All About: Rosacea

Leilani W
May 26
5 min read

Last month was quite the hectic one… What took over my life was solely preparing for my AP exams, and unfortunately, that meant missing a very notable awareness month topic: Rosacea. Making up for that missed opportunity, today, a month after the intended awareness month, we will be looking at all things Rosacea, including what it is, symptoms, types, treatment, and how it affects people daily.

What is Rosacea?

Rosacea is a long-term inflammatory skin condition that leads to redness, or flare-ups, on the face that come and go in cycles. You typically see redness on the nose, cheeks, and forehead, and it can include bumps, pimples, and/or a rash. Rosacea usually starts after the age of 30, and flare-ups can last for weeks or months and disappear for a while.

Rosacea can lead to the following symptoms:

Redness, blushing, flushing
Bumps and pus-filled pimples
Visible veins (aka spider veins)
Skin thickening (especially on the nose)
Dry, irritated eyes; swollen eyes and eyelids
Burning or stinging sensation

Types of Rosacea

Erythematotelangiectatic Rosacea:

This is the most common type, with it being the one that comes to mind for most when rosacea is mentioned. Breaking the word down, we have “erythema-”, meaning redness, and a reference to the word “telangiectasia”, which means the widening of blood vessels. This in mind, it’s characterized by redness with visible blood vessels on the face that come and go without warning. This persistent redness can worsen and cover more skin if not treated.

Erythematotelangiectatic Rosacea example: a woman with facial redness on her forehead, nose, cheeks, and chin

Papulopustular Rosacea:

As the name suggests, this type of rosacea is identified with the presence of papules (red, solid, swollen bumps) and pustules (pus-filled bumps or whiteheads). It’s also known as “acne rosacea” since it appears to have many pimples, thus making it commonly mistaken for acne. These blemishes commonly appear on the cheeks, chin, and forehead but in more severe cases can spread to the scalp, neck, and/or chest. In lighter skin tones, redness and visible blood vessels, characteristics of the earlier type of rosacea, are also present.

Papulopustular Rosacea example: a woman with facial redness with bumps/pimples throughout her face

Phymatous Rosacea:

This type of rosacea causes the skin to swell, thicken, and become bumpy. This can result in rhinophyma, aka a bulbous nose, where the nose appears larger, bumpy, and red; rhinophyma is more frequently seen in men than women. The thickening seen in this rosacea is due to the enlargement of sebaceous glands (exocrine glands that secrete oil/sebum), inflammation, and fibrosis (thickening due to the accumulation of fibrous connective tissue, namely collagen).

Phymatous Rosacea example: a man with facial redness and rhinophyma, or an enlarged nose

Ocular Rosacea:

This rosacea primarily affects the eyes, causing them to become irritated, watery, and/or bloodshot. Other symptoms include persistent dry eye, sensitivity to light, red and swollen eyelids, and the formation of cysts (often painless, firm, round bumps found deeper within the eyelid) and styes (red, swollen, painful bumps, often with a white/yellow head) on the eyelids.

Ocular Rosacea example: irritated, red eyes with some appearing to have bumps (cysts and styes)

Causes

There is no known cause for rosacea. There are some theories on what the cause is, such as an underlying condition that affects the immune or nervous system, having too many demodex folliculorum or skin mites (microscopic organisms that inhabit your skin), a bacterial infection, or a malfunctioning of a protein, cathelicidin, needed for skin protection against infections. What likely plays the largest role, though, is a combination of a genetic predisposition and environmental exposure to irritants. Some things to keep in mind, too, are that rosacea is not contagious, and it is also not caused by poor hygiene.

As mentioned earlier, rosacea is a condition where flare-ups come and go periodically. Each person responds differently to triggers. Several triggers can lead to flare-ups, the most common including:

Spicy foods
Alcohol
Environmental factors (sun, wind, humidity, dryness, hot or cold temperatures)
Exercise, producing too much sweat
Extreme emotional responses like stress, anxiety, and anger
Cosmetic products
medication/drugs
Hormonal changes

Additionally, there are certain traits seen in people that have a higher risk of developing rosacea, such as:

Having a lighter skin tone
Age between 30 and 50 years old
Being female, although men commonly experience more severe symptoms
Relatives who have the condition

Treatments/Cure

Rosacea has no cure, but there are treatments available that can subdue symptoms before they worsen. Each treatment varies depending on the type of rosacea and symptoms experienced. Some of these treatments include:

Topical medicines: Creams, gels, or ointments that treat bumps, pimples, and redness. These include antibiotics, antiparasitics, and vasocontrictors (substances that narrow blood vessels). Lubricant eye drops or ointments are used to treat those with eye irritation, helping reduce inflammation. These topical options are more commonly used to treat those who experience milder symptoms.
Oral medications: includes antibiotics and retinoids, which are more commonly used to treat moderate to severe rosacea.
Laser treatments: used to remove/shrink visible blood vessels, helping decrease redness. It’s also used to remove excess tissue in thickened skin.
Surgery: especially used for severe rhinophyma to correct nose disfigurement. In cases of severe skin thickening, skin removal can be performed with scalpels or specialized tools.

These treatments are usually combined according to the patient and require long-term use. There are other options individuals can choose or add on, such as skin care to control symptoms.

The recommended skin care for rosacea patients follows something along the lines of:

Using a mild, nonstripping cleanser that has no fragrance, is non-foaming, and doesn't contain harsh ingredients, such as exfoliates, sulfates, and alcohol.
After washing, use lukewarm water to rinse off and gently pat dry with a soft, cotton towel
Non-irritating skin care products are a must. Sunscreens with an SPF of 30 or higher are also important, especially those suited for sensitive skin, such as non-chemical or mineral sunscreens.

Effects on Daily Life

Symptoms experienced by those who have rosacea aren’t exactly easy to mask. Unwanted questions, comments, and constantly being reminded of something they can’t control lead many patients to feel insecure and reasonably irritated. Reddit users online have mentioned being frustrated by having to repeat their explanation over and over about why their face looks red after being put on the spot for appearing that way. A Reddit user who commented under this post worded it perfectly by saying we shouldn’t comment on people’s appearance unless it’s something that person can change in the moment. Food stuck between someone’s teeth, makeup smudging, or their zipper being down are things you should 100% help them out with. But birthmarks, facial redness, scars, pimples, weight, or anything a person can’t change are comments that should be kept to oneself. Knowing people’s boundaries, especially when it comes to comments about one’s appearance, is something society needs to improve on. By raising awareness of these conditions, we can encourage more thoughtful interactions and greater respect for personal boundaries.