Rosacea (rose-AY-sha) is a common skin disease. It often begins with a tendency to blush or flush more easily than other people.

The redness can slowly spread beyond the nose and cheeks to the forehead and chin. Even the ears, chest, and back can be red all the time.

Rosacea can cause more than redness. There are so many signs and symptoms that rosacea has four subtypes:

  • Erythematotelangiectatic rosacea: Redness, flushing, visible blood vessels.
  • Papulopustular rosacea: Redness, swelling, and acne-like breakouts.
  • Phymatous rosacea: Skin thickens and has a bumpy texture.
  • Ocular rosacea: Eyes red and irritated, eyelids can be swollen, and person may have what looks like a sty.

With time, people who have rosacea often see permanent redness in the center of their face.

Rosacea causes more than a red face. There are many signs (what you can see) and symptoms (what a person feels) of rosacea.

Because rosacea has so many signs and symptoms, scientists created 4 subtypes of rosacea. Some people have more than one rosacea subtype at the same time. Each subtype requires different treatment.

Rosacea: People with this subtype of rosacea, also called ETR, often have very sensitive skin.

Subtype 1: Facial redness, flushing, visible blood vessels

Signs and symptoms

  • Flushing and redness in the center of the face
  • Visible broken blood vessels (spider veins)
  • Swollen skin
  • Skin may be very sensitive
  • Skin may sting and burn
  • Dry skin, roughness or scaling
  • Have a tendency to flush or blush more easily than other people

*Acne rosacea: This subtype of rosacea is most common in middle-aged women.

 Subtype 2: Acne-like breakouts

Signs and symptoms:

  • Acne-like breakouts, usually where the skin is very red
  • Acne-like breakouts tend to come and go
  • Oily skin
  • Skin may be very sensitive
  • Skin may burn and sting
  • Visible broken blood vessels (spider veins)
  • Raised patches of skin called plaques

*Rhinophyma: Although rare, rosacea can cause the skin to thicken and have a bumpy texture. When this happens, it is called rhinophyma

Subtype 3: Thickening skin

Signs and symptoms:

This subtype is rare. When it does occur, the person often has signs and symptoms of another subtype of rosacea first. The signs of this subtype are:

  • Bumpy texture to the skin
  • Skin begins to thicken, especially common on the nose. When the skin thickens on the nose, it is called rhinophyma (rye-NO-fie-ma)
  • Skin may thicken on the chin, forehead, cheeks, and ears
  • Visible broken blood vessels appear
  • Pores look large
  • Oily skin

*Ocular rosacea: When rosacea affects the eye, it is called ocular rosacea. If rosacea affects your eye, you may need to see an ophthalmologist (doctor who specializes in treating eye diseases).

Subtype 4: In the eyes

Signs and symptoms

Some people get rosacea in their eyes. The eyes may have one or more of the following:

  • Watery or bloodshot appearance
  • Feel gritty, often feels like sand in the eyes
  • Eyes burn or sting
  • Eyes are very dry
  • Eyes itch
  • Eyes sensitive to light
  • Blurry vision
  • Visible broken blood vessels on an eyelid
  • Cyst on the eyelid
  • Person cannot see as well as before

How do dermatologists diagnose rosacea?

If your dermatologist suspects you have rosacea, you won’t need medical tests. No medical test can tell whether you have rosacea.

To diagnose rosacea, your dermatologist will examine your skin and your eyes. Your dermatologist will also ask questions.

Before giving you a diagnosis, your dermatologist may want to make sure you don’t have another medical condition. Sometimes, another medical condition can look a lot like rosacea. Your dermatologist will want to rule out these conditions. Medical tests can help rule out conditions, such as lupus and an allergic skin reaction.

If you have rosacea, your dermatologist can talk with you about treatment options. While treatment cannot cure rosacea, it can help:

  • Reduce (or eliminate) signs of rosacea on your skin
  • Ease your discomfort
  • Prevent rosacea from worsening

How do dermatologists treat rosacea?

To give you the best results, treatment often begins with a bit of education. While medicine or laser treatment can help reduce or clear signs of rosacea, your everyday habits may cause a new flare-up.

Learning how to do the following can help reduce flare-ups:

Find your triggers. Many things you do can cause rosacea to flare. Dermatologists call these tripwires “triggers.” Common triggers for rosacea include becoming overheated, having cold wind blowing on your face, and eating spicy foods. These may — or may not — cause your rosacea to flare. People have different triggers.

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