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Skin Condition · Kensington, London
Rosacea: Diagnosis, Subtypes and Treatment in Kensington
Rosacea is a long-term inflammatory condition of the central face, causing flushing, lasting redness, visible blood vessels and, in some people, red or pus-filled spots — never blackheads. It usually begins after the age of thirty and flares in response to triggers. Dr Prasad diagnoses and treats rosacea at Faciem Dermatology & Medical Clinic in Kensington, London.
- Four subtypes, treated differently
- Diagnosis by a GMC-registered doctor
- Kensington Church St, London
- Medically reviewed by Dr Prasad
This page explains how rosacea is diagnosed, how the four subtypes differ, and how each one is treated at Faciem. It is checked for clinical accuracy.
Last reviewed: 12 September 2026.
Patient information only. Rosacea has several distinct subtypes that respond to different treatment, so any plan follows a face-to-face consultation with Dr Prasad.
Patients since 2019
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TL;DR
Rosacea is a chronic inflammatory condition of the central face: flushing, lasting redness, visible vessels and, in some subtypes, inflammatory spots. Four patterns are recognised and each responds to different treatment, which is why rosacea is one of the most misdiagnosed facial conditions. Heat, alcohol, spiced food, stress and sunlight provoke flares in most people. Rosacea is controlled, not cured, and treating it early aims to prevent the skin thickening that long-standing inflammation can cause. Diagnosis at Faciem is by Dr Prasad, a GMC-registered doctor.
- Central face redness, never blackheads
- Four subtypes, four approaches
- Controlled, not cured
About the Condition
What Is Rosacea?
Rosacea is a chronic inflammatory skin condition of the central face — the cheeks, nose, chin and forehead. It combines abnormally reactive blood vessels with inflammation, so episodes of flushing gradually settle into persistent redness, often with visible thread veins and, in some subtypes, red papules and pus-filled spots.
What are the four subtypes of rosacea?
Rosacea is described in four patterns, and many people have features of more than one. Erythematotelangiectatic rosacea is flushing and fixed redness with visible thread veins, on skin that stings or burns easily. Papulopustular rosacea adds red bumps and pus-filled spots across the same central area, and this is the pattern most often mistaken for acne. Phymatous rosacea is gradual thickening of the skin, usually on the nose, where oil glands enlarge and the tissue coarsens over years. Ocular rosacea affects the eyes and lids — grittiness, dryness, redness and recurrent styes — and it can arrive before any visible change in the skin. Which pattern predominates decides the treatment, so naming the subtype is the first job of a consultation.
Who gets rosacea?
Rosacea usually begins between the ages of thirty and fifty. It is diagnosed more often in people with fair skin who flush easily, and more often in women, though men are more likely to develop the thickened phymatous form. A family history is common. Rosacea is also under-recognised in deeper skin tones, where redness reads as a subtle warm or dusky change against the surrounding skin and is easily missed or put down to something else, so people with brown and black skin are often diagnosed later, once more change has accumulated. Warmth, burning, swelling and gritty eyes can be more reliable clues in those cases than visible redness. Skin tone is recorded on the Fitzpatrick scale at the consultation, because it changes both how rosacea looks and how vascular laser is set. Fitzpatrick I to III skin flushes visibly and burns easily; Fitzpatrick IV to VI skin can still be treated with vascular laser, but the wavelength, energy and cooling are adjusted, longer intervals are left between sessions, and a patch test carries more weight — the risk being managed in deeper tones is post-inflammatory pigmentation rather than the vessels themselves.
What is rosacea mistaken for?
Rosacea is misdiagnosed more often than most facial conditions, and being treated for the wrong thing is a common reason people arrive frustrated. Acne is the usual confusion, but acne produces blackheads and whiteheads while rosacea does not, and acne generally starts in adolescence, not after thirty. Perioral dermatitis clusters small bumps around the mouth and nose, often following topical steroid use — and steroids make rosacea worse. Seborrhoeic dermatitis, which is more common on oily skin, produces redness with greasy flaking around the nose and brows. Lupus causes a butterfly rash over the cheeks and nose, but tends to spare the folds beside the nose, which rosacea involves.
Causes & Contributing Factors
What Causes Rosacea?
The cause of rosacea is not fully established. What is clear is that facial blood vessels behave abnormally and the skin mounts an inflammatory response, with genetics, immune function, the Demodex mite and environmental exposure all appearing to contribute. Triggers do not create rosacea; they set off flares in skin already predisposed to it.
Blood vessel reactivity
Facial vessels in rosacea dilate more readily and are slower to return to normal. Years of repeated flushing appear to leave some vessels permanently widened, which is how episodic flushing turns into fixed redness and visible thread veins.
Inflammation and immune response
An overactive innate immune response drives the papules and pustules of papulopustular rosacea. Because the process is inflammatory, anti-inflammatory treatment frequently helps where anti-bacterial approaches alone do little.
Demodex mites
Demodex mites live in the follicles of most adults, but are present in greater numbers in rosacea-affected skin. Whether they provoke the inflammation or simply thrive in it is unsettled, though treatments that reduce them do help some people.
Genetics
Rosacea runs in families, and a tendency to flush easily is often there long before anyone calls it rosacea. Family history is among the more consistent risk factors identified.
Environmental triggers
Sunlight, heat, cold wind, alcohol, spiced food, hot drinks, exercise and emotional stress all provoke flares. Which of them matter differs from person to person, so identifying your own set is more useful than working through a general list.
Treatments We Offer
How Rosacea Is Treated at Faciem
Rosacea treatment follows the subtype. Fixed redness and visible vessels need a vascular approach, inflammatory spots need an anti-inflammatory one, and thickened skin needs something different again. The shared aim is to calm vessel reactivity, reduce inflammation and protect a skin barrier that is usually more reactive than average.
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Medical-Grade Skincare
Rosacea-prone skin has a compromised barrier and reacts badly to products that suit other skin types. A regime chosen for rosacea calms the surface and supports the barrier, and for some people it reduces how much prescription treatment is needed alongside it.
Best for: sensitivity, barrier repair and daily control
Read about Medical-Grade Skincare
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Laser Thread Vein Removal
Vascular laser targets the dilated vessels and fixed redness that stay put between flares, which creams do not reach. It treats the vascular half of rosacea; the inflammation is treated alongside it, or the vessels come back. Settings are chosen against your Fitzpatrick skin type, with a patch test first on deeper skin tones.
Best for: thread veins and redness that persists between flares
Read about Laser Thread Vein Removal
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Dermatology Consultation
Rosacea is a medical diagnosis, and prescription treatment is often part of the plan. The consultation establishes which subtype predominates, identifies your triggers, and excludes the conditions that imitate rosacea.
Best for: diagnosis, prescriptions and ongoing review
Read about Dermatology Consultation
Where topical treatment and laser do not achieve control, oral medication may be considered after assessment. Which treatments are used, in what order and how often, is decided face to face with Dr Prasad, and how much any individual improves varies.
When to Seek Medical Advice
When Should You See a Doctor About Rosacea?
See a doctor about rosacea early, because it is progressive and frequently misdiagnosed. Central facial redness that persists after the age of thirty, especially with flushing or stinging, should be examined before it is treated as acne or written off as sensitive skin.
Worth getting checked
- Redness that stays on the cheeks, nose, chin or forehead
- Flushing that lasts longer, or happens more often, than it used to
- Gritty, dry, red or repeatedly infected eyes alongside facial redness
- Skin on the nose that is thickening or becoming coarse in texture
Conditions that can look similar
- Acne, perioral dermatitis, seborrhoeic dermatitis and lupus can all look like rosacea, and topical steroids — sometimes prescribed for one of those — make rosacea worse. Eye symptoms need assessing, since ocular rosacea can affect vision if it is left untreated. Any facial rash accompanied by fever, joint pain or feeling generally unwell should be seen promptly.
Self-Care & Prevention
Managing Rosacea Between Flares
The most useful thing you can do at home for rosacea is work out your own triggers, since they differ so much between people. After that the priorities are daily sun protection and a plain, gentle routine, because rosacea-prone skin reacts to products that suit other skin types perfectly well.
Do
- Keep a flare diary for four to six weeks — long enough to show which two or three triggers are yours
- Wear broad-spectrum SPF 50 every day, all year — sunlight is the most commonly reported trigger
- Cleanse twice a day, no more, with a fragrance-free product and lukewarm water
- Patch-test any new product on the jawline for five days before putting it on the face
Avoid
- Topical steroids on the face unless prescribed for rosacea itself — even one or two weeks of use commonly leaves it worse on stopping
- Alcohol-based toners, astringents, scrubs and strong acids; introduce one new product at a time, not three
- Saunas, steam rooms and hot baths, and drinks straight off the boil — two or three minutes’ cooling often prevents the flush
- Rubbing and rough towels — pat the face dry, and keep mechanical exfoliation out of the routine altogether
This is general guidance and does not replace an individual assessment. Rosacea triggers differ from person to person, and what suits your skin depends on which subtype predominates.
Why Patients Choose Faciem
Rosacea Diagnosed First, Then Treated by Subtype
Rosacea is treated at Faciem only once the subtype has been established, because the redness, the spots and the thickening each respond to something different. Many people arrive having been treated for acne for years.
- Subtype established before treatment, since each one responds differently
- Examined face to face by Dr Prasad, a GMC-registered doctor
- Rosacea recognised in deeper skin tones, where it is frequently missed
- Your own triggers identified as part of the plan, not left to guesswork
Experience & Expertise
Why Is Rosacea So Often Treated Wrongly?
Rosacea is misdiagnosed more often than almost any other facial condition, and the consequences compound. Treated as acne, it meets drying products that damage an already fragile barrier. Treated as sensitive skin, the vascular and inflammatory components go unaddressed. Treated with topical steroids, it settles briefly and then flares back worse. The changes are progressive too: flushing that comes and goes in your thirties can become fixed redness later, and prolonged inflammation can thicken the skin of the nose and cheeks, which early treatment aims to prevent. In deeper skin tones the diagnosis is missed more often still, because redness is harder to see. Dr Prasad, who has 20 years’ experience in dermatology, establishes the subtype, excludes what imitates rosacea, and treats each component on its own terms.
- Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
- Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
- Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
- Face-to-face medical consultation and examination before any treatment is prescribed
- 20 years’ experience in dermatology, treating inflammatory skin disease across every skin tone
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Rosacea FAQs
Your Questions, Answered
Rosacea raises the same questions in most consultations: what sets a flare off, whether it ever goes for good, and why it spent years being treated as acne. Anything not covered here can be asked at your appointment.
What triggers a rosacea flare-up?
The most commonly reported rosacea triggers are sunlight, heat, cold wind, alcohol, spiced food, hot drinks, exercise and emotional stress. They differ considerably between people, which is why a flare diary kept for four to six weeks beats a general list: it shows which two or three actually matter for you, so you can work around those instead of avoiding everything.
Can I exercise if I have rosacea?
Yes — and it is the heat rather than the exertion that provokes a rosacea flush, so exercise is usually workable with a few adjustments. Train somewhere cool, or outdoors early or late in the day; sip cold water rather than warm; keep a cold damp cloth for the back of the neck; and break a long session into shorter blocks so core temperature has time to drop. Shower cool afterwards. The flush itself typically settles within 30 to 60 minutes of stopping.
How do I get rid of rosacea?
Rosacea is managed, not eliminated. Treatment is matched to whichever features dominate: anti-inflammatory treatment for papules and pustules, vascular laser for visible vessels and fixed redness, barrier-supporting skincare for sensitivity, and trigger avoidance running through all of it. Most people reach good control, though rosacea usually needs ongoing management to hold it there.
Is rosacea permanent?
Rosacea is a long-term condition, so it is better described as controlled than cured. Inflammatory spots often clear well with treatment. Fixed redness and visible vessels respond to vascular laser, not to creams, and thickened skin needs a different approach again. Left untreated, prolonged inflammation can thicken the skin of the nose and cheeks, which is one reason to start early. How much any individual improves varies.
Can I wear makeup if I have rosacea?
Yes, makeup is compatible with rosacea, and covering redness is a reasonable thing to want to do. Choose fragrance-free, non-comedogenic formulas; a green-tinted primer under foundation neutralises redness more efficiently than layering more coverage on top. Skip alcohol-based and heavily fragranced products, and anything that needs vigorous rubbing to remove. Take it off each evening with a gentle fragrance-free cleanser and lukewarm water. After a vascular laser session, leave makeup off the treated area for 24 hours.
How is rosacea different from acne?
Rosacea and acne both produce spots, but rosacea never produces blackheads or whiteheads, and it sits on a background of flushing and redness across the cheeks, nose, chin and forehead. Acne usually starts in adolescence; rosacea typically starts after thirty. The distinction matters because several standard acne products dry and irritate rosacea-prone skin and can make it worse.
What determines the cost of rosacea treatment?
The cost of rosacea treatment depends on which components need treating and for how long. A doctor’s consultation covers diagnosis and any prescription; visible vessels and fixed redness are treated in laser sessions, priced per session and published on our laser thread vein removal page; skincare is costed separately. Your own figure is confirmed before anything goes ahead.
Sources & Further Reading
- Rosacea — symptoms, triggers and treatment — NHS
- Rosacea patient information leaflet — British Association of Dermatologists
- Rosacea — DermNet NZ
These are general patient-information sources and do not replace an individual medical assessment. Your own diagnosis and rosacea treatment plan are established at consultation.
Rosacea in Kensington, London
A Doctor-Led Clinic in the Heart of Kensington
Faciem Dermatology & Medical Clinic sits on Kensington Church St, a few minutes’ walk from High Street Kensington station and around ten from Notting Hill Gate. Rosacea is rarely a one-appointment condition: the first visit settles the diagnosis and the subtype, and later reviews adjust treatment as the skin responds and as triggers shift with the seasons. Because the clinic is open Monday to Saturday, 10am to 7pm, those reviews do not usually cost a day off work.
Plan Your Visit
- Faciem Dermatology & Medical Clinic
- Phone: +44 20 7131 3539
- 7 Kensington Church St, London W8 4LF, United Kingdom
- Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
- Parking: Kensington council underground car park nearby
- Open Monday–Saturday, 10am–7pm · Sunday closed
- Rosacea consultations bookable online; treatment planned once the subtype is confirmed
- Consultation-first — no treatment without medical assessment
- Serving Kensington, Chelsea, Notting Hill & Central London
Continue Exploring
Related Conditions & Treatments
Acne
The condition rosacea is most often mistaken for — and the blackheads, age of onset and pattern that tell the two apart.
Read more →
Eczema & Dry Skin
Barrier-driven inflammation that also leaves skin reactive, and how its dryness and itch differ from rosacea.
Read more →
Oily Skin
Oiliness and seborrhoeic dermatitis often sit alongside rosacea on the same face and are managed separately.
Read more →
Faciem Dermatology & Medical Clinic · Kensington
Book a Rosacea Consultation in Kensington
Dr Prasad will confirm whether it is rosacea, establish which subtype predominates, and plan treatment for the features actually driving it — the redness, the spots or the thickening.
Prefer to talk? +44 20 7131 3539