Occular Rosacea 

Ocular rosacea is a form of rosacea that affects the eyes and eyelids, and it can occur with or without obvious facial symptoms. Patients may experience dry, gritty or irritated eyes, redness, watering, burning, sensitivity to light, or a feeling of something in the eye. The eyelids can become inflamed, leading to swelling, crusting, or recurrent styes. Ocular rosacea is caused by inflammation affecting the delicate tissues around the eyes and may flare with the same triggers as facial rosacea, such as heat, sun exposure, alcohol and stress. Although it is not contagious, it is important to recognise and treat ocular rosacea early, as ongoing inflammation can affect eye comfort and, in more severe cases, impact the surface of the eye. If symptoms are persistent or worsening, an optician or ophthalmologist assessment is recommended.

What is Rosacea?

People with rosacea often flush more easily than normal and may develop persistent redness across the cheeks, nose and forehead. Some people also notice small red bumps or pus-filled spots (which can look similar to acne) and fine visible blood vessels (“thread veins”). Rosacea is very common and affects a significant number of adults.

Rosacea is a chronic inflammatory skin condition. It is not caused by poor hygiene, it is not a bacterial infection, and it is not contagious. The skin can become more reactive, and flare-ups are often triggered by things such as sun exposure, heat, hot drinks, alcohol, spicy foods, stress, exercise, wind, and irritating skincare products. Not everyone has the same triggers, so learning what affects your skin can make a big difference.

Treatment is aimed at reducing redness, calming inflammation, and improving the skin barrier. For persistent redness and thread veins, vascular laser or LASER can be very effective by targeting the visible vessels and reducing background redness over a course of treatments. For bumps and pustules, medicated topical creams can help settle inflammation and reduce breakouts; these are usually used alongside gentle, supportive skincare.

Daily SPF is essential and can’t be underestimated. UV exposure is one of the most common triggers for flare-ups and can weaken the skin barrier, so a high-quality broad-spectrum sunscreen is one of the most important steps for long-term control. Gentle cleansing, barrier-supporting moisturisers, and avoiding harsh actives or over-exfoliation also help reduce sensitivity.

There is also emerging discussion around protecting rosacea-prone skin from environmental irritants and pollution, particularly in the evening. Using a gentle cleanser to remove the day’s build-up and applying a barrier-repair moisturiser (and, where appropriate, anti-pollution skincare) may help support inflamed, reactive skin.

We can support you with education, trigger identification, skincare guidance, and a personalised treatment plan to help bring rosacea under control and reduce flare-ups over time.

What’s new…and what we do here at Clinic M….

Emerging research suggests that chronic inflammatory skin conditions, including rosacea, may be influenced not only by genetics but also by epigenetic changes—chemical “switches” that control how genes are expressed in response to lifestyle and environmental factors. Epigenetic regulation can be affected by stress, diet, sleep quality, UV exposure, hormones, alcohol, smoking, pollution and gut health, all of which may contribute to persistent low-grade inflammation. In clinical practice, certain inflammatory and metabolic markers can help assess overall systemic inflammation and inflammatory load, including C-reactive protein (hs-CRP), ESR, ferritin, fasting insulin, HbA1c, lipid profile, and markers linked to oxidative stress and cardiovascular inflammation. In some cases, further investigation into vitamin D, B12, folate, thyroid function, and gut-related inflammation may also be helpful. While epigenetic testing is still evolving and is not yet diagnostic, combining symptom patterns with relevant blood markers can provide a broader picture of inflammatory drivers and help guide targeted lifestyle and treatment strategies aimed at reducing systemic inflammation and improving skin resilience.

Rhinophyma

Rhinophyma is a more advanced form of rosacea in which the skin of the nose gradually becomes thickened, enlarged and uneven due to chronic inflammation and sebaceous gland overgrowth. Early prevention focuses on controlling underlying rosacea with appropriate skincare, trigger avoidance, daily SPF, and prescription treatments to reduce inflammation and flare-ups. Once rhinophyma develops, topical creams alone are usually not sufficient, and treatment often involves procedural options such as CO₂ laser resurfacing, surgical sculpting, electrosurgery, or dermabrasion to reshape the nose and remove excess tissue. Early intervention is important, as treatment is typically more effective before significant thickening occurs.

Micro-needling and Rosacea?

There’s no strong clinical evidence that microneedling improves the core features of rosacea (redness, flushing, vessels, papules/pustules), and it may provoke irritation in sensitive skin. It’s not a standard or recommended treatment for rosacea itself, though it may have a role in addressing secondary skin texture concerns under expert guidance; otherwise my advice would be to not risk that treatment.

How can Clinic M help?

We can support you with education and a personalised plan, including:

• DNA Skin and Skin Analysis to identify areas of immediate concern
• Understanding your rosacea type and trigger
• A tailored educated and evidenced skincare routine to protect the barrier
• Medical topical options for inflammatory breakout
• Laser/light treatment options for redness and thread veins

We offer carefully selected regimes from Obagi and AllSkinMed, chosen for their evidence-based formulations and suitability for sensitive, inflammatory skin. Both brands provide products that focus on barrier support, gentle anti-inflammatory action, and hydration, helping to calm heat and discomfort while restoring resilience to compromised skin. These regimes are integrated into personalised treatment plans based on your symptoms, lifestyle and rosacea subtype.

Our clinically proven approach combines advanced topical treatments with professional guidance to reduce flare-ups, minimise redness and protect against environmental and inflammatory triggers. With the right regimen and ongoing support, many patients experience meaningful relief from heat, pain and the long-term effects of rosacea.

Helpful information to the Rosacea Society can be found by following this link