Rosacea symptoms & treatment

Rosacea is a chronic skin condition affecting more than 16 million people in the U.S. It may look like facial acne, but the treatments are different. If you suspect you have rosacea, it’s important to see a dermatologist to find the best treatment for you.

Rosacea symptoms & types

The first sign of rosacea may be frequent blushing (flushing), which causes facial redness. Other common symptoms of rosacea on your face include:

• Persistent redness that resembles a sunburn
• Swelling
• Burning or stinging sensations
• Small, red bumps that may resemble acne
• Visible blood vessels across the nose, cheeks, eyelids and forehead
• Thickened skin on the nose and cheeks (phyma)
• Dry, rough skin
• Raised, red patches (plaques)

There are four types of rosacea, and it’s common to have a mixture of different types. Each one has different symptoms:

• Erythematotelangiectatic rosacea: Swells the blood vessels under the skin, making it feel warm and flushed, and causes visible blood vessels.
• Papulopustular rosacea: Causes pimples (rosacea bumps), redness and swelling.
• Phymatous rosacea (rhinophyma): Enlarges the oil glands in the nose and cheeks, causing the nose to have a bulbous appearance, often described as rosacea nose.
• Ocular rosacea: Affects the eyes, causing redness, irritation and swollen eyelids.

Rosacea risk factors

Rosacea can affect anyone. The condition typically starts between ages 30 and 50, and it’s most common in people with fair skin tones, especially women. Other potential risk factors for rosacea include:

• Being over 30
• Family history of rosacea
• Smoking
• Having a history of acne
• Having a condition that affects your blood vessels, immune or nervous system, such as inflammatory bowel disease (IBD) or rheumatoid arthritis (RA)

What causes rosacea?

The cause of rosacea is unknown, but it may be related to Microscopic Demodex folliculorum mites. Although these parasites are found on the skin of all humans, they frequently occur in greater numbers in people with rosacea. Evidence suggests that an overabundance of Demodex mites may trigger an immune response in people with rosacea. Inflammation might also be caused by certain bacteria associated with these mites.

Find your rosacea triggers

You may notice that hot, humid weather or stress causes your rosacea to flare. These are known as triggers, and they are different for everyone.

Common rosacea triggers include:

• Stress
• Sun exposure
• Hot or cold weather
• Hot food or drinks
• Exercise
• Alcohol consumption
• Hormonal changes

You might also need to avoid certain foods – like caffeine or spicy foods – that can dilate the blood vessels in your skin. In addition, some over-the-counter skin care products can make rosacea worse. Read labels carefully and avoid products with any of these ingredients:

• Alcohol
• Camphor
• Fragrance
• Glycolic acid
• Lactic acid
• Menthol
• Sodium laurel sulfate (often found in shampoos and toothpaste)
• Urea

Diagnosis of rosacea

There are no medical tests to diagnose rosacea. Instead, your dermatologist will examine your skin and your eyes and ask questions about your symptoms. Your answers will help confirm if you have rosacea or a different type of skin condition like eczema.

Rosacea treatment options

Treating rosacea usually starts with learning about proper skin care and understanding how it differs from acne. Your doctor may prescribe creams and oral medications. If you have visible blood vessels, laser therapy might also be suggested.

Medications for rosacea

The type of medication your doctor prescribes depends on your rosacea symptoms. You may need to try different rosacea treatment options or a combination of medications to find a treatment that works best for you.

Prescription medications for rosacea include:

• Topical medications that reduce flushing: For mild to moderate rosacea, your doctor may prescribe a cream or gel with azelaic acid that you apply to the affected rosacea skin. These medications reduce flushing by constricting blood vessels.
• Oral antibiotics: Your doctor may prescribe an oral antibiotic for moderate to severe rosacea with bumps and pimples.
• Oral acne medicine: If you have severe rosacea that doesn't respond to other medications, your doctor may prescribe a more powerful oral acne medication that also helps clear up acne-like lesions of rosacea.

Laser treatment for rosacea

Laser therapy for rosacea can make enlarged blood vessels less visible. Talk with your doctor about the risks and benefits. Side effects of laser therapy for rosacea include swelling and bruising that might last for several days. On skin with darker pigmentation or complexion, laser treatment might cause long-term or permanent discoloration of the treated skin. Laser treatment for rosacea is usually considered a cosmetic procedure, which insurance typically doesn't cover.

Rosacea surgery

If thickened skin (phyma) needs to be removed, your dermatologist may refer you to a dermatologic surgeon. Surgery to remove phyma is complex. It often requires using different procedures to remove the excess skin and reshape the nose or other area of your face.

How to reduce rosacea flare-ups

Rosacea rash flare-ups are common, but there are many ways you can minimize their severity or reduce their frequency. Rosacea self-care tips include:

• Find and avoid your rosacea triggers
• Protect your skin from the sun
• Use mild skin and hair products
• Wash your face gently and avoid scrubbing

Find a dermatologist

Find a dermatology specialist near you.