Stages of Rosacea

Stages Of Rosacea

Rosacea is an inflammatory skin condition that affects the face, often causing redness, blushing of the skin, and pustules that are similar to acne. The four stages of rosacea each bear their own level of severity and quality of symptoms. Many patients choose to undergo laser rosacea treatment as it can be highly effective in the management of rosacea, regardless of the severity.

This article will explore the different stages of rosacea, helping you understand which stage you may be experiencing and how laser treatment can help.

Our specialists use the Fotona SP Dynamis laser to treat rosacea in her patients. We combines the use of the Nd: YAG and Er: YAG laser modalities to tailor rosacea treatment to patients’ individual needs, reducing the appearance of broken capillaries and rejuvenating skin that may have been damaged by pustules.

Contact the CREO Clinic today and find out how our team can help improve your rosacea symptoms.

Stages Of Rosacea Medically reviewed by Dr. Omar Tillo MD, MS, EBOPRAS, FRCS (Plast)

First Signs of Rosacea

Redness or Blushing

One of the most common early symptoms of rosacea are episodes of facial redness or blushing of the skin. Generally, these episodes will be short-lived and occur after periods of exercise, drinking hot drinks, or eating hot or spicy food.

Early stages of rosacea may resemble sunburn or windburn and are typically focused around the centre of the face – the cheeks, nose, or chin.

Burning, Stinging Feeling From Water or Skincare Products

Rosacea, in its early stages, can present with a sensitivity to water or skincare products such as creams or gels. You may find that splashing water or spreading skin care products on certain areas of your face causes a burning or stinging feeling across your facial skin.

Other Common Symptoms of Rosacea

Some other common symptoms of rosacea are:

  • Swelling on the face, particularly in the area around the eyes
  • Thickening skin on the nose – generally the result of very long-term rosacea
  • Orange or yellowish patches on the face
  • Dry skin on the face
  • Crusty eyelash routes or sore eyelids

Common Triggers For Rosacea

Outbreaks of rosacea symptoms are often triggered by external causes. Some of the most common triggers are:

  • Hot or spicy food
  • UV rays
  • Hot drinks such as tea or coffee
  • Extreme temperatures – hot or cold
  • Periods of aerobic exercise
  • Stress

Do’s and Don’ts To Help Rosacea


There are some steps you can take to help improve your rosacea symptoms. These steps generally focus on avoiding common triggers, for example:

  • Wear high-factor sunscreen
  • Use gentle skincare creams and gels, those specially designed for sensitive skin
  • Undergo sessions of laser rosacea treatment to target redness, burst capillaries, and pustules
  • Clean your eyelids every day to treat possible blepharitis
  • Stay covered up in cold, hot, or sunny weather


  • Do not drink hot drinks like tea or coffee
  • Do not eat spicy foods
  • Do not overdo aerobic exercise
  • Do not drink alcohol

When To See Your General Practitioner

Rosacea typically develops between the ages of 30 and 40 but can show early signs in your 20s. It is important not to ignore early symptoms of the condition, as it can increase in severity over time, causing discomfort and aesthetic concerns. 

Therefore, if you think that you have symptoms of rosacea – blushing and persistent facial redness – it may be time to see a General Practitioner and an aesthetic doctor.  

Our specialists can accurately diagnose your rosacea and its severity in your initial consultation. We can also help patients manage their symptoms with laser treatment. 

What Are The Stages of Rosacea?

Stage 1: Pre-Rosacea

The first stage of rosacea is pre-rosacea. In this stage, you may be experiencing flushing of the skin and redness on your face, but this is mostly only provoked by the common rosacea triggers and will disappear quickly after the trigger is no longer affecting you.

The blood vessels in the face are dilating more than usual as a result of the rosacea triggers, but at this initial stage, there will be no visible damage to blood vessels.

Stage 2: Mild Rosacea

This stage is when rosacea begins to have a more serious effect. The redness you experience after rosacea triggers now goes on much longer than before – half an hour or more after the trigger has disappeared. You may also begin to see some visible damage to the blood vessels on the skin.

Stage 3: Moderate Rosacea

At this stage, the redness in your face may continue for days or weeks after the triggers have disappeared. Rosacea’s effects may be almost permanently visible on the nose, cheeks, and chin. Persistently dilated capillaries (telangiectasia) may now be permanently visible.

A degree of swelling, inflamed postural similar to acne, or inflamed solid papules may be present on the face. As well as being permanently dilated, blood vessels in the face may have become severely damaged by this stage.

Stage 4: Severe Rosacea

As its name states, severe rosacea is the most severe stage of rosacea. Flushing on the face, inflammation, painful burning sensations, and inflammatory pustules and papules are now more extreme and last for much longer periods than in the previous stages. Some people with severe rosacea may develop an enlargement of the nose named rhinophyma.

There is significant damage across many facial blood vessels, and the blood vessels will be leaking fluids and proteins. You may be experiencing significant changes to the shape, tone, and texture of the skin.

At this stage, management of the symptoms is difficult, and avoiding triggers will have less effect than in previous stages. 

Treatment Options for Rosacea

Fotona Laser Treatments

One of the most effective ways to treat the symptoms of rosacea is via Fotona laser treatments. The CREO Clinic uses the Fotona SP Dynamis laser to administer both long pulse Nd: YAG and Er: YAG laser modalities to reduce the appearance of redness and broken capillaries and improve the texture of skin that may have been damaged by pustules or papules.

Laser treatment can treat any stage of rosacea, and our doctor’s knowledge of skin conditions and her experience performing laser treatments allow her to adapt laser modalities and wavelengths to appropriately treat your specific symptoms.

Other Treatment Options

Prescription Creams and Gels

There are some prescription-only creams and gels that can have a positive effect on rosacea – generally for mild to moderate stages. Metronidazole is a commonly prescribed treatment, and ivermectin is a newer treatment that is shown to have some positive impact.

Oral Antibiotics

A course of oral antibiotics may be prescribed to treat flare-ups of papulopustular rosacea, but long-term reliance on antibiotics is often discouraged. In general, a course of oral antibiotics for rosacea will last between 4-6 weeks.

Steps for Rosacea Treatment

Fotona laser treatment for rosacea sufferers is multifaceted, addressing damaged and visible blood vessels as well as improving the texture of damaged or inflamed skin. To do this, our specialists harness the power of both long pulse Nd: YAG and Er: YAG laser modalities in different stages for the most effective rosacea treatment. 


To treat broken capillaries, the long pulse Nd: YAG laser is administered to the skin and absorbed by Oxyhaemoglobin within the blood vessels. The thermal energy created then breaks down the walls of the damaged blood vessels. 

The remains of the small blood vessels are naturally removed by the immune system, and the blood supply to the area is taken over by other, healthier blood vessels.

This process removes visible blood vessels. The use of Nd: YAG laser also helps to reduce the bacteria and inflammation associated with acne-like pustules, as well as reducing redness through a fractional effect.


The next stage of laser treatment is the use of the Er: YAG laser to lightly ablate damaged surface skin cells or more deeply ablate thickened tissue, such as the enlarged bumps and lumps caused by phymatous rosacea.

What’s the Recovery Process For Rosacea Treatment?

Your skin will appear clearer and less reactive to the external triggers of rosacea after your laser treatment. Our team will provide detailed after-care instructions for your recovery period to help optimise your outcomes.

No time off work will be necessary after your treatment, and you can return to your daily routine immediately.

Rosacea FAQs

How many sessions of laser treatment for rosacea will I need?

Our team recommends a minimum of three sessions, with sessions every 12-18 months, to ensure your results are maintained in the long term.

Does laser treatment hurt?

Laser treatment is harmless and generally painless, but you may feel a short-lived snapping sensation similar to an elastic band flicking at the skin. Our patients also report a ‘popping’ sound during the laser process – this is the sound of capillaries breaking down and is completely normal.

Is rosacea contagious?

No. While the causes of rosacea are not well understood, we do know that it is not contagious.

Can rosacea be cured?

Rosacea cannot be cured permanently. It can also disappear and reappear throughout your life. However, its symptoms can be managed through laser treatments and other means, such as topical creams and antibiotics.

Is rosacea hereditary?

The root cause of rosacea is unknown, but there are suggestions its symptoms may be the result of both environmental factors and hereditary factors.

How long will my rosacea last?

How long you will experience rosacea is unknown – there is no cure, but its symptoms can be managed through treatments. Rosacea can appear and disappear over the course of your lifetime.

Contact CREO Clinic Today To Schedule A Consultation For Rosacea Treatment

Book a consultation with our team today to discover how laser rosacea treatment could help relieve your rosacea symptoms and improve the appearance of the skin on your face. Through the targeted application of both Nd: YAG and Er: YAG lasers, our specialists can reduce visible broken capillaries and help restore the texture of skin damaged by rosacea pustules and papules.

Call Now Button