Rosacea is a skin condition that can shows up differently for different people, or depending on the day. It can present as red skin across your nose and cheeks, as white pustules that look like a hormonal breakout, or a combination of the two. Learn the causes, symptoms, and treatment for rosacea to understand how to prevent and deal with a flare up.
Symptoms of Rosacea
According to the National Rosacea Society — an org dedicated to this skin condition — there are a few major signs and symptoms of rosacea. The two big ones are persistent redness of the face and (eventually) thickening of the skin. As for other signs and symptoms, it all depends on what type of rosacea you have.
In a type of rosacea called vascular rosacea, or erythematotelangiectatic rosacea, the small blood vessels under the facial skin swell up, causing swollen and warm skin. You may even be able to see these swollen blood vessels through your skin — a problem called telangiectasia. Most often, these vascular rosacea symptoms happen along the nose, cheeks, and other central parts of the face.
The symptoms of inflammatory (papulopustular) rosacea are similar. In addition to facial redness, you might have bumps and pimples. These can look like acne, but the key difference is that you won’t have any blackheads or whiteheads. Also, it’s possible your skin may burn or sting.
Rosacea isn’t just a skin condition — it can also affect the eyes. Some people experience persistent redness in the whites of their eyes, as well as what looks like broken blood vessels. Eyes can also become crusty and swollen.
How Do You Keep Your Symptoms From Flaring Up?
For most people, using a mix of oral or topical medications, such as metronidazole, can keep their symptoms at bay. Metronidazole works by soothing inflammation, helping to reduce swelling and redness.
You may also consider some lifestyle changes. Since rosacea can be triggered by certain foods, you’ll want to cut those out of your diet. Staying out of the sun (or using SPF), keeping stress low, and avoiding excessive heat are other good tips for preventing a flare-up.
Causes of Rosacea
Unfortunately, doctors haven’t nailed down the causes of rosacea. The leading theories are that this common skin condition is caused by an overactive immune system (meaning your body might be attacking itself), genetics (meaning your genes make you more likely to experience rosacea), or the presence of certain bacteria on your skin that cause rosacea symptoms.
How Might the Immune System Cause Rosacea?
Your immune system fights off invaders and infections. One part of the immune system are molecules called cathelicidins that fight bacteria to prevent infection — which sounds good, right? However, during their fight, they can trigger an immune response that leads to inflammation, irritation, and other rosacea symptoms.
But what triggers cathelicidins to flock to an area in the first place? Scientists think it might be a type of cell called mast cells which are connected to both the nervous system and the vascular system, which would explain why rosacea has both inflammatory and painful symptoms.
What Bacteria Can Cause Rosacea?
A bacteria called H pylori is often found in the intestines of people with rosacea. That said, not everyone who has an infection of H pylori has rosacea, meaning scientists don’t know for sure if it’s a cause or just a coincidence.
Scientists also think Demodex might be an issue. Demodex is a mite that commonly lives in the nose and cheeks. People with rosacea tend to have larger-than-usual counts of this mite on their skin. In the case of rosacea eye symptoms, they’ll likely have more of this mite in their eyelashes.
What Are Common Rosacea Triggers?
Certain things can exacerbate symptoms. For example, anything that typically causes skin flushing, like drinking alcohol, stress, heat, or sunlight, can irritate blood vessels and contribute to skin redness.
Many rosacea sufferers also find that eating spicy foods or standing out in the wind or cold for too long can make their sensitive skin prone to bumps and redness. And if you’re taking other medicines or using specific hair care or skin products, it can cause further irritation.
Don’t worry! By reducing these triggers and partnering with a medical provider to find rosacea treatment that works for you, achieving calm, clear skin is possible.
Risk Factors for Rosacea
Rosacea can be more common in specific types of people. Curious if you have the risk factors for rosacea? Here’s what doctors have identified so far.
What Are the Risk Factors for Developing Rosacea?
Women seem to have a higher occurrence of rosacea than men. Strangely though, when men do get rosacea, they seem to have more severe symptoms. Doctors believe it might be because men delay getting treatment until their rosacea symptoms are more advanced.
Another risk factor for rosacea patients is being over 30 years old. It’s less commonly diagnosed in people younger than that. The most common age range is between 30-50, but older people can still be diagnosed as well.
Those with fair skin also have a higher risk of getting rosacea. With that in mind, it makes sense that people of Northern European ancestry, including those with Eastern European, Scandinavian, Scottish, English, or Irish blood, are more prone to rosacea.
Finally, people who tend to have skin redness like blushing or flushing easily are at a higher risk of rosacea.
Can My Triggers Also Be Risk Factors for Rosacea?
Keep in mind, your triggers can also be risk factors for rosacea. It’s a good idea to keep a trigger journal so you can identify what foods you eat, activities you do, or emotions you feel that make your symptoms worse. For example, perhaps a bad risk factor for you personally is drinking too much red wine — a beverage that specifically seems to trigger an increased risk of rosacea symptoms.
Diagnosis of Rosacea
There are two specific signs doctors look for when considering a rosacea diagnosis. The first is persistent redness on your face that never seems to go away entirely. It’s often likened to a sunburn — but without the fun of a beach day.
Another diagnostic sign is skin thickening. This usually happens on the nose, where excess tissue can build up. This is more than just your nose getting bigger as you age — in some people, it can even lead to facial disfigurement or make it harder to breathe.
What Tests Do Health Care Professionals Use to Diagnose Rosacea?
There’s no magic test that immediately diagnoses you with rosacea. Instead, doctors typically rely on your medical history and a physical examination to give you a diagnosis of rosacea.
First, they’ll take a look at any rosacea symptoms you have on your skin or in your eyes. In particular, they’ll be looking for visible blood vessels on your facial skin, chronic redness, papules or pustules, or other inflammation. If you have ocular involvement, they’ll check for redness or crustiness.
The key thing for your medical provider will be making sure your symptoms aren’t actually signs of acne, contact or seborrheic dermatitis, or lupus. There are a few key differences between each condition.
While the pimples from rosacea and acne look similar, the rosacea doesn’t have any whiteheads or blackheads. There’s also no ocular involvement with acne.
Because contact dermatitis is a type of allergic reaction, once you remove the allergen, your symptoms should subside. And with seborrheic dermatitis, you’ll likely get symptoms on the scalp, which isn’t a sign of rosacea.
Finally, lupus can cause a butterfly-shaped rash on the face. While this might look like rosacea, it also comes with other symptoms like joint pain and fatigue, which rosacea doesn’t present with.
Where Can People Get More Information About Rosacea?
Want to get all the details on rosacea? Your doctor is the best place to start. Rosacea can be highly specific from patient to patient, meaning your symptoms might not be like everyone else’s. A medical professional can give you all the best tips on how to treat rosacea, ways to improve your facial skin, and how to avoid flare-ups.
After being diagnosed with rosacea, it’s time to take charge and get your clear skin back. You have a few options at your disposal. The most common rosacea treatment is probably azelaic acid. It’s a topical medication you can use in areas where you have facial redness, pimples, and bumps. Because of its effectiveness in killing bacteria and decreasing the production of keratin (proteins that can jam up pores), it’s also a good acne treatment.
Azelaic acid isn’t the only topical medication your doctor might prescribe. Two other possibilities are brimonidine and oxymetazoline, both of which work by constricting the blood vessels of your face to help reduce flushing. For more serious inflammation, your doctor may prescribe antibiotics like doxycycline to help reduce infection.
An alternative treatment that can minimize the noticeable symptoms of rosacea is laser treatment. Laser therapy works by using light at various wavelengths to eliminate red patches of skin and other chronic bumps.
What Is the Best Rosacea Treatment?
The best rosacea treatment all depends on your symptoms. Your doctor will perform a thorough exam and ask you questions about what you’re experiencing. Based on what you tell them, they can make the perfect recommendation for you.
For example, if you’re just having mild to moderate rosacea symptoms, topical creams like azelaic acid or brimonidine might do the trick. But if you’re having painful and severe rosacea with inflammatory lesions, a more aggressive treatment like an oral antibiotic might be better.
What Can You Do to Maximize Your Rosacea Treatment?
Make sure you’re using fragrance- and irritant-free skincare products. Avoid anything that contains menthol, urea, camphor, or alcohol, as these can inflame your skin. Keep your skin cleansed and moisturized to help it stay hydrated.
You’ll also want to protect your skin from the sun as much as possible. Always apply an SPF of 30 or more when you’ll be heading outdoors — even if you don’t plan on sunbathing. Additionally, make sure it has broad-spectrum coverage so you’re protected from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. You might also want to wear a hat and try to avoid the sun during the harsh midday hours. You should do that anyway to reduce your skin cancer risk!
Can You Get Rosacea Treatment Online?
Yes, it’s totally possible to get rosacea treatment online! You’ll just need to connect with an online medical provider who can assess your medical history and current symptoms. After a virtual visit, they can prescribe you a regimen of medication or creams to help with your rosacea (if they feel you can safely and effectively be treated virtually).
Questions to Ask Your Medical Provider About Rosacea
If you’ve scheduled an appointment to talk to your doctor about rosacea, it helps to be prepared. Here are some of the questions to ask your doctor so you’ll feel armed with knowledge.
What Kind of Rosacea Do I Have?
There are a few different kinds of rosacea, and the type you have may alter your treatment options. For example, vascular rosacea usually presents with red skin and visible blood vessels, so topical creams might work best. Inflammatory rosacea, on the other hand, can sometimes involve pus-filled pimples that become painful and infected, so you may need antibiotics.
What Can I Do to Avoid Triggers?
Your doctor may have some suggestions for keeping track of your triggers. They can provide information on starting a trigger journal or doing an elimination diet.
What Is the Best Treatment Option for Me?
This is something your doctor should bring up on their own! But still, it doesn’t hurt to ask. That way, you can be sure you’re getting a personalized plan of care.
What Lifestyle Changes Can I Make?
Rosacea treatment works for most people, but it doesn’t hurt to make additional lifestyle modifications as well. Your doctor can make some recommendations based on your habits.
How Often Will I Have to Make an Appointment?
Your primary care provider will likely want to follow your progress and see how treatment is going. Asking this can help you know what to expect with your care plan.