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Rosacea

Rosacea is a common inflammatory skin condition that mainly affects your face, though it can sometimes affect your neck, chest or scalp. It often causes redness, flushing and acne-like bumps that may come and go over time. 

If you have rosacea, you may notice: 

  • Facial redness with lighter skin tones or brown discoloration with darker skin tones 
  • Easy flushing or blushing 
  • A warm or burning feeling in your face 
  • Visible blood vessels (telangiectasia) 
  • Acne-like bumps or pus-filled pimples (papules and pustules) 
  • Dry, rough or sensitive facial skin 
  • Facial swelling 

Many people overlook rosacea at first because they think the redness will go away on its own. But without treatment, symptoms may gradually worsen. 

Rosacea signs and symptoms can vary from person to person. The condition is more common in women and people with fair skin, but symptoms may be more severe in men. Your risk may also be higher if someone in your family has rosacea. 

Rosacea is a chronic condition. While it isn’t life-threatening, it can affect your comfort and confidence. The good news is that treatment and lifestyle changes can help manage symptoms. 

Concerned about persistent redness, flushing or bumps on your face? A Banner Health dermatologist can help diagnose rosacea and create a treatment plan tailored to your symptoms. 

What causes rosacea? 

Experts don’t know the exact cause of rosacea. It is not contagious, so you cannot catch it from another person. 

Researchers believe rosacea may be linked to a combination of factors, including: 

  • Genetics or family history 
  • Blood vessel abnormalities 
  • Immune system responses 
  • Certain bacteria on the skin 

Symptoms often flare when something triggers inflammation. 

Common rosacea triggers include: 

  • Sun exposure 
  • Hot or spicy foods and drinks 
  • Alcohol 
  • Dairy products 
  • Very hot or cold temperatures 
  • Strong wind 
  • Stress or strong emotions 
  • Some skin care or hair products 
  • Certain medications 
  • Strenuous exercise 
  • Smoking 

Triggers can vary from person to person. Tracking your symptoms may help identify patterns. 

Types of rosacea 

There are four main types of rosacea. Some people have more than one type at the same time. 

Erythematotelangiectatic rosacea 

This type mainly causes redness and visible blood vessels. 

Symptoms may include: 

  • Persistent facial redness (erythema) 
  • Visible small blood vessels (telangiectasia) on the cheeks, nose, chin or forehead 
  • Frequent flushing or blushing 
  • Sensitive skin that burns or stings 
  • Dry, tight or warm skin 

Sunlight, temperature changes and certain skin care products often trigger flare-ups. 

Papulopustular rosacea 

Papulopustular rosacea can look similar to acne. 

Symptoms may include: 

  • Red, inflamed skin 
  • Acne-like bumps or pus-filled pimples 
  • Breakouts mainly on the nose, cheeks and forehead 

Heat, spicy foods, alcohol or stress can trigger or worsen symptoms. 

Phymatous rosacea 

Phymatous rosacea causes thickened skin, usually affecting the nose. 

Symptoms may include: 

  • Thick, bumpy or uneven skin 
  • Enlarged oil glands 
  • Rough skin texture that may resemble an orange peel 

In some cases, the nose becomes enlarged. This condition is called rhinophyma. 

This type occurs more often in men and may slowly worsen over time. 

Ocular rosacea 

Ocular rosacea affects the eyes and eyelids and may occur along with other types of rosacea. 

Symptoms may include: 

  • Dry or irritated eyes 
  • Burning or stinging sensations 
  • A gritty feeling in the eyes 
  • Red or watery eyes 
  • Sensitivity to light (photophobia) 
  • Blurred vision 

If you notice eye symptoms, it is important to see an eye care professional. Early treatment can help prevent eye damage or vision problems. 

How rosacea is diagnosed 

There is no single test to diagnose rosacea. A dermatologist or experienced health care provider usually diagnoses rosacea based on: 

  • Your medical history 
  • Your symptoms 
  • A physical examination of your skin 

Because other conditions can look similar, your provider may sometimes order tests to rule them out. 

Conditions that may be confused with rosacea include: 

Acne 

Acne often causes blackheads and whiteheads, which rosacea typically does not. Acne also tends to affect the forehead, jawline and chin more than rosacea. 

Seborrheic dermatitis 

This condition causes redness and flaking and often affects the scalp, eyebrows and oily areas of the face. 

Lupus 

Some forms of lupus can cause facial redness and rashes similar to rosacea but usually include other symptoms such as joint pain or fatigue. 

Perioral dermatitis 

This condition causes small red bumps around the mouth and nose and may be linked to steroid creams, cosmetics or certain toothpaste. 

Contact dermatitis 

Skin irritation from allergens or irritants can cause redness, swelling and itching that may resemble rosacea. 

Rosacea treatment options 

Rosacea treatment focuses on controlling symptoms and preventing flare-ups. Your dermatologist may recommend a combination of treatments based on your symptoms and type of rosacea. 

Skin care and sun protection 

Gentle skin care can help reduce irritation. 

Helpful steps include: 

  • Using mild cleansers 
  • Avoiding harsh products such as astringents 
  • Choosing oil-free and fragrance-free skin care and makeup 
  • Protecting your skin from sun exposure 

Daily sunscreen is especially important. 

Topical medications 

Prescription creams or gels applied to the skin can reduce redness and inflammation. 

Examples include: 

  • Oxymetazoline (Rhofade) 
  • Metronidazole (Metrogel, Noritate) 
  • Azelaic acid (Azelex, Finacea) 
  • Brimonidine (Mirvaso) 
  • Ivermectin (Soolantra) 

Oral medications 

Your provider may prescribe oral antibiotics to reduce inflammation. 

Examples include: 

  • Tetracycline 
  • Doxycycline (Oracea) 

These medications are often used for moderate or severe rosacea. 

Laser and light therapies 

Laser or light treatments can help: 

  • Reduce visible blood vessels 
  • Decrease redness 
  • Improve thickened skin 

These procedures are often considered cosmetic treatments, so health insurance may not cover them. 

Lifestyle changes 

Lifestyle adjustments can help prevent rosacea flare-ups. 

Helpful strategies include: 

  • Avoiding known triggers 
  • Protecting your skin from the sun 
  • Managing stress 
  • Tracking foods, activities and skin care products that worsen symptoms 

Keeping a symptom journal may help you identify patterns. 

Surgery for phymatous rosacea 

In rare cases, surgery may help reshape thickened nasal tissue caused by rhinophyma. 

How ocular rosacea is treated 

If rosacea affects your eyes, an eye care professional can recommend treatments to reduce irritation and protect your vision. 

Treatment may include: 

Eyelid hygiene 

Cleaning the eyelids with gentle cleansers or medicated lid scrubs. 

Artificial tears 

Lubricating eye drops can help relieve dryness and irritation. 

Medicated eye drops or ointments 

Antibiotic or anti-inflammatory medications may help control symptoms. 

Oral antibiotics 

These medications may reduce inflammation in more severe cases. 

Environmental protection 

Wearing sunglasses and protecting your eyes from wind, dust and bright sunlight may help prevent irritation. 

Regular eye exams are important to monitor ocular rosacea. 

Living with rosacea 

Rosacea can affect emotional well-being. Some people feel embarrassed or self-conscious about facial redness or breakouts. 

You may find it helpful to: 

  • Work with a dermatologist to manage symptoms 
  • Learn your personal triggers 
  • Follow a consistent skin care routine 
  • Seek support or reliable information about the condition 

Helpful resources include: 

With the right treatment plan and lifestyle changes, many people are able to control rosacea symptoms and improve their skin health. 

Rosacea FAQ 

What are the early signs of rosacea? 

Early signs often include facial redness, flushing or blushing more easily than normal. Some people also notice visible blood vessels or a burning or warm feeling on the skin. Over time, acne-like bumps or persistent redness may develop. 

Can rosacea go away on its own? 

Rosacea usually does not go away without treatment. Symptoms may come and go, but the condition is chronic. Treatment and lifestyle changes can help control symptoms and prevent flare-ups. 

What foods trigger rosacea? 

Some foods and drinks may trigger rosacea symptoms. Common triggers include spicy foods, hot drinks, alcohol and dairy products. Triggers vary from person to person, so keeping track of what you eat may help identify patterns. 

Is rosacea the same as acne? 

No. Rosacea and acne are different conditions. Acne typically causes blackheads and whiteheads, while rosacea does not. Rosacea also tends to cause facial redness and visible blood vessels. 

What is the best treatment for rosacea? 

Treatment depends on the type and severity of rosacea. Many people benefit from a combination of gentle skin care, prescription topical medications, oral antibiotics and lifestyle changes to avoid triggers. 

If you are experiencing persistent redness, flushing or acne-like bumps on your face, a Banner Health dermatologist can help identify the cause and recommend treatment options to improve your skin and comfort.