Management of rosacea in perimenopausal skin using intense pulsed light (IPL) and barrier-supportive skincare

Rosacea is a chronic inflammatory facial dermatosis characterised by recurrent flushing, persistent erythema, telangiectasia, inflammatory papules and pustules, and cutaneous sensitivity. Although historically classified into subtypes, current consensus guidance supports a phenotype-led approach, recognising that patients frequently present with overlapping features. Perimenopause may represent a clinically relevant period for the onset or worsening of rosacea, due to vasomotor instability, hormonal fluctuation, increasing skin sensitivity and barrier impairment. This case report describes the management of a 46-year-old woman who developed rosacea during the preceding two years, presenting predominantly with erythematotelangiectatic features and mild papulopustular involvement. Management combined a barrier-supportive skincare regimen and a course of six intense pulsed light treatments. The case highlights the importance of recognising rosacea in perimenopausal patients and using a combined approach targeting vascular change, inflammation and barrier dysfunction.