, causing irritation, redness, and sensitivity.

   Key Features:

   • Dry, irritated, or bloodshot eyes

   • Grittiness or burning

   • Styes or cysts on the eyelids

   
   

Causes and Triggers of Rosacea

While the exact cause of rosacea is unknown, several factors are thought to contribute:

1. Genetics

   A family history increases your risk of developing rosacea. 

2. Vascular Dysfunction

   Abnormalities in facial blood vessels can contribute to redness and flushing.

3. Immune System Response

   Hypersensitivity to certain mites that live near hair follicles (called Demodex mites) or bacteria

4. Environmental Triggers

   • Several external factors can trigger or worsen rosacea symptoms:

   • Sun exposure

   • Hot weather

   • Wind

   • Spicy foods

   • Alcohol (especially red wine)

   • Hot beverages

   • Stress

   • Skincare products with alcohol, fragrance, or harsh exfoliants

Diagnosis

Diagnosis is clinical and based on patient history and physical examination. There are no specific blood tests or biopsies required unless we suspect another condition such as lupus or seborrheic dermatitis.

At our clinic, we take high-resolution facial imaging as well as 3D images to assess severity, vascular activity, and skin texture. This allows us to customize a treatment plan tailored to your subtype and skin goals.

Treatment of Rosacea in Aesthetic Medicine

Rosacea cannot be cured, but it can be very effectively managed with a combination of treatments. 

Fotona SP Dynamis NX Line (Vascular Laser)

1. Laser Treatment

This is where aesthetic medicine shines—literally.

a) Vascular Laser (e.g. Fotona SP Dynamis Nx Line)

These devices target and collapse visible blood vessels, reducing redness and flushing dramatically. The laser heats and shrinks dilated capillaries without harming surrounding tissue. Results will be visible after each session and you will usually require 4-6 sessions. This treatment comes with very minimal downtime.

2. Injectable Treatments

a) Botulinum Toxin (Micro-Botox)

Micro-doses of botulinum toxin can calm neurovascular inflammation and significantly reduce flushing and redness. Botox is injected superficially to relax the muscles around dilated vessels and reduce nerve signals that trigger redness. Studies show significant improvement in rosacea-related flushing and erythema

b) Mesotherapy with Anti-inflammatory Complexes

Cocktails containing vitamin B3, peptides, and antioxidants can be delivered via superficial microneedling to calm inflammation and improve skin resilience.

c) Hydratorors

3. Oral Medication

For moderate to severe papulopustular rosacea, oral doxycycline is often prescribed in conjunction with aesthetic treatments.

4. Lifestyle & Internal Health Management

• Sun protection: Daily use of mineral-based sunscreen (zinc oxide or titanium dioxide)

• Diet: Avoid trigger foods (spicy, hot drinks, alcohol)

• Stress management: Mindfulness, adequate sleep, and hydration can reduce flare-ups

Conclusion

Rosacea may be a chronic condition, but it doesn’t have to control your life or your face. With modern aesthetic treatments like lasers and injectables, managing rosacea is no longer about hiding your skin, it’s about healing it.

If you suspect you have rosacea or have been struggling to manage your symptoms, don’t wait. An early, tailored treatment plan makes all the difference in preventing progression and restoring skin confidence.

Ready to calm the redness and take control of your rosacea? Book a consultation at Dream Clinic and let’s build a personalized plan that brings out your skin’s healthiest glow.

The Dream Doctors

References

1. Institute for Quality and Efficiency in Health Care (IQWiG). (2023, September 19). Overview: Rosacea. InformedHealth.org - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK279476/

2.  Information for patients: If you have rosacea, you’re not alone. (n.d.). Rosacea.org. https://www.rosacea.org/patients/information

3. Rosacea: Diagnosis and treatment. (n.d.). https://www.aad.org/public/diseases/rosacea/treatment/diagnosis-treat

4. Zhang, H., Tang, K., Wang, Y., Fang, R., & Sun, Q. (2020). Rosacea treatment: review and update. Dermatology and Therapy, 11(1), 13–24. https://doi.org/10.1007/s13555-020-00461-0