What Is Rosacea? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Rosacea is a common skin condition that causes redness and acne-like bumps in the central part of the face. It can develop on the cheeks, nose, forehead, and chin, and sometimes spreads to other parts of the body, like the ears, back, or chest.

Once rosacea sets in, flares can happen at any time. The length and severity of flares vary for this chronic inflammatory condition. Some people experience symptoms that last a few weeks, while others experience them for a few months.

Rosacea doesn’t only cause skin redness. You may also experience other symptoms, depending on the type you have.

The symptoms associated with these four types include:

Erythematotelangiectatic (Vascular) Rosacea

• Skin redness in the center of the face (may spread to the cheeks, forehead, or chin)
• Visible broken blood vessels
• Swollen skin
• Stinging or burning skin
• Dry skin
• Frequent blushing or flushing

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Papulopustular (Inflammatory) Rosacea

• Skin redness and swelling
• Bumps or pimples
• Widened blood vessels
• Raised skin patches
• Burning or stinging skin

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Phymatous Rosacea

• Enlarged or thickening skin around the nose, as well as the chin and forehead
• Rounded lumps or nodules

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Ocular Rosacea

• Eye redness and irritation
• Watery eyes
• Gritty sensation in the eyes
• Sensitivity to light
• Blurred vision
• Itchy and dry eyes

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You might mistake rosacea for another skin condition like acne, or even downplay the condition if you have milder symptoms. But you shouldn’t ignore persistent redness in your face.

With any type of inflammatory condition, understanding the underlying cause is one of the first steps in reducing flares.

• Sun exposure
• Weather extremes — hot, cold, exposure to sun or strong winds
• Aerobic exercise
• Stress and anxiety
• Hormonal changes
• Alcohol
• Spicy food
• Hot beverages

Keep in mind that different people have different triggers, so you’ll need to get to know your own body, says Anna D. Guanche, MD, a board-certified dermatologist based in Calabasas, California. Your rosacea might be triggered by one of the above, or several of the above.

It’s worth noting that rosacea isn’t caused by poor hygiene, nor is rosacea a contagious skin disease.

Rosacea can look like several other conditions; some people may think their skin redness is the result of acne or an allergic reaction. It isn’t until the condition worsens that they seek medical attention.

Although rosacea can mimic other skin problems, it also has its own distinctive signs.

• Lupus
• Acne
• Scalp eczema

Lupus is a chronic inflammatory autoimmune condition that can cause a reddish skin rash over the nose and face, usually in a butterfly shape.

But if you have a breakout that looks like acne but doesn’t behave like acne, you might be dealing with a case of rosacea instead, says Erum Ilyas, MD, a board-certified dermatologist based in the Philadelphia area. “This might include a pimple that never comes to a head, or popping a pimple and having nothing come out, yet it looks worse after,” she continues.

But while acne can develop over the entire face and on different parts of the body, rosacea is often limited to the central part of the face. Rosacea symptoms can occur beyond the face, but this is rare.

Once your doctor makes a definitive diagnosis, you’ll work together to determine the best treatment plan for your skin. There’s no one-size-fits-all approach. Your doctor may prescribe a medication, monitor your skin for improvement, and then recommend a different medication if the one you’re currently taking doesn’t work.

Medication Options

Or you may receive a topical cream designed to constrict the blood vessels in your face. This helps reduce blood flow, and subsequently lessens flushing and redness.

Along with medication to constrict your blood vessels, your doctor may prescribe a drug to kill bacteria on your skin, which can improve rosacea pimples and acne, along with redness and other skin irritation. Results aren’t immediate; it can take up to three to six weeks to see improvement.

Oral Medication

Nonmedical Therapies

Light Therapy If oral medication and creams don’t improve skin, talk to your doctor about laser or light therapy. This type of therapy can reduce the size of blood vessels in your face and remove excess skin around your nose.

Alternative and Complementary Therapies

Starting a rosacea diary is one of the first steps to pinpointing your triggers. Keep track of days when symptoms appear or worsen, and then write down everything that happened on this day. What did you eat? What type of activity did you perform (such as exercise or working in the garden)? Were you exposed to cold or hot temperatures?

Also, make a note of your emotional state during this time. Were you under a lot of stress or anxiety? This type of diary can help narrow down the underlying cause of your flares.

• Spicy foods
• Hot drinks (tea, coffee, hot chocolate)
• Alcohol (red wine, gin, Champagne, beer)
• Chocolate
• High-histamine foods (fermented cheese, citrus fruits, spinach, eggplant, mushrooms)
• Dairy (yogurt, sour cream, cheese)

Of course, just because a particular food or drink is a known rosacea trigger doesn’t mean it’s a trigger for you — which is why it’s important to keep track of what you eat and how that may affect your symptoms.

Rosacea can lead to complications if left untreated. Redness can gradually worsen or become permanent. What’s more, untreated rosacea increases the risk for skin enlargement around the nose. Talk to your doctor about any redness that doesn’t go away, or redness that comes and goes.

Most people who get rosacea are between 30 and 50 years old, although children can get rosacea, too.

“As a dermatologist of color, I always worry that our resident physicians aren’t taught to look for other signs and symptoms of rosacea outside of rosy cheeks to accurately make a diagnosis,” says Dr. Ilyas. “Most of my patients of color are only diagnosed with rosacea once it has become severe and potentially scarring.”

• A persistent warm feeling
• Dry, swollen skin
• Patches of darker skin or a dusky brown discoloration to your skin
• Acne-like breakouts that don’t go away with acne treatment
• Yellowish-brown, hard bumps around your mouth or eyes
• Burning or stinging when you apply skin-care products
• Thickening skin on the nose, cheeks, chin, or forehead

Research has suggested a number of other health conditions are associated with rosacea. It’s not clear whether there’s a cause-and-effect relationship, but the following conditions may occur with rosacea:

• Depression
• Anxiety
• Hypertension
• Cardiovascular diseases

• Rosacea is a common skin condition characterized by redness and bumps.
• It can occur on the cheeks, nose, forehead, and chin, and may spread to other parts.
• Rosacea has four subtypes: erythematotelangiectatic (vascular) rosacea, papulopustular (inflammatory) rosacea, phymatous rosacea, and ocular rosacea.
• There is no cure for the skin condition, but treatments can help manage it, including prescription medications, avoiding triggers, and light therapy.