Conditions
Rosacea: facial redness, bumps and how to keep it under control
Rosacea is a long-term skin condition that makes the face red, especially the nose and cheeks, and sometimes causes acne-like bumps. There is no cure, but it can be controlled. The doctor diagnoses it by looking at your skin over video and, if appropriate, prescribes and we send your prescription to your pharmacy. Refills of a treatment you already use are a follow-up visit.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Severe eye pain or changes in your vision
- Swelling of the face, lips or tongue, or trouble breathing
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At a glance
Rosacea
Common symptoms
- Facial redness that comes and goes, or stays, sometimes with burning or stinging
- Red or pus-filled bumps on the nose and cheeks that look like acne
- Visible small red blood vessels on the cheeks and nose
- Thicker or bumpy skin on the nose
- Red, irritated, watery or dry eyes
- Other names
- Facial redness · Ocular rosacea
- Treatment
- Prescription creams or gels; a medicine by mouth only when the medical evaluation calls for it
- Possible complication
- Ocular rosacea, which can affect eyesight if untreated
On this page(8)
What is rosacea?
Rosacea is a chronic inflammation of the skin on the face. It often starts with flushing that comes and goes, and over time the redness can stay. It can cause red or pus-filled bumps that look like acne, visible small blood vessels on the cheeks and nose and, in some people, thickened skin on the nose.
It is more common in middle-aged and older adults and in women, though it tends to be more severe in men. The exact cause isn’t known; genes and environment both play a part.
Many people find certain things make it worse: sun, heat, stress, spicy food and alcohol. With Puerto Rico’s sun and heat, sun protection is part of the treatment.
How we treat rosacea by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. There is no test for rosacea: it is diagnosed from the look of your skin and eyes and your history, so a video visit works well. Show your face in natural light without makeup, or send photos through the secure link we send you.
The doctor asks what triggers your redness, what products you use and whether your eyes bother you, for example with dry eyes. From there she evaluates, diagnoses and treats. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If rosacea could be acne, eczema or seborrheic dermatitis, the doctor explains the difference.
If you already use a rosacea treatment and just need a refill, that is a US$49 follow-up visit: see prescription refills. You need to be physically in Puerto Rico during the visit.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit" (or "Follow-up visit" for a refill only). You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy, with a plan for avoiding your triggers.
What the visit costs
A first visit for rosacea is a US$79 doctor visit, the same price for every age, with no membership. A refill of a treatment you already use is a US$49 follow-up visit. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. See all prices.
Rosacea symptoms
Rosacea looks different from person to person. The most common signs are:
- Facial redness that comes and goes, or stays, sometimes with burning or stinging
- Red or pus-filled bumps on the nose and cheeks that look like acne
- Visible small red blood vessels on the cheeks and nose
- Thicker or bumpy skin on the nose
- Red, irritated, watery or dry eyes
Rosacea treatment
Rosacea has no cure, but treatment improves how your skin looks and feels. Mild cases are treated with prescription creams or gels; for moderate or severe cases, the doctor may consider a medicine by mouth with an anti-inflammatory effect. Results take time: it can be 3 months or more.
Laser and light treatments for visible blood vessels are done in person at a skin specialist’s office; if you are interested, the doctor can point you in the right direction.
- Use a broad-spectrum sunscreen with SPF 30 or higher every day.
- Wash your face with a gentle cleanser and don’t scrub.
- Keep track of what triggers your redness (sun, heat, spicy food, alcohol, stress) and avoid it.
Rosacea in the eyes: you need to be seen in person
Rosacea can affect the eyes and, if it isn’t treated, it can harm your eyesight. If your eyes are red, sore, itchy, watery or dry, or your eyelids are swollen, you need an in-person exam with an ophthalmologist (eye doctor). For your safety, if you have severe eye pain or changes in your vision, go to the emergency room or call 911.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Can rosacea be treated by video?
Can rosacea be cured?
What makes rosacea worse?
Is rosacea the same as acne?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (2)
- Rosacea (NIAMS, NIH) (opens in a new tab) (accessed 2026-10-02)
- Rosacea: Diagnosis, Treatment, and Steps to Take (NIAMS, NIH) (opens in a new tab) (accessed 2026-10-02)