Facial Redness – Could It Be Rosacea?
I am Dr. Manami Hayama, board-certified dermatologist.
At our clinic, we often see patients who come in for cosmetic consultations because they are concerned about facial redness.
When thinking about facial redness, we usually consider whether it is caused by vascular dilation or inflammation. One condition that falls under this category is rosacea, and I’d like to share some information about it here.
For some people, realizing that their persistent redness is actually rosacea can be eye-opening, and it may lead to effective improvement through appropriate treatment and skincare.
What Is Rosacea?
Rosacea is a chronic inflammatory skin disease characterized by persistent facial redness and small bumps or pustules.
In Japan, it is often misunderstood as simply “red face,” and it can easily be confused with acne or eczema.
However, rosacea differs in its mechanisms, aggravating factors, and treatment, which makes accurate diagnosis essential.
I hope this article will serve as a helpful reference for those researching rosacea or struggling with long-lasting facial redness.
Epidemiology
Rosacea is seen worldwide but is most common among adults in their 30s to 50s, with a slightly higher prevalence in women—though the rhinophyma subtype tends to occur more in men.
In Western countries, it is more frequent among people with fair skin, but cases are also increasing in Asian populations, including Japan. In darker skin tones, redness may be less noticeable, making diagnosis more difficult.
Depending on the study, prevalence in Western countries ranges from 5–10% of adults.
In Japan, the rate is lower, but due to lifestyle and increased UV exposure, patient numbers are rising.
Because rosacea is a chronic condition—even mild forms can persist for years—early diagnosis, lifestyle management, and treatment are essential.
Pathophysiology (Causes and Mechanisms)
Rosacea is not just “red skin” but a condition caused by multiple overlapping factors:
-
Vascular abnormalities – capillaries dilate easily, and redness worsens with triggers such as UV, temperature changes, and alcohol.
-
Skin barrier dysfunction – leading to dryness, irritation, and heightened sensitivity to external stimuli.
-
Immune dysregulation – overactivity of the antimicrobial peptide cathelicidin and proliferation of Demodex mites contribute to inflammation.
-
Neurogenic factors – TRPV1 receptor activity can cause flushing, burning, or stinging sensations.
Sebaceous gland activity is also involved. Excess oil can worsen papules and pustules by promoting Demodex growth, while too little oil increases dryness and barrier damage—making balance critical.
How to Identify Rosacea
Typical features include:
-
Persistent redness lasting for months
-
Symmetrical distribution on the cheeks, nose, forehead, and chin (usually sparing the eye area)
-
Visible capillaries
-
Red bumps or small pustules (but rarely comedones, unlike acne)
-
Burning, stinging, or flushing sensations rather than itching
Compared to eczema, which often involves itchiness, scaling, and crusting, rosacea is dominated by redness, flushing, and sensitivity, often worsening with alcohol or irritation.
Common Triggers
Rosacea often flares with lifestyle or environmental factors such as:
-
Sun exposure
-
Temperature extremes (saunas, hot baths, cold winds, A/C)
-
Alcohol
-
Spicy foods or hot drinks
-
Stress and lack of sleep
-
Intense exercise causing facial flushing
-
Prolonged mask use (moisture and friction)
-
Harsh skincare (peels, scrubs, strong cleansers)
Skincare and Lifestyle for Rosacea
The basics are to avoid triggers and protect the skin:
-
Use lukewarm water and gentle cleansing
-
Choose low-irritant, fragrance-free, alcohol-free skincare
-
Ingredients such as ceramides and azelaic acid are recommended
-
Use non-chemical (mineral-based) sunscreens for sensitive skin
-
Select simple, hydrating moisturizers to protect the barrier
-
Remove makeup gently, without friction
-
Maintain a healthy lifestyle with adequate sleep and moderate exercise (walking, stretching), supporting autonomic balance
Medical Treatment and Guidelines
According to the Japanese Dermatological Association’s Rosacea Guidelines:
-
Topical therapy: metronidazole, oxytetracycline, etc. are covered by insurance
-
Oral antibiotics: doxycycline or minocycline are effective for papulopustular rosacea and help prevent relapse
-
Laser therapy: vascular lasers (such as V-beam) and IPL are recommended for prominent redness and telangiectasia
Advanced Private Treatment
At our clinic, we also offer Advatx laser therapy, which targets both vascular dilation and sebaceous gland activity—two key elements of rosacea.
This makes it an excellent treatment option not only for rosacea but also for other forms of persistent facial redness.
Book a Consultation Today
📲 Follow us for updates! BIANCA international Instagram
🔹 How to Book Your Appointment
Click the link below and fill the form with your concerns, referral code if you have any and day/time preferred.
📝 Note: All consultations, treatments, and follow-up visits include free translation services—no extra fees!
Clinic Locations
📍 Ginza Clinic
12F Ginza ONE, 1-8-19 Ginza, Chuo-ku, Tokyo, Japan
☎ 050-3196-4834
🚇 Access:
🚶♀️ A 4-minute walk from Ginza Station on the Tokyo Metro Ginza Line.
🚶♀️ A 1-minute walk from Exit 7 of Ginza-itchome Station on the Tokyo Metro Yurakucho Line.
🚶♀️ A 3-minute walk from Exit 3 of Kyobashi Station on the Tokyo Metro Ginza Line.
🚶♀️ An 8-minute walk from the Kyobashi Exit of JR Yurakucho Station.
📍 Omotesando Clinic
Minami-Aoyama 511 Building 2F, 5-11-10 Minami-Aoyama, Minato-ku, Tokyo, Japan
☎ 050-1807-1593
🚇 Access:
🚶♀️ A 5-minute walk from Exit B1 of Omotesando Station on the Tokyo Metro Ginza Line, Hanzomon Line, and Chiyoda Line.
Consultation Hours: 10:00–19:00 Closed: Irregular holidays
About BIANCA Clinic
At BIANCA, we redefine beauty care by offering a holistic approach that transcends traditional cosmetic surgery and dermatology. 20 specialized doctors in different fields including plastic surgery, dermatology, internal medicine, regenerative medicine, gynecology will carefully listen to your needs and help you to enhance your beauty and wellness from the inside out. We are committed to creating personalized treatment plans with precision and care, and ensuring you experience the true spirit of Japanese omotenashi and hospitality.