There is a lack of evidence from controlled trials to support lifestyle changes, as they are generally not suitable interventions for this type of study. Recommendations are therefore based on physiological and pharmacological principles, pragmatism, and clinical experience, as described in narrative reviews [Berth-Jones, 2004; Powell, 2005; Diamantis and Waldorf, 2006].

• Explaining the natural history of the disease will usually reassure the person. Although the categorization of rosacea implies a progressive disorder, this is not necessarily the case. For instance, many people with facial flushing do not develop other symptoms; this has led some experts to believe the term 'pre-rosacea' (that is sometimes used) is inappropriate [Powell, 2005]. Where severe disease does develop (e.g. rhinophyma), the person can usually be treated by surgery or laser treatment in secondary care [Berth-Jones, 2004].
• Solar radiation has been implicated in the pathogenesis of rosacea, and areas of exposed fair skin are most affected [Diamantis and Waldorf, 2006]. The use of sunscreens should limit further skin damage from sunlight, although this has not been verified by controlled studies.
• The possible trigger factors (temperature, exercise, stress, alcohol, foodstuffs) all have the potential to physically irritate skin or dilate cutaneous blood vessels and elicit blushing [Powell, 2005]. It is therefore reasonable to advise the person to avoid them, at least on a trial basis.
• Dry skin is a common complaint of rosacea, therefore CKS recommends an emollient should be used as appropriate. However:
• People with rosacea tend to have sensitive skin [Jappe et al, 2008], so products with potential irritants (e.g. perfumes) should be avoided.
• Topical corticosteroids (e.g. hydrocortisone) should not be used, except for severe inflammatory rosacea (under expert supervision) [Nally and Berson, 2006], as they can trigger, worsen, or mimic, the condition [Powell, 2005].