Episode 41: Rosacea Explained — Triggers, Treatments, and What Actually Works

Rosacea is one of the most common conditions seen in dermatology, and one of the most misunderstood.

In this episode, Dr. Dustin Portela and PA Austin Lee break down exactly what rosacea is, why it shows up, and why it can look completely different from one person to another. From persistent redness and flushing to acne-like breakouts and even thickened skin on the nose, they walk through the different types and how to recognize them.

They dive into what is actually happening beneath the skin, including inflammation, blood vessel changes, and even the role of Demodex mites. The conversation also covers one of the most important parts of managing rosacea: identifying triggers. From sun exposure and heat to alcohol, caffeine, spicy foods, and exercise, they explain why flare-ups happen and how to better control them without over-restricting your lifestyle.

Dustin and Austin also clear up one of the biggest mistakes patients make: treating rosacea like acne. They explain why harsh scrubs, over-exfoliation, and aggressive skincare routines often make things worse, and how focusing on barrier repair, gentle products, and consistency can make a major difference.

On the treatment side, they walk through everything from over-the-counter options like niacinamide and azelaic acid to prescription topicals, oral medications, and when more advanced options like lasers or low-dose Accutane come into play. They also explain why rosacea is a chronic condition, what realistic expectations should look like, and how to maintain long-term control.

If you struggle with redness, flushing, or breakouts that never quite respond to typical acne treatments, this episode will help you understand what is really going on and how to manage it effectively.

Products of the Week

Paula's Choice 10% Azelaic Acid Booster
A great starting point for rosacea-prone skin, especially if you're dealing with redness and acne-like bumps. Azelaic acid helps calm inflammation, improve tone, and is one of the most versatile ingredients for rosacea.

EltaMD UV Skin Recovery
A green-tinted sunscreen that not only protects against UV exposure but also helps neutralize visible redness. It is lightweight, hydrating, and designed specifically for sensitive, rosacea-prone skin.

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Dr. Portela
TikTok: @drdustinportela
Instagram: @drdustinportela
YouTube (Reactions): @208SkinDoc
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Austin Lee
TikTok: @austinleepac
Instagram: @austinleepac