Rosacea symptoms & treatment

Rosacea typically starts between ages 30 and 50, and it’s most common in people with fair skin. It may look like acne, but the treatments are different. It's important to have it checked by your dermatologist to get the right treatment for your potential rosacea skin.

What is rosacea?

Rosacea is a skin condition that makes a person’s face turn red and blotchy. Small pimple-like bumps filled with pus may also appear.

Symptoms of rosacea

Rosacea symptoms usually affect the middle of the face – a red rash, pimples or broken blood vessels may appear across the nose, cheeks, eyelids and forehead – but it can also cause redness on other parts of the face. About 50% of people with rosacea also have eye symptoms like redness, burning, tearing, swelling or the sensation of something being in their eye.

Four types of rosacea

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

• Prerosacea frequently causes flushed skin on the face and neck.
• Vascular rosacea swells the blood vessels under the skin, making skin feel warm and swollen.
• Inflammatory rosacea causes pimples and enlarged blood vessels on the face.
• Rhinophyma enlarges the oil glands in the nose and cheeks, causing the nose to have a bulbous appearance, often described as rosacea nose.

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 skin. Your answers will confirm to the doctor if you have rosacea or some other type of skin condition.

Find a dermatologist near you.

What causes rosacea

Microscopic Demodex folliculorum mites are thought to cause rosacea rash. Although they’re found on the skin of all humans, they frequently occur in greater numbers in people with rosacea. Evidence is also mounting that an overabundance of Demodex may possibly trigger an immune response in people with rosacea, or that the inflammation may be caused by certain bacteria associated with the mites, which are among potential rosacea causes.

Rosacea treatment options

Rosacea treatment often begins with education about proper skin care and the differences between acne and rosacea. Your doctor might also order prescription creams and medications or laser treatments.

You might also need to avoid certain foods – like caffeine, spicy foods and alcohol – 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

Medications

Many new medications for rosacea treatment have been developed recently. The type of medication your doctor prescribes will depend on which potential signs and symptoms of rosacea you're experiencing. You may need to try different rosacea treatment options or a combination of drugs to find a treatment that works best for you, especially considering the signs of rosacea can vary from person to person.

Prescription drugs for rosacea include:

• Topical drugs that reduce flushing: For mild to moderate rosacea, your doctor may prescribe a cream or gel 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, also known as rosacea bumps.
• 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

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 brown or black skin, 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.

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 flare-ups

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

Find your triggers

Common rosacea triggers include cold wind blowing against your face, getting overheated and eating spicy foods. These may or may not cause your rosacea to flare. Different people have different triggers.

Protect your skin from the sun

People with rosacea usually have sun-sensitive skin. To protect your skin from the sun, you’ll want to:

• Stay in the shade when outdoors.
• Avoid midday sun.
• Apply a broad-spectrum sunscreen with an SPF 30 or higher every day before you head outdoors. If sunscreen irritates your skin, try using one that contains only titanium oxide and zinc oxide.
• Wear a wide-brimmed hat, sun-protective clothing and sunglasses when outdoors to protect your face and neck from the sun.

Practice rosacea-friendly skin care

Many skin care products can irritate rosacea. Wash your face gently, avoid scrubbing and use mild cleansers and moisturizers recommended by your doctor.