Medical Dermatology · Burien & Bellevue, WA
Rosacea Treatment
Rosacea affects an estimated 16 million Americans and is one of the most frequently misdiagnosed skin conditions. Our board-certified dermatologists identify your rosacea subtype, uncover your triggers, and create a targeted treatment plan to reduce redness, prevent flares, and protect your skin long-term.
Schedule an AppointmentWhat Is Rosacea?
Rosacea is a chronic inflammatory skin condition that primarily affects the central face — the cheeks, nose, chin, and forehead. It is characterized by persistent redness, visible blood vessels, and in many patients, acne-like bumps that have nothing to do with clogged pores.
Rosacea often begins as a tendency to flush or blush more easily than others. Over time, that redness may become permanent as inflammation damages superficial blood vessels. Without treatment, rosacea is a progressive condition — it tends to worsen gradually, not resolve on its own.
The condition is most common in fair-skinned individuals of Northern and Eastern European descent, though it occurs across all ethnicities and may be harder to recognize in darker skin tones. It typically emerges between ages 30 and 60 and is more prevalent in women — though men tend to develop more severe forms, including rhinophyma (thickening of the skin on the nose).
The Four Subtypes of Rosacea
Rosacea is not a single presentation — it has four recognized subtypes, and patients may have more than one simultaneously:
- Subtype 1 — Erythematotelangiectatic Rosacea: Facial flushing, persistent central redness, and visible broken blood vessels (telangiectasias). Skin may be rough, dry, or very sensitive.
- Subtype 2 — Papulopustular Rosacea: Acne-like breakouts with red bumps (papules) and pus-filled lesions (pustules), alongside persistent redness. Often mistaken for acne vulgaris.
- Subtype 3 — Phymatous Rosacea: Skin thickening and irregular surface changes, most commonly affecting the nose (rhinophyma). More common in men. Can cause significant disfigurement without treatment.
- Subtype 4 — Ocular Rosacea: Affects the eyes and eyelids — causing redness, burning, dryness, blurry vision, and recurring styes (chalazion). Often accompanies skin rosacea.
Common Rosacea Triggers
Triggers don't cause rosacea — but they provoke flares. Identifying and avoiding yours is a critical part of management:
Rosacea Treatment at Dermatology of Seattle
Treatment is tailored to your specific subtype and symptom severity. There is no cure for rosacea, but with the right approach, most patients achieve excellent long-term control.
Topical Medications
- Brimonidine (Mirvaso) — topical gel that constricts blood vessels to quickly reduce facial redness
- Oxymetazoline (Rhofade) — similar mechanism to brimonidine; once-daily application
- Metronidazole (Metrogel, Noritate) — reduces papulopustular lesions and redness
- Azelaic acid (Finacea, Azelex) — reduces bumps, redness, and post-inflammatory discoloration
- Ivermectin (Soolantra) — anti-inflammatory cream effective for papulopustular rosacea
Oral Medications
- Doxycycline (Oracea) — sub-antimicrobial dose; FDA-approved for rosacea; reduces inflammation without promoting antibiotic resistance
- Tetracycline and minocycline — for more severe papulopustular presentations
- Isotretinoin — for severe or refractory cases
Laser & Light Therapy
- Pulsed dye laser (PDL) — targets and destroys visible blood vessels (telangiectasias)
- Intense pulsed light (IPL) — reduces diffuse redness and flushing across larger areas
- Nd:YAG laser — effective for deeper or thicker blood vessels
- CO₂ laser — used to reshape and reduce tissue in rhinophyma (phymatous rosacea)
Skincare & Sun Protection
Daily broad-spectrum SPF 30+ sunscreen is non-negotiable for rosacea patients — sun is the #1 trigger. We recommend gentle, fragrance-free cleansers and moisturizers that reinforce the skin barrier without provoking inflammation.
Rosacea Specialist in Seattle
Left untreated, rosacea progresses. Our dermatologists help patients in Burien and Bellevue find lasting control.
Schedule an AppointmentQuick Facts
- 16 million Americans affected
- Most common in ages 30–60
- 4 distinct subtypes
- Sun is the #1 trigger
- Often misdiagnosed as acne
- Progressive without treatment
Other Conditions We Treat
Frequently Asked Questions About Rosacea
Is rosacea the same as acne?
No, though they can look similar. Rosacea involves persistent facial redness, flushing, and sometimes acne-like bumps — but it is driven by vascular inflammation and immune dysfunction, not clogged pores. Standard acne treatments may actually worsen rosacea. A correct diagnosis from a board-certified dermatologist is essential.
What triggers rosacea flares?
Common triggers include sun exposure (the most frequent), emotional stress, hot weather, wind, alcohol (particularly red wine), spicy foods, hot beverages, strenuous exercise, hot baths or saunas, and certain skincare products with alcohol or fragrance. Triggers are highly individual — keeping a flare diary helps identify yours.
Can rosacea spread beyond the face?
Yes. While rosacea most commonly affects the central face — cheeks, nose, chin, and forehead — it can extend to the neck, chest, and scalp in some patients. Ocular rosacea can also affect the eyes, causing redness, dryness, burning, and in severe cases, vision problems.
Is rosacea permanent?
Rosacea is a chronic condition, meaning it does not go away on its own. However, with the right treatment and trigger avoidance, most patients achieve significant control over their symptoms. Without treatment, rosacea tends to worsen over time — making early intervention important.
Can laser treatment help rosacea?
Yes. Laser and intense pulsed light (IPL) treatments are effective for reducing persistent facial redness and visible blood vessels (telangiectasias) that don't respond to topical medications. These are in-office procedures performed by our dermatologists at Dermatology of Seattle.
What sunscreen should I use if I have rosacea?
The American Academy of Dermatology recommends a broad-spectrum SPF 30 or higher for rosacea patients, applied daily year-round. Mineral sunscreens containing zinc oxide or titanium dioxide tend to be better tolerated than chemical sunscreens. Fragrance-free, non-comedogenic formulas are ideal.
Take Control of Your Rosacea
With the right diagnosis and treatment plan, rosacea doesn't have to control your life. Our Burien and Bellevue dermatologists are ready to help.