The DM:
Dear derm,
My rosacea always gets worse in the summer and I have a lot more flare ups. How can I avoid this?
Yvonne S
The Derm:
Dr Sina Ghadiri, Consultant Dermatologist and founder of Sinaesthetics
The Diagnosis:
Dear Yvonne,
Rosacea is a chronic inflammatory skin condition that most commonly affects the central face, particularly the cheeks, nose, forehead and chin, but it can present in a variety of patterns and severities. It typically emerges between the ages of 30 and 60 and while it can affect all skin types, it’s most frequently seen in individuals with fair skin.
As a dermatologist, I see rosacea regularly in clinic. Patients often report persistent redness, visible blood vessels, papules, pustules and in some cases, burning, stinging, or sensitivity to skincare products. In certain subtypes, there may also be thickening of the skin, especially around the nose or involvement of the eyes, which can cause irritation and dryness.
Here’s what you need to know…
Why is my rosacea worse in summer?
The underlying causes of rosacea, like many skin conditions, are complex and multifactorial. Genetics can contribute to a person’s susceptibility, and several well-known triggers – such as sunlight/UV radiation, spicy foods, alcohol, caffeine and smoking – may influence inflammatory pathways through their effects on certain neurotransmitters (chemical messengers that transmit signals between nerve cells) and this explains why flares during summer can be worse.
Immune system malfunction can further exacerbate the condition and in some individuals, heightened sensitivity to stimuli like heat or sunlight can lead to burning or stinging sensations, a presentation sometimes referred to as ‘neurogenic rosacea’. Additionally, research has suggested links to changes in gut microbiota and the overgrowth of a tiny skin mite known as Demodex.
How to prevent rosacea flare-ups
Trigger avoidance, including using a high factor sunscreen which includes visible light protection is essential.
Establishing a gentle skincare routine with fragrance-free cleansers and moisturisers designed for sensitive or rosacea-prone skin can make a big difference. It’s best to avoid products particularly containing certain alcohols (like denatured alcohol, ethanol and isopropyl alcohol), menthol, or strong exfoliants, as these can irritate the skin in people with rosacea.
For some patients, treating Demodex mites may be helpful, and dermatologists can formulate prescribed protocols for patients to specifically address this.
Ingredients to consider
A powerful anti-inflammatory and antimicrobial ingredient, azelaic acid helps calm redness, reduce swelling and smooth bumpy skin. Commonly found in 10-20% concentrations in prescription and over-the-counter creams.
A calming, barrier-strengthening ingredient that helps reduce flushing, blotchiness, and irritation. Typically used at 2-5% concentrations in moisturisers and serums, niacinamide is gentle and well-tolerated – even in sensitive skin.
A prescription-only topical treatment containing 1% ivermectin, Soolantra is commonly used to manage inflammatory rosacea, especially when redness, bumps, and pustules are present. It’s particularly effective in cases associated with Demodex mite overgrowth. To access it, you’ll need to consult a specialist pharmacist, dermatologist or primary care physician.
A prescription-only topical treatment with anti-inflammatory and antibacterial properties. Metronidazole (0.75% or 1%) helps calm redness, reduce inflammation, and target the pimples commonly seen in rosacea. To access it, you’ll need to consult a specialist pharmacist, dermatologist or primary care physician.
Derm-recommended treatments
For over-the-counter options, I really like the Facetheory Blemicalm Azelaic Acid 10% Clarifying Serum, it’s effective yet gentle at the highest possible percentage for azelaic acid over the counter, helping to calm inflammation. When it comes to sun protection, the La Roche-Posay Anthelios Pigment Correct SPF50+ is a standout choice for rosacea-prone skin to cover the visible light spectrum.
A good barrier-supporting, fragrance-free moisturiser is also essential. I often recommend The Inkey List Omega Water Cream, which is lightweight, hydrating and includes 5% niacinamide to help soothe redness and support the skin barrier.
Got a skin question for our derms? Drop us a DM at @glamouruk.
