What is rosacea?
Rosacea is a chronic inflammatory skin condition that primarily affects the central face and typically follows a pattern of flares and remissions. Although it is more commonly recognised in fair skin, it can affect people of all skin tones and may present differently in darker skin, making careful assessment particularly important. There are several overlapping subtypes, so identifying which features dominate is what determines the treatment approach.
Rosacea cannot be cured, but with the right treatment it can usually be controlled very effectively. An accurate diagnosis and identification of the rosacea subtype are fundamental to selecting the most appropriate treatment and achieving the best possible long-term control.
Types of rosacea Dr Phillips treats:
Persistent redness, blushing and heat Broken capillaries across the nose and cheeks
Persistent facial redness and flushing are among the most common features of rosacea. They typically affect the nose, cheeks, forehead and chin in a characteristic central facial distribution, although the pattern and severity vary considerably between individuals.
Rosacea affecting the nose may present with persistent redness, flushing and visible blood vessels. In longstanding cases, some patients develop thickening of the skin, known as rhinophyma. Inflammatory rosacea can also affect the forehead, chin and areas around the mouth, where it is sometimes mistaken for acne. Unlike acne, rosacea does not produce blackheads and is usually accompanied by a background of persistent redness.
Symptoms often fluctuate over time and are commonly triggered by heat, alcohol, exercise, spicy foods and emotional stress. Many patients also experience sensations of warmth, burning or stinging during a flare.
Treatment depends on the predominant features of your rosacea. Prescription medication can help control inflammation and reduce flushing in some patients, while vascular laser and light treatments, including the Lutronic Derma V and Stellar M22 IPL , can be highly effective for persistent redness and visible blood vessels. The most appropriate treatment is determined by your rosacea subtype, skin tone and the features driving your condition.
Take control of persistent facial redness
If persistent redness or flushing is affecting your skin, a consultation with Dr Phillips can help identify the features driving your rosacea and the most appropriate treatment options.
Visible blood vessels (telangiectasia) Broken capillaries across the nose and cheeks
Papulopustular rosacea The acne-like component, with papules and pustules
Papulopustular rosacea is characterised by inflammatory red bumps and pustules that can closely resemble acne. Because the two conditions share many features, distinguishing between them is important, as they require different treatment approaches.
One of the key differences is that papulopustular rosacea does not produce blackheads or whiteheads and is usually accompanied by persistent facial redness or flushing. Careful assessment of the pattern of the rash and the surrounding skin is therefore essential to establish the correct diagnosis.
In some patients, increased numbers of Demodex mites may contribute to the inflammation. Where this is suspected, treatment with topical ivermectin (Soolantra®) may be appropriate, alongside other prescription treatments selected according to the subtype and severity of the rosacea.
If you have been treated for acne without the expected improvement, particularly if your spots are accompanied by persistent facial redness or flushing, Dr Phillips can assess whether rosacea, acne or a combination of both is responsible and develop an appropriate treatment plan.
If you have been told you have acne but your spots sit on a background of persistent redness or flushing, or if standard acne treatment has not worked as expected, papulopustular rosacea may be the underlying diagnosis. Dr Phillips explains the differences between Acne and Rosacea in this video.
Acne or rosacea? Get a clear diagnosis
If facial spots persist despite acne treatment or occur alongside redness and flushing, Dr Phillips can determine whether acne, rosacea or both are contributing to your symptoms.
Phymatous rosacea Skin thickening, most often of the nose (rhinophyma)
In some patients, most commonly men, longstanding rosacea can lead to gradual thickening of the skin of the nose, a condition known as rhinophyma. This results from enlargement of the sebaceous glands and overgrowth of connective tissue, giving the nose a progressively enlarged, irregular appearance.
Early phymatous change may respond to medical treatment and careful control of the underlying rosacea. More established rhinophyma is typically treated with ablative laser resurfacing using either a CO₂ laser or the UltraClear® laser, selected according to the severity of the changes and the desired clinical outcome. Dr Phillips will assess the extent of the condition and recommend the most appropriate treatment for each individual.
Book a consultation to discuss Rhinophyma treatment options in London with Dr Derrick Phillips.
Explore treatment for rhinophyma
If rosacea has caused thickening or changes to the skin of your nose, Dr Phillips can assess the extent of the condition and discuss the most appropriate treatment options.
Ocular rosacea Eye involvement including dryness, irritation and recurrent styes
Rosacea can affect the eyes as well as the skin, a form known as ocular rosacea. Symptoms may include dryness, grittiness, burning, watering, inflamed eyelid margins and recurrent styes. Some patients also experience blurred vision or increased sensitivity to light. Eye symptoms may develop before, alongside or after the skin changes of rosacea, and in some individuals they are the predominant feature.
Because ocular rosacea can resemble conditions such as dry eye disease or blepharitis, it is often overlooked. Dr Phillips routinely assesses for ocular involvement during consultation and incorporates these findings into the treatment plan. Management may include eyelid hygiene, topical or oral treatments where appropriate and, for patients with more significant eye involvement, referral to or co-management with an ophthalmologist.
Explore treatment for rhinophyma
If you are experiencing persistent eye irritation alongside rosacea, Dr Phillips can assess your symptoms and recommend appropriate treatment or specialist referral where needed.
Rosacea overlap Where rosacea co-exists with acne, seborrhoeic dermatitis or Demodex-related inflammation
Acne isn't confined to the face — the chest, back and shoulders carry the same oil glands and follicles, and breakouts there respond to the same hormonal and inflammatory drivers. Back acne, often called "bacne," tends to be overlooked or self-managed with body washes long after it would have prompted a dermatology visit if it were on the face, but it carries the same risk of scarring, particularly across the back, where skin is thicker.
Topical treatment is often harder to apply consistently over a larger area, and clothing, sweat and friction can all aggravate body acne in ways facial acne isn't exposed to.
Dr Phillips assesses body and back acne with the same rigour as facial acne, considering severity, scarring risk and any hormonal driver, and treatment may include medicated washes, topical or oral therapy, or isotretinoin where the acne is severe or scarring.
For a practical starting point, see his back acne treatment guide.
Explore treatment for rhinophyma
If rosacea has caused thickening or changes to the skin of your nose, Dr Phillips can assess the extent of the condition and discuss the most appropriate treatment options.
Rosacea and skin of colour
Rosacea can affect people of all skin tones, although it is more commonly recognised in fair skin. In darker skin tones, redness may be less apparent, and the condition may instead present with facial warmth, sensitivity, burning, persistent irritation or changes in pigmentation. As a result, the diagnosis can be more challenging and is sometimes delayed.
Many patients describe their skin as feeling as though it is "running hot", even when visible redness is minimal. The absence of obvious redness does not exclude rosacea, and careful assessment of the history and associated clinical features is often key to establishing the diagnosis.
Dr Phillips has extensive experience diagnosing and treating rosacea across diverse skin tones. Treatment is tailored to the individual, with careful consideration of skin tone when selecting prescription treatments and laser therapy.
If you think you may have rosacea, book a consultation with Dr Derrick Phillips to receive an accurate diagnosis and a personalised treatment plan.
Rosacea and menopause
Many women notice that their rosacea changes during the perimenopause and menopause, with flushing becoming more frequent and the skin feeling increasingly sensitive and reactive. These changes are thought to be related, at least in part, to hormonal fluctuations and the vasomotor changes that occur during this stage of life.
Dr Phillips takes hormonal changes into account when assessing and treating rosacea, tailoring management to your symptoms, rosacea subtype and stage of life. Treatment may include prescription medication, laser therapy and practical measures to help reduce flushing and improve symptom control.
If you have noticed your rosacea worsening during the perimenopause or menopause, book a consultation with Dr Derrick Phillips to discuss a personalised treatment plan.
Rosacea and Demodex
Demodex mites are microscopic organisms that live naturally within the hair follicles of the skin. Patients with rosacea often have higher numbers of these mites, and they are thought to contribute to inflammation in some individuals. Where Demodex is suspected to be an important factor, treatment may include topical ivermectin (Soolantra®), which reduces Demodex populations while also exerting anti-inflammatory effects. Dr Phillips considers this treatment where it is clinically appropriate, particularly in patients whose rosacea has not responded as expected to other therapies.
If your rosacea has not responded as expected to treatment, book a consultation with Dr Derrick Phillips to determine whether Demodex-associated rosacea may be contributing to your symptoms.
Rosacea or something else?
Rosacea is commonly mistaken for, and can also overlap with, several other conditions:
Acne
Spots can look similar
Acne includes blackheads and whiteheads, which rosacea does not. The two can coexist.
Seborrheic dermatitis
Redness & flaking
Common around the nose, eyebrows and hairline, and can occur alongside rosacea.
Perioral dermatitis
Around the mouth & chin
Papules and pustules around the mouth and chin, often linked with steroid use.
Contact dermatitis
Reaction & sensitivity
Allergic or irritant reactions can cause redness and sensitivity that resemble rosacea.
Why an accurate diagnosis matters
The distinction matters clinically: rosacea, acne and seborrheic dermatitis each require a different treatment approach, and using the wrong one doesn't just fail to help — it can actively aggravate the skin and delay the correct diagnosis by months or years. Book a consultation to understand your conditions and get on the right treatment plan.
Unsure what’s causing your symptoms?
Book a consultation to get a clear diagnosis and personalised treatment plan.
How rosacea is treated
Treatment is matched to the dominant features and may include one or more approaches.
Rosacea is a long-term condition, so treatment is reviewed regularly and adjusted as your symptoms and skin change over time.
Trigger management and skincare
Identifying and avoiding personal triggers (sun, heat, alcohol, stress, spicy food) and using a gentle, barrier-supporting routine that doesn't aggravate sensitivity.
Topical prescriptions
Metronidazole, azelaic acid or ivermectin for redness and papules, depending on the subtype.
Oral antibiotics
For moderate-to-severe papulopustular rosacea, used for a defined course.
Laser and light treatment
For persistent redness, flushing and visible vessels, the Lutronic Derma V and Stellar M22 IPL are often the most effective step, and can achieve results that prescription treatment alone cannot.
Sunscreen
Essential for all rosacea patients; Dr Phillips advises on formulations that protect without triggering sensitivity.
What to expect at a rosacea consultation
Your consultation begins with a comprehensive assessment of your skin, medical history and any identifiable triggers. Dr Phillips will explain your rosacea subtype, discuss realistic expectations and develop an individualised treatment plan. Because rosacea is a long-term condition, follow-up appointments allow treatment to be reviewed and refined over time, with skincare, prescription treatments and, where appropriate, laser therapy incorporated according to your clinical response.
Comprehensive assessment
Dr Phillips will assess your skin, medical history and any identifiable triggers.
Diagnosis and discussion
You'll receive a clear explanation of your roscea subtype and what may be contributing to it.
Personalised treatment plan
A tailored treatment plan will be recommended based on your skin, which may include a combination of skincare, prescription and, where appropriate, laser therapy
Ongoing review and follow-up
Because rosacea is a long-term condition, follow-up appointments allow treatment to be reviewed and refined over time, with treatment adjusted as your skin responds.
Why choose Dr Derrick Phillips for rosacea in London
Effective rosacea management begins with an accurate diagnosis, including identification of the rosacea subtype, any overlapping skin conditions and the factors contributing to flare-ups. Dr Phillips provides comprehensive, consultant-led care, combining prescription treatments and laser therapy where appropriate within a single, individualised treatment plan. He has extensive experience diagnosing and treating rosacea across diverse skin tones and tailoring management to the individual, including consideration of factors such as hormonal change, Demodex-associated inflammation and coexisting skin conditions.
Dr Phillips is regularly featured in the national media, providing expert commentary on skin conditions and their treatment. Read his contribution to this Yahoo Life article: How I finally got my rosacea under control.
Dr Phillips's approach to rosacea is built on:
Rosacea is a long-term condition that can usually be managed very effectively with an individualised treatment plan
Accurate diagnosis of the rosacea subtype guides treatment selection
Prescription treatments and laser therapy are combined where appropriate to address the features driving the condition
Ocular symptoms and overlapping skin conditions are assessed as part of a comprehensive evaluation
Particular expertise in diagnosing and treating rosacea across diverse skin tones
Triggers and contributing factors, including hormonal changes and Demodex-associated inflammation, are considered when developing your treatment plan
FAQs
Can rosacea be cured?
No. Rosacea is a long-term condition, but with the right treatment it can usually be controlled very effectively. The aim is to reduce redness, control inflammation, minimise flares and maintain healthy skin with an individualised treatment plan.
What triggers rosacea flares?
Common triggers include sun exposure, heat, alcohol, spicy foods and emotional stress, although triggers vary considerably between individuals. Identifying your personal triggers forms an important part of your treatment plan.
Does laser help rosacea?
Yes. Laser and light treatments can be highly effective for persistent facial redness and visible blood vessels. Devices such as the Lutronic Derma V and Stellar M22 IPL are often used alongside prescription treatment where appropriate.
Is rosacea different in darker skin?
Rosacea can be more difficult to recognise in darker skin tones, where redness may be less apparent and symptoms such as warmth, burning, sensitivity or pigmentation change may predominate. Dr Phillips has extensive experience diagnosing and treating rosacea across diverse skin tones.
Can rosacea affect the eyes?
Yes. Ocular rosacea may cause dryness, grittiness, burning, eyelid irritation and recurrent styes. Because these symptoms can resemble other eye conditions, Dr Phillips assesses for ocular involvement during your consultation and will refer to an ophthalmologist where appropriate.
Is rosacea the same as acne?
No. Although both conditions can cause facial papules and pustules, rosacea does not produce blackheads or whiteheads and is usually associated with persistent facial redness or flushing. The two conditions can also coexist.
What is papulopustular rosacea?
Papulopustular rosacea is characterised by inflammatory papules and pustules that resemble acne but occur on a background of persistent facial redness or flushing. Unlike acne, it does not produce blackheads or whiteheads. Dr Phillips can distinguish between acne and rosacea and identify when the two conditions coexist.
Can menopause make rosacea worse?
Yes. Many women notice that their rosacea changes during the perimenopause and menopause, with flushing becoming more frequent and the skin feeling increasingly sensitive and reactive. Dr Phillips takes these changes into account when tailoring treatment.
Will my redness return after laser treatment?
Laser treatment can produce significant and long-lasting improvement in redness and visible blood vessels, but it does not cure rosacea. Because rosacea is a long-term condition, maintenance treatment is often recommended to help preserve the results over time.
Explore knowledge base
Learn more about rosacea, common triggers and available treatment options through Dr Derrick Phillips' expert videos and articles. Browse trusted information to help you better understand your skin and manage flare-ups with confidence.