Rosacea is an inflammatory skin condition. It mainly affects your face, though it can also affect your neck, chest and scalp. If you have rosacea, you may notice:
- Your face is red if you have a lighter skin tone, or has a brown discoloration if you have a darker skin tone
- You blush or flush easily
- Your face feels warm or burning
- You can see your blood vessels (called telangiectasia)
- A rash or pus-filled bumps that look like acne (called papules or pustules)
- Your facial skin feels dry or rough
- Facial swelling
A lot of times, people overlook rosacea because they think that it will go away. But symptoms often get worse if they aren’t treated.
Rosacea signs and symptoms are different for everyone. They are usually more common in women and people with fair skin, but more severe in men. You may be more likely to get rosacea if someone else in your family has it.
What causes rosacea?
Experts don’t know exactly what causes rosacea. It’s not contagious, so you can’t catch it from others. It’s possible that some combination of genetics, blood vessel problems, bacteria and immune system issues causes rosacea.
Symptoms can come and go. Triggers can cause rosacea symptoms to flare up or make them worse. Some common triggers are:
- Sunlight
- Hot or spicy foods and drinks
- Alcohol
- Dairy foods
- Extreme hot or cold temperatures
- Strong wind
- Stress or strong emotions
- Some skincare and hair care products
- Some medications
- Strenuous exercise
- Smoking
Rosacea is a chronic (long-term) condition. It can be uncomfortable, but it’s not life-threatening. It may also affect you emotionally, causing embarrassment and lower self-confidence, which may make it hard to interact with others. The good news, however, is that there are ways you can manage rosacea.
What are the types of rosacea?
There are four main types of rosacea with slightly different symptoms. You could have more than one type.
Erythematotelangiectatic rosacea
Your face may be red most of the time (erythema). You may also see blood vessels (telangiectasia) on your cheeks, nose, chin or forehead. You may flush or blush often and have sensitive skin that stings or burns easily. Your face may also feel dry, tight or warm.
Sunlight, temperature changes and certain skincare products can trigger this type of rosacea.
Papulopustular rosacea
You may have bumps that look like acne and your face might often be red and inflamed. You’ll notice symptoms mainly in the middle of your face, on your nose, cheeks and forehead.
Heat, spicy foods, alcohol or stress can trigger symptoms or make them worse.
Phymatous rosacea
You may have thick, bumpy, swollen or uneven skin, usually affecting the nose (rhinophyma). Your nose can get bigger, which can affect your airflow. This type of rosacea can also enlarge your oil glands, which causes a rough or “orange peel” texture.
This type is more common in men and can slowly get worse over time. It sometimes occurs along with other types of rosacea.
Ocular rosacea
Ocular rosacea mainly affects the eyes. It can happen along with other types of rosacea. It may cause dryness, burning, stinging, grittiness, redness, watering or tearing, sensitivity to light (photophobia) or blurred vision.
With this type of rosacea, it’s important to see an eye care professional to prevent eye damage and vision problems.
How is rosacea diagnosed?
There’s no test for rosacea. However, a dermatologist (skin doctor) or health care provider who has experience diagnosing and treating rosacea can review your symptoms and come up with a personal treatment plan for you.
Your provider can usually diagnose rosacea based on your medical history, symptoms and the appearance of your facial skin. But there are other skin conditions that are similar to rosacea, so your dermatologist may also order additional tests to rule out those conditions.
Several conditions that have symptoms like rosacea include:
- Acne: Acne and papulopustular rosacea both cause bumps and facial redness. With acne, you typically have blackheads and whiteheads. With rosacea, you do not. Acne usually affects the forehead, nose and chin, while rosacea usually affects the cheeks and nose.
- Seborrheic dermatitis: Like rosacea, this common skin condition can cause redness and flakiness. However, seborrheic dermatitis usually affects the scalp, eyebrows and other oily areas of the face. Rosacea mainly affects the center of the face.
- Lupus: Some types of lupus cause facial redness, rashes and skin problems that look like rosacea. However, lupus often has other symptoms, such as joint pain, fatigue and sensitivity to sunlight.
- Perioral dermatitis: Perioral dermatitis causes small red bumps around the mouth and nose. It is similar to papulopustular rosacea but usually doesn’t affect the area around the eyes like rosacea does. Perioral dermatitis is linked with steroid use, cosmetics and certain types of toothpaste.
- Contact dermatitis: You could have contact dermatitis if your skin touches an irritant or allergen. This could cause facial redness, swelling and itching, similar to rosacea.
How is rosacea treated?
Your dermatologist can recommend treatments based on your symptoms and the type of rosacea you have. Options include:
- Skincare practices: Treating your skin gently by using mild cleansers and avoiding harsh products like astringents can help reduce symptoms. Choose oil-free and fragrance-free skin care products and makeup. Protect your skin from sun exposure and sun damage.
- Medications you apply to your skin: Prescription creams or gels may help. Your provider may recommend oxymetazoline (Rhofade), metronidazole (Metrogel, Noritate) azelaic acid (Azelex, Finacea), brimonidine (Mirvaso) or ivermectin (Soolantra).
- Antibiotics: Sometimes, your doctor may prescribe antibiotics such as tetracycline or doxycycline (Oracea) that you take as pills. They can help manage inflammation.
- Laser or light therapies: These treatments can reduce visible blood vessels, redness and thick skin and help improve the way your skin looks. These are usually considered cosmetic procedures, so your health insurance plan may not cover them.
- Lifestyle modifications: Protecting your skin from the sun, managing stress and avoiding triggers can help minimize flare-ups. If you’re not sure what triggers your rosacea, track your symptoms along with what you eat and drink, your skincare products and your activities for a few weeks. You can look for links between your symptoms and possible triggers.
- Surgery: Although rare, with phymatous rosacea surgical reduction may play a role in reshaping the nose.
During rosacea flares, you can mask redness and symptoms with:
- Foundation that’s a shade lighter than what you normally use
- Mineral powders
- Green-tinted moisturizer or color correcting creams to counteract redness
Because rosacea is a chronic condition, you’ll need to manage it for a long time. Your dermatologist can help you find the right treatment plan and lifestyle changes to keep symptoms under control.
How is ocular rosacea treated?
You’ll want to see an eye care professional if you have ocular rosacea. Here are some treatments they may recommend:
- Good eyelid hygiene: Gently cleaning the eyelids and eyelashes with a mild cleanser or prescribed lid scrubs can reduce inflammation and keep your eyelids clean.
- Artificial tears and lubricating eye drops: These products can moisturize your eyes and treat irritation.
- Eye drops, gels or ointments: Corticosteroids or antibiotics you apply to your eyes may help reduce inflammation and manage symptoms.
- Antibiotics: If your symptoms are severe or persistent, your health care provider may prescribe oral antibiotics to help reduce inflammation.
- Environmental modifications: Wearing sunglasses or goggles to protect your eyes from wind, dust and harsh sunlight can help. You may also want to keep the air in your home at a healthy humidity level and avoid air conditioning or dry heating systems.
You’ll want to see an eye care professional regularly to monitor ocular rosacea. Let your provider know about any concerns or changes in your symptoms.
Connecting with resources and support
Coping with rosacea can be challenging. People with rosacea may have low self-esteem and self-confidence.
These resources can help you get more information about the condition and connect with others who are facing similar challenges:
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