Rosacea Treatment In London

Medically Reviewed by Doctor Björn Thomas, GMC: 7084005

What Is Rosacea?

Rosacea is a common, long-term skin condition that mainly affects the central part of the face and sometimes the eyes. When reviewing symptoms listed by the NHS, Rosacea often causes facial flushing, persistent redness and visible small blood vessels. Many people also develop red or pus-filled spots that look similar to acne, although rosacea is a different condition that needs proper diagnosis in order to find effective treatment.

The condition is more frequent in adults with fair skin and usually appears between the ages of thirty and sixty, although it can occur at any age and in all skin tones. According to The Primary Care Dermatology Society, in the UK, it is estimated to affect around one in ten people. 

The PCDS offers a free Rosacea patient leaflet for anyone who wants to see visual examples of the symptoms of the skin condition.

Rosacea is Classed as a Chronic Skin Condition

Rosacea is a chronic condition, so it tends to flare and settle over time rather than disappear completely. However, official guidance from The National Institute for Health and Care Excellence confirms that symptoms can usually be brought under good control with the right combination of skin care, prescription treatments and trigger avoidance. Furthermore, the guidance recommends that individuals exhibiting symptoms should seek medical assessment.  

Given that rosacea affects the face, it can have a significant impact on self-confidence, social life and work. Many people feel embarrassed about flushing or worry that others will assume they drink too much alcohol, as the redness can mimic conditions that alcoholics suffer. 

Speak to Our Medical Skin Expert

At the Thomas Clinic, consultant dermatologist Dr Bjorn Thomas is focused on both medical control of the condition and its emotional impact, aiming to help you feel more comfortable in your own skin.

If you are concerned that you may have rosacea, or your current treatment is not working, you are welcome to contact our dermatology team to arrange a private consultation at a time that suits you.

Speak to Our Skin Experts Today

Common Features of Rosacea

Rosacea can involve the skin and the eyes. In some people, particularly older men, it may also cause thickening of the skin on the nose.

Common features include:

• The central area of the face is usually most affected, especially the cheeks, nose, forehead, and chin.
• Redness is an early sign, often with episodes of intermittent flushing.
• In time, the redness may become fixed and look similar to sunburn.
• The skin is often very sensitive and can easily feel like it’s stinging or is irritated by products or changes in temperature.
• Inflammation in the skin can cause small red bumps or yellowish spots (papules and pustules).
• Background redness and broken blood vessels (telangiectasia) are common.
• The eyes can be involved, sometimes even before the facial skin changes are obvious, causing dryness, burning, grittiness or red eyelids.
• In some older men with long-standing rosacea, the nose can enlarge, and pores can appear more open, which may lead to a condition called rhinophyma.

If you notice eye symptoms or thickening of the nose, specialist assessment is particularly important so that treatment can be started early.

What Causes Rosacea?

The exact cause of rosacea is not fully understood. Current research suggests that several factors work together, including changes in how facial blood vessels and nerves respond, alterations in the innate immune system and disruption of the normal skin barrier.

As documented by The British Association of Dermatologists, Rosacea often runs in families and is more common in people with fair skin, yet no single gene has been identified. Some studies also suggest that microscopic Demodex mites on the skin and certain bacteria living in the gut or on the skin surface may contribute to some individuals, although this is still being researched.

What we do know is that rosacea is not infectious, and nothing you have done has caused the condition. However, many people find that certain triggers make their symptoms worse.

Triggers That May Cause Flare-ups

Different people have different triggers, so it can be useful to keep a simple diary of what you were doing or eating before a flare-up. 

Commonly reported triggers include:

• Exercise, particularly heavy lifting and cardio, in warm settings.
• Stress and anxiety. Around eight in ten patients say this worsens their skin.
• Skin care products that contain fragrance, witch hazel or alcohol.
• Foods such as yoghurt, sour cream, spicy foods, cheese, chocolate, vanilla, soy sauce, aubergine, avocado, spinach, broad leaf beans, citrus fruit, tomatoes, bananas and figs, which some people find aggravate flushing.
• Alcohol, especially red wine, beer, and spirits. Hot drinks may also trigger flushing for some people.
• High temperatures from saunas, hot tubs or very warm environments.
• Weather factors such as strong sunshine, wind, cold, and changes in humidity.
• Medicines such as topical or oral steroids, vasodilators for heart conditions, some blood pressure tablets (for example, calcium channel blockers), niacin, some antidepressants, medicines for erectile dysfunction, opioids, and high-dose antihistamines.

You do not need to avoid every possible trigger. The aim is to identify the ones that affect you personally and then find practical ways to reduce them where possible.

Managing Rosacea

Although rosacea is a long-term condition, many people achieve good control by combining self-care with medical treatment. National and local NHS guidance emphasises three main areas: avoiding or minimising triggers, adopting gentle skin care and using appropriate prescription treatments such as topical or oral medicines and, in some cases, laser or light procedures.

At the Thomas Clinic, we consider:

• Minimising triggers
• Skin care
• Topical medication
• Oral medication
• Laser therapy and other procedures

To help control and reduce the symptoms of rosacea, we advise avoiding products that contain fragrance, alcohol, witch hazel, peppermint, eucalyptus or acetone, as these can irritate sensitive skin. Toners, strong astringents and exfoliants should be avoided, and chemical peels or dermabrasion are usually not recommended for active rosacea.

Skin Care

To help control and reduce the symptoms of Rosacea, we advise avoiding products containing fragrance, alcohol, witch hazel, peppermint, eucalyptus and acetone.

​Toners, astringents or exfoliants should not be used, and no chemical peels or dermabrasion should be performed on the skin.​

Here are some useful skincare product tips for those suffering from Rosacea:

• Cleansers – Wash with lukewarm water and avoid hot water. Gently used fingertips and soap-free cleansers, such as Cetaphil lotion or Cerave cleanser.
• Moisturisers –  Opt for non-fragrance moisturisers containing glycerin and ceramides. Petroleum jelly is usually tolerated by the skin. Using petroleum jelly can be advised, as it creates a protective barrier. This is important as the natural skin barrier is often defective as a result of Rosacea.
• Sunscreens –  Stick to an SPF of 30 to 50. Sun creams with titanium dioxide and zinc oxide do well. Chemical screens can be used but do produce heat from the reaction to the sun, but are nevertheless cosmetically usually better tolerated. E.g. La Roche-Posay, Anthelios Ultralight Invisible Fluid.
• Camouflage – Green-tinted foundation can be used to counteract the background redness caused by Rosacea. Some examples include: Clinique Redness Solution Instant Relief Mineral powder, Dermablend Quick-Fix concealer stick, Maybelline Fit Me Concealer, Vichy Dermafinish Full Coverage Foundation.

During your consultation, we can review your current products and suggest a simple routine tailored to your skin.

Specialist Rosacea Flare-up Treatment in London

Consultant dermatologist Dr Bjorn Thomas provides specialist assessment and treatment for all forms of rosacea, from mild flushing to more complex cases that involve the eyes or thickening of the skin. 

Dr. Thomas treats rosacea regularly in his private practice, drawing on extensive experience from his previous NHS roles at Guy’s and St Thomas’ NHS Foundation Trust. This gives him particular depth in managing both straightforward and complex presentations.

We offer several evidence-based options for managing flare-ups and maintaining long-term control. During your first appointment, Dr Thomas will take a detailed history, examine your skin and discuss your main concerns and triggers. Together you can agree on a personalised plan that may include topical, oral and procedural treatments, alongside skin care and lifestyle advice.

Topical Treatment

Topical treatments aim to reduce inflammation and, in some cases, target redness and flushing.

These include:

• Metronidazole: An anti-inflammatory antibiotic gel or cream that helps to reduce redness and to prevent papules and pustules (for example, Metrogel or Noritate cream).
• Ivermectin: A cream that targets Demodex mites that live in skin pores and also has anti-inflammatory effects
• Azelaic acid: A gel or foam that works as an anti-inflammatory and antimicrobial treatment and helps to increase shedding of dead skin cells
• Calcineurin inhibitors: Creams or ointments used off-label as powerful anti-inflammatory treatments in selected cases
• Brimonidine or oxymetazoline: Gels or creams that temporarily constrict small blood vessels, which can reduce background redness for several hours

Your dermatologist will explain how and when to apply these treatments and how they can be combined safely.

Oral Treatment

For moderate to severe rosacea, especially when there are many pustules or acne-like lesions, oral medicines may be recommended.

These include:

• Oral antibiotics: Doxycycline is often used for its anti-inflammatory effect on the skin and eyes. Traditional short courses use doses of 100 to 200 milligrams for flare-ups. A lower daily dose that works mainly through anti-inflammatory pathways, rather than as an antibiotic, can also be prescribed in selected cases.
• Oral isotretinoin: In more severe or treatment-resistant rosacea, isotretinoin, which is also used for acne, can be very helpful in reducing inflammation and oil production under close specialist supervision.
• Beta blockers: Medicines such as propranolol, nadolol or carvedilol may be considered to reduce the tendency to flush in particular situations, for example, public speaking, though these are not suitable for everyone and require careful assessment.

All oral treatments are prescribed only after a full medical review, with appropriate monitoring and advice about possible side effects.

Laser & Light Treatment

Laser and light-based treatments can play an important role in some types of rosacea.

They are mainly used in two situations:

Anti-redness treatment for broken blood vessels and persistent redness.

For redness and visible vessels, pulsed dye laser uses a yellow light wavelength that is absorbed by red blood cells, which makes it well-suited to treating rosacea-related blood vessels. This is an in-clinic procedure that does not require a general anaesthetic. Temporary swelling or bruising can occur and usually settles over several days. A series of sessions, followed by occasional maintenance, is often needed for the best results.

Treatment of rhinophyma, where the skin of the nose becomes thickened and irregular.

For rhinophyma, the overgrown tissue at the tip of the nose can be carefully reduced and reshaped with a carbon dioxide laser. This can significantly improve the contour of the nose, and many patients report a positive impact on confidence and daily life.

Get Treated by a Professional Rosacea Dermatologist in London

Dr Thomas MBBS, PhD, MRCP is a British-certified consultant dermatologist who has treated thousands of patients with inflammatory skin conditions, including rosacea, acne, eczema, and psoriasis. 

His vast experience includes earning a PhD on the genetics of atopic eczema and the effects of environmental stress, and he has been awarded the Royal Society of Medicine Trainee Research Prize for his work. 

He has published multiple medical articles, presented at national and international meetings, and regularly gives talks on research into chronic skin conditions.

Whether it is through providing treatment in his positions at Guy’s and St Thomas’, St John’s, or within the private clinic, many patients value the combination of consultant-level expertise and clear, practical explanations that Dr Thomas provides.

Book a Personalised Consultation

Treatment for rosacea at the Thomas Clinic is private, so you can self-refer without seeing a GP and avoid long waiting lists. 

From your first inquiry, our team aims to make the process straightforward and discreet.

During your initial consultation, we will take time to understand how rosacea is affecting you, examine your skin carefully and review any previous treatments you have tried. We then discuss the options with you and agree on a plan, so that you are fully involved in each decision. 

Ongoing support and follow-up are available if needed, particularly when starting new medicines or procedures.

Benefits of Professional Rosacea Treatment

Because rosacea is visible and often affects the central face, many people feel self-conscious, avoid social situations or worry about how others may perceive them. 

Studies and clinical experience show that effective treatment of chronic skin conditions can improve quality of life, confidence and emotional well-being.

Professional treatment can help you:

• Reduce flushing, redness and spots.
• Minimise burning, stinging and skin sensitivity.
• Lower the risk of complications such as eye problems or rhinophyma.
• Understand and manage your personal triggers.
• Feel more in control and less anxious about flare-ups.

Patients who choose to have their rosacea treated often report feeling more confident and more comfortable in work, social, and family life.

Register for Rosacea Treatment

The first step to treating Rosacea is to register your interest with the clinic.

We can contact you to arrange an appointment at a time that is convenient for you.

Rosacea Treatment FAQs

Why do I have rosacea?

The cause of rosacea is not fully understood. It appears to develop from a combination of inherited tendency, changes in blood vessels and immune responses in the skin, and environmental triggers such as sunlight, temperature changes and certain foods or drinks.

Rosacea is not infectious, and you cannot pass it on through normal contact. The observation that anti-mite creams can help some people raises the possibility of an immune reaction to Demodex mites in certain cases, but this is only one part of a wider picture.

What can I do to get rid of the redness on my cheeks?

You can start by identifying and reducing your personal triggers, such as heat, alcohol, hot drinks or spicy foods, and by using gentle skin care and regular sun protection. 

Prescription topical treatments such as brimonidine or oxymetazoline gels can temporarily reduce redness in some people. Laser treatment can be very effective for visible blood vessels and persistent redness, especially when combined with medical therapy and trigger management. During your consultation, we can discuss the best combination for you.

Why are my eyes gritty and sore?

Gritty, dry or irritated eyes, red eyelids and a feeling of burning or soreness are common signs of ocular rosacea. 

Artificial tear drops, warm compresses and careful eyelid hygiene can all help. In more troublesome cases, oral antibiotics such as doxycycline may be prescribed to reduce inflammation, often with very good effect. 

Because rosacea can, rarely, affect the clear front of the eye (cornea), it is important to seek medical advice promptly if you develop eye pain or any change in vision.

What can I do myself to help my rosacea?

Adopt a simple, gentle skin care routine, avoid scrubs and harsh products, use a non-perfumed moisturiser and apply a broad-spectrum SPF every day. 

Try to identify and minimise your personal triggers, and consider keeping a diary to spot patterns. There is no strong evidence that herbal or “natural” remedies cure rosacea, but if a cream containing ingredients such as chamomile, green tea extract or aloe vera soothes your skin and does not cause irritation, it may be reasonable to continue using it alongside medical treatment.

Rosacea Medical Resources

For patients who wish to learn more about the condition, below are some useful medical resources:

• British Association of Dermatologists: Rosacea Patient Information Leaflet
• NHS: Symptoms of Rosacea
• NHS guidance on the treatment of Rosacea
• National Rosacea Society: Coping with Rosacea 
• National Rosacea Society: All About Rosacea: Signs & Symptoms and Treatment
• British Association of Dermatologists guidelines for the management of people with rosacea
• NHS North and East Devon: Treatment of rosacea
• Primary Care Dermatology Society: Rosacea Patient Information Leaflet

Are there support groups or websites that are helpful for people with rosacea?

Yes. Some useful links to these support groups include:

www.rosacea.org.uk

www.bad.org.uk

www.reddit.com/r/rosacea

rosacea-support.org

Speak to Our Rosacea Treatment Specialists Today

If you are ready to seek help for rosacea, our team is here to support you with clear information, evidence-based treatment and compassionate care. Consultations are available at all three Thomas Clinic central London locations, with flexible appointment times for busy schedules.