Calming the Flush - Your 2025 Guide to Understanding and Managing Rosacea

That persistent flush across your cheeks and nose. The stinging sensation when you try a new product. The small, stubborn bumps that refuse to leave. If this sounds painfully familiar, you might be one of the millions of people living with rosacea.

It’s a frustrating, often misunderstood skin condition. The internet is full of conflicting advice, and it can feel like you’re in a constant battle with your own skin. But managing rosacea is possible. It’s not about finding a single "miracle cure," but about understanding your triggers and building a smart, gentle, and consistent plan.

Let me cut through the noise. This is your updated, practical guide to what causes rosacea and, more importantly, what you can do about it.

The Mystery of that Red Flush - What Causes Rosacea?

While the exact cause of Rosacea is still a puzzle, researchers now believe rosacea stems from an overactive immune response combined with genetic and environmental factors. Think of it less as one single problem and more as a perfect storm of contributing factors.

• Unfortunately It’s in Your Genes - If your parents or siblings have rosacea, you're more likely to develop it. Thanks, family!
• An Overactive Immune System (and Mites) - Our skin is home to microscopic mites called Demodex folliculorum. Everyone has them, but people with rosacea often have more. The leading theory isn't that the mites cause rosacea, but that the immune system overreacts to them, triggering inflammation. Research continues to support this link between Demodex and the inflammatory pathways seen in rosacea.
• The Gut-Skin Connection - The link between gut health and skin health is a hot topic for a reason. Studies, like those highlighted by the American Academy of Dermatology (AAD) , suggest that imbalances in your gut microbiome could influence skin inflammation.
• "Leaky" Blood Vessels -- In rosacea-prone skin, the blood vessels in the face can dilate too easily and become "leaky," leading to the characteristic flushing and persistent redness.
• Your Personal Triggers - These are the external factors that cause a flare-up. Common culprits include sun exposure, extreme temperatures, wind, spicy food, alcohol (especially red wine), stress, and harsh skincare ingredients .

How to Fight Rosacea - A Practical Management Plan

Managing rosacea is a marathon, not a sprint. The foundation of any good plan is a gentle daily routine combined with targeted treatments.

Step 1: Build Your Gentle Skincare Routine

This is your first line of defense. The goal here is to soothe, hydrate, and protect your skin barrier, not attack it. The healthier your skin barrier (and your gut microbiome ) the better natural barrier defense you have. Therefore your skin and gut have less need to fight this condition.

Cleansing

• How to Use - Use lukewarm—never hot—water. Gently massage the cleanser with your fingertips (no rough washcloths!) and rinse thoroughly before patting your face dry with a soft towel.

Burt's Bees 99% Natural Sensitive Facial Cleanser with Cotton Extract - It's specifically designed and formulated with lots of hydrating, calming and soothing oils that will gently cleanse the skin, without stripping away the barrier. The ingredients in this one are really great at calming redness from rosacea and can help balance the skin microbiome.

Price - £15.30

Full Ingredient List: aqua (water, eau), helianthus annuus (sunflower) seed oil, glycerin, cetyl alcohol, cera alba (beeswax, cire d'abeille), sucrose stearate, cetearyl alcohol, cocos nucifera (coconut) oil, gossypium herbaceum (cotton) flower extract, oryza sativa (rice) extract, beta vulgaris (beet, extrait de racine de betterave) root extract, quillaja saponaria bark extract, theobroma cacao (cocoa) seed butter, yucca schidigera leaf/root/stem extract, artemisia umbelliformis extract, theobroma cacao (cocoa) seed butter, yucca schidigera leaf/root/stem extract, artemisia umbelliformis extract, euphrasia officinalis extract, hamamelis virginiana (witch hazel) water, saccharum officinarum (sugar cane, extrait de canne à sucre) extract, aloe barbadensis leaf juice, silica, sucrose, fructose, glucose, coco-glucoside, inositol, maltodextrin, citric acid, benzoic acid, trehalose, xanthan gum, potassium sorbate, sodium benzoate, CI 77947 (zinc oxide), alcohol denat., phenoxyethanol

Forget foaming cleansers, harsh scrubs, and anything that leaves your skin feeling "squeaky clean" (which actually means stripped and irritated). Opt for a creamy, hydrating, non-foaming, and soap-free cleanser.

Moisturising

A healthy skin barrier is crucial for keeping irritants out and moisture in. Look for moisturisers with barrier-repairing ingredients like ceramides, glycerin, niacinamide, and hyaluronic acid. This helps reduce sensitivity and keep your skin comfortable.

• How to Use - Apply morning and evening after the gentle cleansing as above. Remember tht your skin repairs and regenerates overnight during your deep and r.e.m. sleep cycles, so don't skip the evening cleanse and moisturise.

Burt's Bees 98.9 Percent Natural Daily Face Moisturising Cream, Sensitive Skin Formula. It's fragrance-free and the combination of aloe vera and rice extracts are formulated to calm sensitive, red and irritated skin. It's very light-weight and should provide a light surface hydration to feed your skin with moisture, whilst not further irritating or destroying the natural barrier function.

Price - £16.50 £17.49

Full Ingredient List: aqua (water, eau), helianthus annuus (sunflower) seed oil, glycerin, cetyl alcohol, CI 77947 (zinc oxide), zea mays (corn) starch, gossypium herbaceum (cotton) flower extract, oryza sativa (rice) extract, beta vulgaris (beet, extrait de racine de betterave) root extract, artemisia umbelliformis extract, euphrasia officinalis extract, butyrospermum parkii (shea) butter, saccharum officinarum (sugar cane, extrait de canne a sucre) extract, aloe barbadensis leaf juice, jojoba esters, hydrolyzed jojoba esters, kaolin, lecithin, sucrose, fructose, glucose, inositol, citric acid, benzoic acid, trehalose, xanthan gum, glyceryl laurate, potassium sorbate, sucrose stearate, sucrose polystearate, sodium benzoate, sodium stearoyl lactylate, sodium PCA, alcohol denat., phenoxyethanol.

Avoid using anything with retinol (despite what some influencers might say to treat "Acne-Rosacea") as this will only damage an already compromised skin barrier. Instead the idea with any moisturisation is to be light-enough to be effective. Yet, moisturising enough to provide relief from dryness and dehydration. Again, avoid thick-creamy formulations that will block the normal skin respiration. We want to rebuild your barrier and strengthen it gradually. So light hydration is the best way to go.

Sunscreen - Preferably with Zinc Oxide

Sun exposure is the #1 trigger for rosacea flare-ups. You need to wear a broad-spectrum sunscreen with at least SPF 30 every single day, during the day, even when it's cloudy. Mineral (or physical) sunscreens containing zinc oxide are usually better tolerated than chemical sunscreens. I would try to avoid sunscreens with titanium dioxide, as these are applied to the face, titanium dioxide - TiO₂ is a BANNED - food ingredient in the UK & EU, so in my opinion, this shouldn't be applied anywhere to your face, because when you sweat, it could inadvertently end up on your lips and therefore in your mouth.

Green People Mineral Sun Cream SPF30 with Zinc Oxide - It's non-comedogenic and is a 100% mineral based sunscreen as a best option for rosacea prone skin. It's also formulated with ingredients that fight UV damage from free radicals and is reef-safe.

Price - £31.50

Full Ingredient List: Aqua, Zinc Oxide (Non Nano), Helianthus Annuus (Sunflower) Seed Oil**, Caprylic/Capric Triglyceride, Butyrospermum Parkii (Shea) Butter*, Glycerin***, Cetearyl Alcohol, Argania Spinosa (Argan) Kernel Oil*, Coco-Glucoside, Tocopherol, Aloe Barbadensis (Aloe) Leaf Juice Powder*, Prunus Amygdalus Dulcis (Almond) Oil*, Sequoia Sempervirens Leaf Cell Extract, Simmondsia Chinensis (Jojoba) Seed Oil*, Calendula Officinalis (Calendula) Flower Extract*, Camellia Sinensis (Camellia) Leaf Extract*, Rosmarinus Officinalis (Rosemary) Leaf Extract*, Bisabolol, Coconut Alcohol, Lecithin, Isostearic Acid, Polyglyceryl-3 Polyricinoleate, Polyhydroxystearic Acid, Xanthan Gum, Gluconolactone, Calcium Gluconate, Sodium Benzoate, Potassium Sorbate. *Organic Ingredient. **Mixture Of Organic And Non-Organic Ingredient. ***Made Using Organic And Non-Organic Ingredients. 99.7% Natural Origin Of Total / 67.0% Of The Total Ingredients Are From Organic Farming. This product should be used within 12 months of opening.

Note: If you are visiting my blog from USA, then this option is not available for you. Unfortunately due to archaic sunscreen regulations in the USA, this type of sunscreen product is not approved for use as a Sunscreen product. See my blog post about this here.

An alternative for my USA readers would be this one Safe Sea Zinc Oxide Sunscreen SPF30 | Clear Mineral Face And Body Sunscreen Without White Cast. Whilst not as good as the UK & EU recommendation, this is a close, next-best option for you.

Step 2: Add Key Treatment Ingredients

Once your basic routine is solid, you can introduce active ingredients known to calm rosacea.

The INKEY List (Redness Relief Serum) - 10% Azelaic Acid Serum. It's a dedicated Redness Relief Serum with 10% Azelaic Acid that can calm irritated skin, redness and itching. It also has another powerhouse calming ingredient allantoin to help soothe the skin even further.

However, the true magic, or should I say illusion with this product lies in its colour. Green to be precise. Green is the opposite of red on the colour spectrum, so green creams and serums have traditionally been used to camouflage redness immediately upon application.

Price - €17.00

Full Ingredient List: Aqua (Water), Azelaic Acid, Propanediol, Hydroxyethyl Acrylate/Sodium Acryloyldimethyl Taurate Copolymer, Phenoxyethanol, Acacia Senegal Gum, Xanthan Gum, Allantoin, Glycerin, Ethylhexylglycerin, Polysorbate 60, Sorbitan Isostearate, Maltodextrin, Sodium Hydroxide, Hydrolyzed Gardenia Florida Extract, Gardenia Florida Fruit Extract, Polylysine.

Ivermectin - (Prescription Only Medication)

No discussion of Rosacea is ever complete without looking at what doctors and dermatologists look at when treating this condition. There are certain medicinal options available for treating the root cause of some forms of rosacea. Ivermectin is one such PRESCRIPTION ONLY medication commonly prescribed to eliminate or at least reduce the number of Dermodex mites on the surface of the skin.

It's important to point out, that use of these types of medicines, will not repair the barrier function of your skin, so you must seek the advice of your doctor before taking this medication and following any of the skin care product recommendations above. I'm not in any way suggestion or recommending use of prescription medications. This is a conversation that you and your Dermatologist must have to see if this type of medicine can be of help to you.

Metronidazole - (Prescription Only Medication)

An alternative option to Ivermectin is Topical Metronidazole. A topical antibiotic that has been used for decades to help control the inflammation and pustules associated with rosacea.

Again, Please discuss this treatment only with your doctor or dermatologist as in no way am I recommending or endorsing use of prescription medications to treat rosacea.

Step 3: Consider Professional and Medical Treatments

If, after altering your daily skin care routine isn't successful, it's time to call in the professionals.

• Oral Medications: For more moderate to severe cases, a dermatologist may prescribe oral antibiotics like doxycycline to reduce inflammation, or in some cases, low-dose isotretinoin. These require careful medical supervision due to potential side effects.
• Laser and Intense Pulsed Light (IPL): These treatments are excellent for reducing persistent redness and visible blood vessels (telangiectasias). Over the course of 15 years as a professionally licenced Laser Skin Therapist, I treated thousands of clients with rosacea with IPL. I can't stress enough though that It’s crucial to find a properly qualified and experienced therapist, as these powerful devices can cause damage in the wrong hands. Always insist on a full consultation and patch test, and ensure that your therapist is properly licenced and insured. Any fully competent therapist should be happy and willing to supply evidence of their qualifications, licences and appropriate registrations with local licencing authorities. Stay well away from any who can't provide this vital information. Your skin is at stake!
• LED Light Therapy: This is a fantastic, non-invasive option for calming inflammation. Red light helps reduce overall redness and promotes healing, while Near-Infrared (NIR) light penetrates deeper to tackle inflammation. Studies, including early research by NASA on wound healing, have validated the therapeutic effects of these wavelengths. Professional devices like Dermalux offer a powerful combination of lights and can significantly improve skin health with consistent sessions.

I can't recommend this as an effective treatment option highly enough. I treated many hundreds of clients with rosacea (and other skin conditions) with this device in my clinic. To see this now available for home use is a huge step forward and offers privacy and convenience.

Price - £1,999.99 and I would say, worth every penny.

This device was a game-changer in my clinic and I often used this in combination with a complete skin care regime for my clients. It's not just for rosacea, but treats a whole lot more. For anti-aging skin fortification it's truly the best device and tool at my disposal to firm, tone, reduce redness, improve acne, reduce hyperpigmentation. The list is endless and this is a wise investment in your future-skin.

The Bottom Line

Living with rosacea can be a journey of discovery—learning your triggers, finding the right products, and having patience. Your skin didn't get this way overnight, and it won't calm down overnight either. Be patient, consistent and don't rush things. Only then, will you see lasting results.

By adopting a gentle daily routine, incorporating proven active ingredients, and seeking professional help when needed, you can take back control. Be kind to your skin, be consistent with your plan, and you can achieve a calmer, healthier complexion.