Rosacea: Common Symptoms, Causes & Risk Factors
Rosacea is a common skin condition that affects around one in 20 people in the UK. What are the most prevalent symptoms, causes and risk factors? When should you see a doctor about rosacea?
6 minute readRosacea (pronounced roe-ZAY-she-uh) is a common skin condition that affects around one in 20 people in the UK. It causes facial redness, commonly on the nose and cheeks and is more common in women. Rosacea is not contagious, meaning it cannot be passed from one person to another.
In this article, we will look at what rosacea is, what the causes and symptoms of rosacea are, and what treatments are available.
What is rosacea?
Rosacea is a chronic (long-term) inflammatory skin condition that causes reddening of the skin, and in some cases visible blood vessels and small pus-filled bumps. It usually occurs on the nose and cheeks, but can affect other areas such as the forehead, chin, neck, and chest. Some people with rosacea also have eye problems.
Symptoms usually come and go, and may be triggered by factors such as stress, alcohol, certain foods, or exposure to sunlight.
There are four different types of rosacea:
Erythematotelangiectatic rosacea (ERT/vascular rosacea)
This is usually the first stage of rosacea and causes blushing and facial redness (erythema) with visible, enlarged blood vessels (telangiectasia). People with this type of rosacea often experience flare-ups, where symptoms get worse and then better.
Papulopustular rosacea (inflammatory rosacea)
Papulopustular rosacea appears as small pus-filled or red bumps that form close together on your skin. Your skin may also feel itchy, swollen, or hot to the touch. This type of rosacea is often mistaken for acne.
Phymatous rosacea
This is a rare type of rosacea that causes thickening and scarring of the skin. It commonly affects the nose and can make your nose appear bigger, a condition known as rhinophyma.
Ocular rosacea
This type of rosacea affects your eyes and the skin around them. Your eyes may feel irritated, bloodshot, and sensitive to light. You may also develop painful bumps on your eyelids, known as styes. If ocular rosacea is left untreated, it can lead to eye damage and loss of vision.
What are the symptoms of rosacea?
The symptoms of rosacea vary depending on the type and severity of your condition. You may have one, several, or all of the below symptoms.
Symptoms of rosacea may include:
Facial redness - may start as short periods of facial flushing but may last for longer periods over time. In people with darker skin, facial redness may be more subtle or appear pink or purple.
Your skin may feel hot, tender, tingling, or burning.
Facial burning or stinging when using water or skincare products.
Small, swollen bumps on the skin that may contain pus and often resemble acne. They may also appear on the chest and back.
Visible blood vessels - typically appear as thin red lines on the cheeks and nose.
Thickening of the skin - especially on the nose, making the nose appear larger. This symptom is more common in men.
Eye irritation
What causes rosacea?
It isn’t known exactly what causes rosacea, but several potential factors have been suggested.
Genetics - rosacea tends to run in families, and there may be a genetic component.
Blood vessel abnormalities - abnormalities in the small blood vessels of the face may cause facial flushing, persistent redness, and visible blood vessels.
Sun damage
Microscopic mites - demodex folliculorum are microscopic mites that normally live harmlessly on the skin. People with rosacea have an abnormally high number of these mites, which may play a role in the condition.
Skin peptides — triggers such as exercise, stress, heat, cold, ultraviolet (UV) light, spicy food, and alcohol may lead to molecules in the skin called peptides being activated. This may affect the immune system or nerves and blood vessels in the skin, causing the blood vessels to dilate (widen) and leading to redness and inflammation.
Helicobacter pylori bacteria - Helicobacter pylori is a type of bacteria found in the digestive system. There may be a link between Helicobacter pylori and rosacea, but more research is needed.
What can trigger rosacea?
Though it isn’t clear what causes rosacea, certain foods and environmental factors are known to make symptoms worse.
Common triggers for rosacea include:
Alcohol (particularly red wine)
Exposure to sunlight or strong winds
Hot, humid, or cold temperatures
Stress
Spicy foods
Caffeine
Hot drinks
Dairy products
Some medications such as calcium channel blockers, corticosteroids, and high doses of vitamins B6 and B12
Vigorous exercise
What are the risk factors for rosacea
Rosacea can affect anyone, but is more common in people who:
Are between 30 and 50 years of age.
Are female - women are more likely than men to get rosacea, however, men with rosacea are more likely to have severe symptoms.
Are fair-skinned, with blonde hair and blue eyes.
Have a family member with rosacea or severe acne.
Have a history of severe acne.
Are of Scandinavian or Celtic descent.
When should I see a doctor?
See your GP if you have ongoing symptoms of rosacea. Your GP can make a diagnosis and offer advice on managing the condition. In some cases, they may prescribe treatment.
It’s important to get a professional diagnosis for rosacea so you can manage the condition effectively. Rosacea sometimes looks like other conditions, such as:
Acne
Lupus
Contact dermatitis and other types of dermatitis
Keratosis pilaris
If your rosacea is severe, your GP may refer you to a specialist skin doctor called a dermatologist.
How is rosacea diagnosed?
There’s no specific test to diagnose rosacea. To make a diagnosis, your GP or dermatologist will examine your skin and ask you some questions about your symptoms, general health, and medical history.
Your GP may also request a blood test to rule out any underlying medical conditions that could be causing your symptoms.
How is rosacea treated?
There is currently no cure for rosacea, but there are several treatments available. The type of treatment most suitable for you depends on the type and severity of your rosacea, as well as how well it has responded to other treatments.
Avoiding triggers
The first step in treating rosacea is to avoid triggers you know make your condition worse. Here are some things you can do to avoid triggering your rosacea:
Use a high SPF sunscreen (at least SPF 30) every day
Avoid exposing your skin to sunlight, and hot or humid weather where possible
Protect your skin from the cold
Use skincare products for sensitive skin
Keep your eyelids clean if you have blepharitis (inflammation of the eyelids)
Avoid alcohol, hot drinks, spicy food, and other foods that trigger your symptoms
Avoid or limit strenuous or aerobic exercise
Medical treatments
Treatments for rosacea include:
Antibiotics - such as doxycycline or minocycline. Antibiotics usually take about three to four weeks to start to work, and it’s normally around six weeks before your rosacea has cleared completely.
Topical treatments - are applied directly to the skin and include topical antibiotics and azelaic acid.
Diathermy - uses electric currents (radio and sound waves) to heat your skin just below the surface. It can help reduce inflammation and improve blood circulation.
Laser surgery - This painless treatment uses pulses of light energy to shrink visible blood vessels
Can rosacea be prevented?
As the cause of rosacea is unknown, it’s difficult to prevent the condition from developing. However, you can reduce your risk of flare-ups by identifying and avoiding things that trigger your symptoms.
Managing rosacea
Rosacea is a common skin condition of unknown cause that causes symptoms such as facial redness, visible blood vessels, acne-like bumps, and thickening of the skin.
Though not dangerous to your health, rosacea can make you self-conscious about your appearance and result in anxiety and low self-esteem. This is unfortunately a consequence of many skin conditions.
Rosacea can often be managed by avoiding “triggers” that make your symptoms worse. However, if your symptoms are severe, treatments such as antibiotics, topical creams, and laser therapy are often highly effective.
