Managing Telangiectatic Rosacea With Facial Redness — Village Dermatology Katy & Houston, Texas

Written By Honey Cisneros

By: Dr. Caroline Vaughn

Rosacea is a chronic inflammatory skin condition that commonly affects adults and can significantly impact self-confidence and skin comfort. At Village Dermatology, serving patients throughout Katy, Texas and Houston, Texas, we specialize in diagnosing rosacea subtypes and creating personalized treatment plans.

This case highlights the evaluation and management of a 49-year-old female with persistent facial and neck redness consistent with telangiectatic rosacea.

Chief Complaint

The patient presented for follow-up management of rosacea, involving the:

  • Face

  • Neck

Symptoms were described as moderate in severity and had been present for several months.

History of Present Illness

The patient reported:

  • Persistent redness on the cheeks and neck for approximately 6 weeks

  • Significant dryness of the skin

  • No improvement with previous anxiety medications

Notably, the patient is currently undergoing hormonal therapy with progesterone for endometriosis, which can contribute to flushing and skin sensitivity.

Clinical Examination

A focused facial examination was performed with the assistance of a dermatoscope.

Key Findings

  • Diffuse facial erythema

  • Prominent telangiectasias (visible blood vessels)

  • Dry, sensitive skin

The patient appeared well-nourished, alert, and in no acute distress.

Diagnosis

Rosacea – Telangiectatic Type

Telangiectatic rosacea primarily presents with:

  • Persistent facial redness

  • Flushing

  • Visible blood vessels

  • Dryness and skin sensitivity

Triggers commonly include:

  • Sun exposure

  • Heat

  • Stress

  • Alcohol

  • Spicy foods

  • Wind

Treatment Discussion

After reviewing treatment options, a stepwise approach was recommended.

Topical Therapy

  • Rhofade® (oxymetazoline)

    • Reduces facial redness by constricting superficial blood vessels

    • Can provide improvement for up to 8 hours

The patient elected to begin with an over-the-counter Rhofade alternative before prescription therapy.

OTC Rhofade Alternative (Counseled Regimen)

  • Mix:

    • CeraVe PM lotion (remove ⅓ of the bottle)

    • One full bottle of Afrin nasal spray

  • Apply to affected areas to temporarily reduce redness

Procedural Options (Discussed)

Laser therapy was discussed as a long-term solution for telangiectasias and persistent redness. The patient plans to schedule laser treatment if desired.

Patient Counseling

The patient received extensive counseling on:

Skin Care

  • Use gentle cleansers and moisturizers

  • Avoid harsh or fragranced products

  • Consider green-tinted moisturizers to neutralize redness

  • Daily broad-spectrum SPF 30+ sunscreen

Expectations

  • Rosacea is chronic with periods of flare and remission

  • Redness and flushing can be managed but not cured

  • Laser treatments can significantly reduce visible blood vessels

When to Contact the Office

  • Worsening redness

  • Development of nodules or cysts

  • No improvement despite consistent treatment

Samples of gentle skincare products were provided.

Plan & Follow-Up

  • Begin topical redness control regimen

  • Consider laser therapy for long-term improvement

  • Follow up as needed based on symptom control

At Village Dermatology in Katy and Houston, we tailor rosacea treatments to each patient’s triggers, lifestyle, and skin sensitivity.

Honey Cisneros
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