- It’s Not Just Redness: Rosacea has 4 distinct types. "Acne-like" bumps (Type 2) are often caused by Demodex mites, not bacteria.
- The "Vascular" Laser: Yellow Laser (577nm) is the gold standard for redness because it targets blood vessels 40% more effectively than standard green lasers.
- The "Repair" Tool: RF Microneedling (Sylfirm X) repairs the skin's basement membrane to stop redness from coming back.
- Topicals: Ivermectin (Soolantra) is now often preferred over Metronidazole for treating bumps.
If your skin is always red, reactive, or breaking out in ways that don’t quite make sense, you may be dealing with rosacea. But here is the catch: Rosacea is a spectrum. One patient might have a constantly flushed nose (Type 1), while another has painful, deep, pus-filled bumps (Type 2). Treating Type 2 with Type 1 protocols often leads to failure.
Keep reading to learn more about the various types of rosacea and the treatment options our dermatologists at DermAlly recommend.
The 4 Types of Rosacea and How They Differ
Rosacea appears differently in different people. That’s why it’s helpful to know which type you have when deciding on treatment.
1. Erythematotelangiectatic Rosacea (ETR)
ETR is a form of rosacea that primarily affects your blood vessels. It’s often the most recognisable type, with these symptoms:
- Frequent or constant flushing
- Diffuse facial redness
- Visible blood vessels (telangiectasia)
- Burning, stinging, or tightness in the skin
- Skin that reacts easily to temperature, sun, or skincare products
2. Papulopustular Rosacea (PPR)
This inflammatory type is also known as “acne rosacea, but it’s not the same as typical acne. Here’s what you’ll see and experience if you have PPR:
- Red, inflamed skin with acne-like breakouts
- Pustules and papules around the nose, cheeks, and chin
- Flushing and background redness
- Possible swelling or burning sensation
PPR is common among adults, even if they haven’t had acne before. This type of rosacea requires medical treatment to calm the underlying inflammation and restore skin balance.
3. Phymatous Rosacea
This less common form of rosacea is more advanced and can lead to a thickened, bumpy skin texture around the nose — a condition known as rhinophyma. Women typically experience this form of rosacea, accompanied by the following symptoms:
- Thick, bumpy, or waxy skin texture
- Enlarged pores or visibly rough skin
This type is caused by excess tissue growth and can lead to permanent skin changes if not managed early.
4. Ocular Rosacea
Ocular rosacea affects the eyes before or alongside facial symptoms. You may notice:
- Dry, itchy, or burning eyes
- Redness or watering
- A gritty or sandy sensation
- Swollen eyelids or eyelid margin redness
- Sensitivity to light or blurry vision
Treatment for ocular rosacea is often a combination of dermatological and (sometimes) ophthalmologic care, depending on its severity.
Rosacea Triggers: The "Singapore" Factor
In Singapore, avoiding triggers is half the battle. Our unique climate poses specific risks:
- Heat & Humidity: High temps cause immediate vasodilation (flushing).
- Spicy Food: Capsaicin triggers neurogenic inflammation.
- UV Exposure: UV rays destroy the elastic tissue supporting your blood vessels, making them "leaky".
Symptoms of Rosacea
This condition often appears on the cheeks, nose, chin, and forehead, though it can also spread to the ears, neck, chest, and back, often accompanied by the following symptoms:
- Persistent redness or flushing
- Visible blood vessels (also called telangiectasia)
- Bumps or pimples that resemble acne
- Burning or stinging sensations
- Skin thickening in more advanced cases
- Eye discomfort, such as dryness, itchiness, or redness
These vary from person to person. Some experience only one or two symptoms, while others may develop multiple that evolve.
Rosacea Treatment Options Based on Your Type
Store-bought aloe vera gel might soothe the skin temporarily, but medical treatment aims to shut down the underlying inflammation.
Topical & Oral Medications
For mild to moderate rosacea, prescription creams or gels can reduce inflammation, calm redness, and shrink visible vessels. Common ingredients include:
- Metronidazole, an anti-inflammatory and antimicrobial,
- Azelaic acid, which helps with bumps and texture.
- Brimonidine or oxymetazoline, to constrict blood vessels and reduce redness.
- Ivermectin (Soolantra) is anti-parasitic (kills Demodex mites) and anti-inflammatory.
In moderate to severe cases, especially with PPR, oral medications like doxycycline may be prescribed to control inflammation.
Laser & Other In-Clinic Treatments
For persistent redness or visible blood vessels, these in-clinic rosacea treatments can offer the long-term improvement you need.
- Yellow Laser uses 577nm wavelength light to precisely target haemoglobin, reducing redness, flushing, and broken capillaries with minimal downtime. It effectively "seals" the dilated vessels without heating up the surrounding skin, making it safer for Asian skin than traditional green lasers.
- RF Gold Microneedling supports deeper skin healing, stimulates collagen, and reduces inflammatory lesions often seen in PPR or phymatous rosacea. Strengthening the skin barrier prevents triggers from penetrating deep into the skin, reducing the frequency of flares.
- Salmon DNA Skin Booster hydrates and repairs the skin barrier while calming inflammation, a great option to complement laser or microneedling treatments.
| If you have… | We recommend… | How it works |
| Visible Veins & Flushing | Yellow Laser | Shrinks dilated capillaries. |
| Acne-like Bumps | Ivermectin / Soolantra | Reduces the Demodex mite population. |
| Chronic Relapsing Redness | Sylfirm X | Repairs the basement membrane. |
| Stinging/Sensitive Skin | PDRN (Salmon DNA) | Anti-inflammatory cellular repair. |
Diagnosis to Treatment: Here's How It Works
At DermAlly, your journey begins with a detailed skin consultation. We assess your triggers, examine your symptoms, and classify your rosacea type. From there, we design a customised treatment plan, which may include:
- Trigger management advice
- Skincare guidance (cleanser, SPF, moisturiser recommendations)
- Topical or oral prescriptions
- In-clinic treatments like Yellow Laser or RF Microneedling
- Maintenance plans for long-term flare prevention
Reduce Redness With the Right Rosacea Treatment
You don’t have to live with persistent redness or discomfort. Let’s find a treatment that’s suitable for your skin, rosacea type, and long-term goals. Book your consultation at DermAlly today.
Frequently Asked Questions (FAQ)
Is Rosacea curable?
Rosacea is a chronic inflammatory condition, meaning there is no permanent “cure.” However, with the right combination of lasers and medical management, we can put it into long-term remission, where you have clear skin for months or years at a time.
Can I just use acne cream for the bumps?
No. Acne creams (like Benzoyl Peroxide or Salicylic Acid) are often too harsh for rosacea skin and can severely worsen the redness. Rosacea bumps are not “clogged pores”; they are inflammatory lesions.
Does diet affect Rosacea?
Yes. In Singapore, common triggers include alcohol, spicy foods (mala), and piping hot soups. We recommend keeping a food diary to identify your specific triggers.
Our articles are written and reviewed by Dr. Coni Liu (MRCS, FAMS) and Dr. Heng Jun Khee (MRCP, FAMS), Ministry of Health-accredited Consultant Dermatologists at DermAlly.
Both are Fellows of the Academy of Medicine (Dermatology) and previously served as Consultants at the National Skin Centre (NSC), bringing extensive experience in medical, surgical, and aesthetic dermatology. They are committed to making expert-led skin education accessible, practical, and clear, helping patients look and feel their best through evidence-based care rooted in science and compassion.
