Could this be Rosacea? How to spot the signs if you're not sure
One of the most common things I hear from patients is: “I just thought I had sensitive skin.” And honestly? Fair enough.
Rosacea is one of the most commonly misidentified skin conditions because it doesn’t look the same on everyone. It’s often mistaken for acne, eczema, or just “reactive skin.” So, if you’ve been Googling “Do I have rosacea?” or wondering why your face is always red, you’re not alone.
The 4 signs that point to rosacea
If you’re wondering what does rosacea look like, here’s a simple checklist:
Intermittent or persistent redness
Looks like a mild sunburn across the cheeks and nose that doesn’t fully settle
Acne-like bumps (but no blackheads)
Small red bumps or pus-filled pimples, often mistaken for acne (Keep reading to learn how to spot rosacea vs acne).
Visible blood vessels
Telangectasia are tiny thread-like veins (sometimes called broken capillaries) just under the skin
Skin that stings or burns
Products, or even water can feel irritating or uncomfortable. Especially for women with rosacea.
If you’re ticking a few of these boxes, it’s worth considering rosacea symptoms as a possibility.
Flushing and redness
The sign most people overlook first: flushing. Rosacea often starts quietly. At first, it’s just a tendency to flush- affecting 80% of people, your cheeks get warm, red, maybe a bit stingy. It comes and goes. You might blame wine, spicy food, stress… all the usual suspects.
But here’s the difference:
Normal blushing fades quickly
Rosacea flushing lingers, and over time, it starts to stick around. Eventually, that “temporary redness” can become facial redness that won’t go away.
Important note for darker skin tones; Rosacea can be harder to spot in deeper skin tones because redness isn’t always obvious. Instead, you might notice warmth or heat in the cheeks, stinging or sensitivity and possibly a change in skin texture. This is one of the reasons rosacea is often underdiagnosed in non-fair skin.
Rosacea vs acne vs eczema . How to tell the difference
This is where many people get stuck. Lots of people assume that if their skin feels stingy and burns, it must be eczema. Worse, they sometimes opt for steroids which can worsen or even cause rosacea. So here are my tips for telling them apart; Eczema is usually itchy, dry, (more than stingy) and appears on multiple areas of the body. Rosacea is typically facial (especially the midface), symmetrical, and more about redness and sensitivity than itch. If your skin feels reactive and looks persistently red, rosacea climbs higher on the list.
Rosacea vs acne. Decoding your zits properly.
I often see patients who have assumed the redness and pustules on their face was acne. They have been using harsh treatments in the hope of combatting their pimples unwittingly making the problem worse.
Here is a little checklist to help you decipher your pimples.
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Redness + flushing prominent? Think rosacea first. Sometimes they do happen together!
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Acne tends to be more scattered; rosacea is often centred on cheeks and nose and is pretty symmetrical. That’s way less common in acne!
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Predictable triggers? Rosacea is more likely. If you can predict a flare after sun exposure, spicy foods, alcohol or even stress, that’s very unlikely to be acne.
The eye symptoms almost nobody connects
This is one that flies under the radar. Up to 50% of people with rosacea experience eye symptoms, called ocular rosacea, but many don’t realise it’s related.
Look out for:
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watery or bloodshot eyes
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a gritty or “sand in the eye” feeling
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swollen eyelids
As I often say to patients, “If you’ve been treating your eyes separately and nothing’s working, it’s worth looking at the bigger picture.” And the opposite is true, too. If you have rosacea, keep your eyes peeled for eye symptoms!!!!
We use scrupulous eye hygiene (cleaning your eyelids with a non-irritating cleanser or wipe, warm compresses etc), the very best sunglasses, gentle lubricants, sometimes antibiotic eye drops and omega 3 supplements!)
Who is most at risk of rosacea and who gets missed
Rosacea is most commonly diagnosed in fair-skinned adults and especially women aged between 30 and 50. But that doesn’t mean it’s exclusive to this group. We know it’s often underdiagnosed in people with darker skin, because it’s harder to spot redness or rosacea on darker skin tones. Interestingly, in a study from 2021, rosacea was more common the older people were and it affected just as many men as women. So if you don’t fit the bill of the classic rosacea patient, don’t be so sure you don’t have it!)
Having a family history of rosacea increases your risk of getting it yourself fourfold! Some studies have also shown a link with some inflammatory conditions like inflammatory bowel disease like Crohn’s or rheumatoid arthritis. So, if rosacea runs in the family or you’ve got other inflammatory conditions, your radar should be a little higher.
What to do if you think: “Do I have rosacea?”
First, don’t self-diagnose and don’t panic. Rosacea is diagnosed clinically. There’s no blood test or scan, just a careful look at your skin, your eyes, and your history. Step one: see your GP to confirm your hunch.
In the meantime, there are a few simple things you can do:
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Avoid common rosacea triggers. Typical triggers include sun, heat, alcohol, spicy food, stress and harsh skincare. Avoiding these will be critical for your ongoing management so if you’re unsure, start keeping a diary or paying close attention.
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Keep your rosacea skin care routine simple. Avoid soap, scrubs, toners, aggressive actives like AHAs and even retinol and no fragrance-heavy products!
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Use sunscreen daily. UV is a major trigger for rosacea flushing. Look for zinc oxide, titanium dioxide, or both (mineral sunscreen.)
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Focus on calming, barrier-supportive skincare. Look for ceramides, panthenol and niacinamide.
If your skin has been:
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persistently red
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unusually sensitive
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reacting to things it never used to
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or has any other signs of rosacea
…it’s worth asking the question: “Could this be rosacea?”
The earlier you recognise it, the easier it is to manage and the less likely you are to accidentally use products that make it worse. With the right diagnosis and the right approach, rosacea is absolutely something you can get on top of.
Rosacea Skincare Kit - Anti Redness
With evidence-based ingredients to help hydrate, calm and support the skin barrier. This kit includes:
- a soap-free, emollient-rich cleanser that gently removes impurities.
- A matte, Zinc based day cream with broad-spectrum sun protection, to gently help shield from UV rays—a common skin trigger;
- Moisturisers with skin barrier builders like ceramides, panthenol and niacinamide, (all in our Repair +) help reduce water loss and strengthen the skin barrier;
Finally, our Ultimate A Gold (retinal) night cream with Retinal, the most gentle and effective form of Vitamin A and PHAs to gently hydrated and exfoliate. Thoughtfully designed for calm, clear, and comfortable skin.
Key Features:
- Formulations to support skin hydration and barrier function.
- Ingredients to help manage the appearance of redness.
- Gentle, non-irritating formulations suitable for irritable skin, moody or sensitive skin.
We've swapped Ultimate A with the new Ultimate A Gold. If you prefer Ultimate A, you can build your own kit here.
*Ultimate A Gold (Retinal) may transfer onto white or light-coloured fabrics. For best results, we recommend using darker clothing or surfaces to avoid visible marks.