Your cheeks are often red. You think it's from the cold, stress, or maybe that second cup of coffee. But if that redness doesn't go away anymore, it could be rosacea. A chronic skin condition that affects an estimated 1 in 10 people.
What is rosacea?
Rosacea is a chronic inflammatory skin condition that mainly affects the face. It often starts subtly - a flush that lasts longer than normal - and can gradually worsen if left untreated.
It's not acne, although it sometimes looks like it. It's not an allergy. It's a medical condition with a genetic component.
The four subtypes
1. Erythematotelangiectatic rosacea (ETR) The most common form. Features: persistent facial redness, visible blood vessels, burning or stinging sensation.
2. Papulopustular rosacea Resembles acne with red bumps and pimples, but without blackheads. More common in middle-aged women.
3. Phymatous rosacea Rarer. Leads to skin thickening, especially on the nose (rhinophyma). More common in men.
4. Ocular rosacea Affects the eyes: red, dry, irritated eyes, burning sensation, light sensitivity. Often goes unrecognised.
Common triggers
- Sun: The biggest trigger. UV radiation causes inflammation.
- Temperature changes: Going from cold outdoor air to a warm room.
- Food and drink: Alcohol (especially red wine), spicy food, hot drinks.
- Stress: A well-known trigger.
- Wrong skincare: Harsh products, scrubs, alcohol in products.
- Exercise: Intense exertion can trigger flare-ups due to increased body temperature.
Keeping a trigger diary helps identify your personal patterns.
Treatment
At the dermatologist:
- Prescribed creams with metronidazole, azelaic acid or ivermectin
- Low-dose oral antibiotics for anti-inflammatory effects
- Laser therapy (IPL or PDL) for persistent blood vessels
In your daily routine:
- Cleanse: Use a mild, soap-free cleanser. Avoid foaming cleansers, scrubs and products with alcohol or fragrance.
- Moisturise: A rich, soothing moisturiser strengthens the skin barrier. Look for ceramides, niacinamide and hyaluronic acid.
- Sun protection: Every day, all year round. Mineral filters (zinc oxide, titanium dioxide) are often better tolerated than chemical ones.
- Calming actives: Thermal water, aloe vera, bisabolol and green tea extract have proven anti-inflammatory properties.
Ingredients to avoid
- Retinol (at least initially)
- AHAs and BHAs in high concentrations
- Menthol and peppermint
- Alcohol (alcohol denat.)
- Synthetic fragrances
- Witch hazel
Lifestyle tips
- Use cool water to wash your face
- Green makeup primer neutralises redness optically
- Stress management: yoga, meditation, breathing exercises
- Eat anti-inflammatory: omega-3 fatty acids support healthy skin from within
When to see a doctor?
See your GP or dermatologist if facial redness doesn't go away, if you have bumps that don't respond to regular acne products, or if you have eye complaints.
Early treatment matters. The sooner you address rosacea, the better it can be controlled.
Belgian online pharmacies offer a wide range of products specially developed for sensitive, rosacea-prone skin. Brands like Avène, La Roche-Posay and Bioderma have complete lines for reactive skin.