Supporting Patients with Rosacea:

Rosacea is a common chronic inflammatory skin condition, estimated to affect approximately 5.5% of the global adult population. For clinics, it can present both a treatment challenge and an opportunity to provide valuable long-term support.

Patients may initially report occasional flushing, sensitivity or warmth before more persistent redness becomes apparent. Others may seek help for visible vessels or acne-like lesions that they have unsuccessfully treated as conventional acne.

Although rosacea cannot be cured, professional guidance, appropriate treatment and consistent homecare can make a meaningful difference to the appearance and comfort of redness-prone skin.

Rosacea is associated with vascular dysregulation and inflammation, causing the facial blood vessels to respond more readily to internal and external stimuli.

Its presentation can vary considerably, but commonly recognised forms include:

• Erythematotelangiectatic rosacea, characterised by persistent redness, flushing and visible facial vessels.
• Papulopustular rosacea, which presents with redness alongside papules and pustules and can sometimes be mistaken for acne.
• Phymatous rosacea, associated with thickening and textural changes in the skin, most commonly around the nose.
• Ocular rosacea, which affects the eyes and eyelids and may occur alongside, or before, visible facial symptoms.

Rosacea and acne can look similar and may occasionally coexist, but they are different conditions and require different management strategies.

Clinic professionals should remain within their scope of practice and avoid diagnosing rosacea unless appropriately qualified. Where symptoms are severe, unusual or involve the eyes, patients should be advised to consult their GP, dermatologist or another suitably qualified medical professional.

The precise cause of rosacea is not fully understood. Current research indicates that several factors may be involved, including an overactive immune response, increased vascular reactivity, genetic predisposition and, in some individuals, a higher density of Demodex mites.

Rosacea can occur at any age but is frequently diagnosed in adults between the ages of 45 and 60.

Understanding the inflammatory and vascular nature of the condition can help practitioners avoid overly aggressive protocols that may compromise the skin barrier or intensify visible redness.

Triggers differ between patients, making a detailed consultation an important part of any professional approach.

Frequently reported triggers include:

• Sun exposure
• Cold weather, wind and sudden changes in temperature
• Alcohol, particularly red wine
• Spicy foods and hot drinks
• Emotional stress
• High-intensity exercise or activities that increase body temperature
• Harsh exfoliants, fragranced products and alcohol-based toners

Encouraging patients to keep a simple diary of their symptoms can help identify patterns between flare-ups, lifestyle factors, skincare products and environmental exposure.

This creates an opportunity for the practitioner and patient to develop a realistic, personalised management plan rather than relying on a generic list of restrictions.

A thorough consultation should explore more than the visible appearance of the skin. Consider asking about:

• When the redness first appeared and whether it is persistent or intermittent
• Sensations of heat, burning, itching or stinging
• Known lifestyle, environmental or dietary triggers
• Current prescription and non-prescription skincare products
• Previous professional treatments and how the skin responded
• Any history of allergic reactions or impaired barrier function
• Eye irritation, dryness, swelling or recurring eyelid problems
• Current medical care or prescribed treatment for rosacea

Photographs can provide a useful baseline for monitoring progress, provided the patient has given appropriate consent. Clinics should also set realistic expectations: the goal is to help manage visible redness, sensitivity and flare-ups rather than promise a permanent cure.

When recommending homecare, practitioners should consider the complete formulation, product strength and condition of the patient’s skin rather than assessing an ingredient in isolation.

Azelaic acid

Azelaic acid is widely used in the management of rosacea-prone skin. It offers anti-inflammatory benefits while helping to improve uneven tone and texture.

Peptides

Certain peptides, including tetrapeptide-14, may help regulate inflammatory pathways associated with visible redness.

Antioxidants

Antioxidants such as vitamin C and extracts of green, white and red tea help defend the skin against free-radical damage that can contribute to inflammation.

Glycolic acid

Glycolic acid provides exfoliating, moisturising and skin-renewing benefits. When correctly formulated and introduced appropriately, it may form part of a professional programme for some redness-prone patients.

Tolerance should always be assessed, particularly where the skin barrier is compromised or the patient is experiencing an active flare.

Salicylic acid

Salicylic acid offers exfoliating and anti-inflammatory properties. As with other active ingredients, its suitability should be assessed individually and introduced carefully.

Broad-spectrum SPF

Daily broad-spectrum sun protection should be a central part of every rosacea-focused homecare programme. UV exposure is one of the most consistently reported triggers, making daily SPF an essential recommendation rather than an optional addition.

The Marini SkinSolutions approach combines the Skin Care Management System™ with RosaLieve® Redness Reducing Complex to support multiple concerns associated with redness-prone skin.

Bioglycolic® Face Cleanser

Bioglycolic Face Cleanser provides thorough cleansing and gentle resurfacing without relying on traditional soap-based cleansing agents. It helps prepare the skin for the products applied afterwards and can support improvements in texture and clarity.

C-ESTA® Face Serum

C-ESTA Face Serum provides antioxidant support through a lipid-soluble form of vitamin C combined with DMAE. It can help improve the appearance of skin tone, texture and firmness while supporting protection against environmental free radicals.

Bioclear® Face Cream

Formulated with glycolic, salicylic and azelaic acids, Bioclear Face Cream supports improvements in uneven texture, congestion and discolouration.

For reactive patients or those who are new to active ingredients, practitioners may wish to introduce Bioclear gradually and monitor tolerance closely.

Antioxidant Daily Face Protectant SPF 30

Antioxidant Daily Face Protectant SPF 30 provides daily broad-spectrum protection alongside antioxidant support. Consistent use can help minimise exposure to one of the most common triggers of rosacea flare-ups.

RosaLieve® Redness Reducing Complex

RosaLieve is designed to address unwanted facial redness and flushing directly. Its formula combines azelaic acid and tetrapeptide-14 with calming ingredients including oat extract, green, white and red tea extracts, and Boswellia serrata.

It can be incorporated into a wider Skin Care Management System to support a calmer, more even-looking complexion over time.

Patients with redness-prone or reactive skin may not be ready to begin an entire programme at once.

A phased introduction allows the practitioner to monitor tolerance and identify any product that may be contributing to irritation. Depending on the patient’s skin, this could involve introducing the cleanser first, followed by antioxidant support, a targeted treatment product and daily SPF.

Allowing one or two weeks between additions may be helpful for particularly reactive patients.

Instructions should be clear and specific. Advise patients how much product to apply, how frequently to use it and what level of response is expected. They should also know when to reduce frequency, stop using a product or contact the clinic for advice.

Professional treatments may help improve the appearance of vascular redness, but the patient’s homecare programme remains an important part of the overall strategy.

A controlled study involving 30 subjects with mild to moderate erythematotelangiectatic rosacea compared laser treatment alone with laser treatment combined with daily use of the Skin Care Management System and RosaLieve.

The combined approach was reported to be statistically superior to laser treatment alone. The addition of the topical programme enhanced results by an amount comparable to, or greater than, an additional laser session.

This supports the value of pairing carefully selected professional treatments with consistent, evidence-led homecare.

Before carrying out laser, light-based treatments, chemical peels or other advanced procedures, practitioners should assess the current condition of the skin, establish whether symptoms are stable and check for relevant contraindications.

Treatment intensity and homecare may also need to be adjusted before and after a procedure to minimise unnecessary irritation.

Rosacea management requires consistency. Clinics can improve patient compliance by explaining the purpose of each product and keeping the recommended routine manageable.

Follow-up appointments allow practitioners to:

• Review the patient’s response to treatment and homecare
• Monitor changes using consistent photography
• Adjust active ingredients or frequency of use
• Reinforce the importance of daily SPF
• Identify new triggers or seasonal changes
• Recommend medical assessment where symptoms require further investigation

With professional guidance, realistic expectations and a personalised programme, clinics can help patients achieve calmer, more comfortable and more even-looking skin while building trust and encouraging long-term treatment compliance.

Hampton, P. J., et al. “British Association of Dermatologists guidelines for the management of people with rosacea 2021.” British Journal of Dermatology, 185(4), 725. https://academic.oup.com/bjd/article/185/4/725/6599936↩

American Academy of Dermatology. “Rosacea: Causes.” https://www.aad.org/public/diseases/rosacea/what-is/causes

American Academy of Dermatology. “Rosacea: Causes.” https://www.aad.org/public/diseases/rosacea/what-is/causes

WebMD. “18 Common Rosacea Triggers.” https://www.webmd.com/skin-problems-and-treatments/18-common-rosacea-triggers↩

MDedge Dermatology. “Combined laser-topical therapy improves erythema associated with rosacea.” https://www.mdedge.com/dermatology/article/198848/rosacea/combined-laser-topical-therapy-improves-erythema-associated↩