Understanding Rosacea...
Rosacea is not one condition — it is a collection of overlapping features that present differently in every person. Identifying your dominant phenotype is the foundation of effective, targeted treatment.
What is Rosacea?
Rosacea is a chronic inflammatory skin condition affecting predominantly the face. It is more common than many people realise — affecting an estimated one in ten people in the UK — and is significantly underdiagnosed, particularly in skin of colour where redness may not be the presenting feature.
It most commonly affects the cheeks, nose, chin and forehead, and can involve the eyes. Triggers including heat, sun exposure, alcohol, spicy food, stress and certain skincare products can provoke flares — but triggers vary widely between individuals.
Rosacea cannot be cured, but with accurate diagnosis and appropriate treatment it can be very well controlled.
If you suspect you have rosacea, a consultant-led assessment is the most important first step.
Persistent redness & flushing
Vascular Rosacea
The vascular phenotype is characterised by persistent central facial redness and episodic flushing — a sudden, intense sensation of heat and redness that may last minutes to hours. Visible superficial blood vessels, known as telangiectasia, are also common.
Inflammatory Rosacea
Papules & pustules
The inflammatory phenotype presents with recurrent papules and pustules — red bumps and pus-filled spots — distributed across the central face. It is frequently mistaken for acne, and the distinction matters enormously because the treatments differ significantly.
Unlike acne, inflammatory rosacea is not driven by blocked pores or excess sebum. It is an inflammatory and neurovascular condition, and treating it as acne — with comedolytic agents or certain topical retinoids — can worsen symptoms.
Accurate diagnosis is essential. Management typically involves a combination of prescription topical agents, oral anti-inflammatory therapies and trigger identification.
If you've been treated for acne that hasn't improved, rosacea may be the correct diagnosis.
Phymatous Rosacea
Skin thickening & texture changes.
The phymatous phenotype involves progressive thickening and irregular texture of the skin, most commonly affecting the nose — a condition known as rhinophyma. It can also affect the chin, forehead, cheeks and ears.
More common in men, phymatous change develops gradually and is often not recognised as rosacea by patients or, in some cases, by non-specialist clinicians. Early identification and treatment of the underlying inflammatory component can slow progression significantly.
Established phymatous change may require procedural intervention alongside medical management. Dr Khan will assess the extent of involvement and guide appropriate treatment options.
Phymatous rosacea is treatable. Earlier intervention leads to better outcomes.
Ocular Rosacea
Eye involvement
Rosacea frequently affects the eyes — causing redness, irritation, burning, grittiness and light sensitivity. Ocular rosacea is present in a significant proportion of patients with skin rosacea, yet it is often overlooked or attributed to other causes.
In some individuals, ocular symptoms precede skin involvement entirely, making diagnosis challenging without specialist awareness. Blepharitis — inflammation of the eyelid margins — is a common associated feature.
Management requires a coordinated approach, and Dr Khan will identify when onward referral to ophthalmology alongside dermatological treatment is appropriate.
Rosacea in Skin of Colour
Frequently missed. Rarely discussed.
Rosacea in darker skin tones is significantly under diagnosed - in large part because the hallmark feature of facial redness may not be visible. Instead, patients may present with a burning or stinging sensation, papules and pustules, skin sensitivity or persistent irritation without an obvious cause.
Post-inflammatory pigmentation can also complicate the picture, creating a presentation that may be confused with melasma, acne or contact dermatitis. The diagnostic challenge is real, and it requires clinical experience with diverse skin tones.
Dr Khan has specific expertise in dermatological conditions across a broad range of skin types, developed through clinical training across multiple continents.
A missed diagnosis means years of ineffective treatment. Expert assessment changes that.