What is rosacea?
Rosacea (say it like “row-ZAY-sha”) is a common skin condition that makes your face—or sometimes other areas like your eyes—look red and irritated. You might also notice pimples or swelling in some cases. While rosacea can be uncomfortable, it’s important to know it’s a chronic (long-term) condition that doesn’t have a cure yet, but it can be managed with the right care.
What are the types of rosacea?
Rosacea comes in a few different types, each with its own set of symptoms:
Erythematotelangiectatic Rosacea – This type causes your face to stay red for a long time, and you might notice tiny, visible blood vessels on your skin. The redness can come and go in flare-ups, sometimes without warning.
Papulopustular Rosacea – This one looks a bit like acne, with red, swollen bumps that may have pus inside. Your skin might also feel tender or swollen.
Phymatous Rosacea – This type makes your skin thick and bumpy, usually around the nose. It can cause your nose to look larger or bulbous, which is sometimes called rhinophyma.
Ocular Rosacea – This affects your eyes, making them red, irritated, and watery. You might also find that your eyes are sensitive to light, and painful bumps (called styes) can appear on your eyelids.
How common is rosacea and who does rosacea affect?
Rosacea is pretty common—it affects over 14 million people in the U.S. While anyone can get it, it tends to show up more often in women and people with fair skin. Most people start noticing symptoms after they turn 30. It’s rare, but kids and teens can get it too. If someone in your family has rosacea, your chances of getting it are higher.
Interestingly, studies show that men with rosacea often have worse symptoms because they tend to wait longer before seeking treatment.
Symptoms and Causes
What are the signs of rosacea?
Rosacea can show up differently for different people, and usually, you won’t have each and every symptom. But most people with rosacea have at least one of the main signs, such as:
- Flushing: Many people with rosacea tend to blush or flush easily. This red, warm feeling on the face might come and go and is often the first sign.
- Persistent redness: Sometimes, the redness sticks around and looks like a constant blush or sunburn that just won’t fade.
- Bumps and pimples: You might notice small red bumps or pus-filled pimples on your skin. These can look a bit like acne, but rosacea doesn’t cause blackheads. You might also feel a burning or stinging sensation.
- Visible blood vessels: Tiny blood vessels near the surface of your skin can become visible as thin red lines.
What are the symptoms of rosacea?
Rosacea doesn’t just cause redness—there are several symptoms that can show up, depending on the type and severity of your condition.
- Eye problems: Your eyes might feel irritated, look red or watery, and you could even get styes (painful bumps on the eyelid). In more serious cases, untreated eye rosacea can damage your cornea and affect your vision.
- Burning or stinging: You might feel a burning or stinging sensation on your face, and your skin can feel itchy or unusually tight.
- Dry, rough skin: Sometimes, the skin on your face may feel very dry or rough, even if you’re using moisturizers.
- Red patches (plaques): Some people develop raised red patches that look like a rash but don’t affect the surrounding skin.
- Thickened skin: In rare cases, especially in men, the skin—usually on the nose—can become thicker and swollen. This condition is called rhinophyma and can make the nose look bulbous.
- Swelling: You may also notice swelling in your face, either on its own or along with other symptoms.
Where Can Rosacea Symptoms Appear on the Body?
While rosacea is most commonly known for affecting the face, its symptoms can actually show up in several areas. You might notice redness, bumps, or irritation on:
- Nose
- Chin
- Cheeks
- Forehead
- Eyes (can feel irritated or look bloodshot)
- Chest
- Ears
- Neck
- Scalp
Everyone’s experience with rosacea can be a little different, so the areas affected may vary from person to person.
What Triggers Rosacea Symptoms?
Rosacea flare-ups can be different for everyone, but most people have certain things—called triggers—that make their symptoms worse. Some common rosacea triggers include:
- Too much sun
- Hot or cold weather
- Stress or anxiety
- Drinking alcohol
- Eating spicy foods
- Using certain skin or hair products (like lotions or hairspray)
- Hormonal changes
If you're unsure what’s causing your flare-ups, try keeping a simple journal. For a few days or weeks, write down what you eat, drink, use on your skin, or do—and note how your skin reacts. This can help you figure out your personal triggers. Once you know what to avoid, you’ll have a better chance at keeping your rosacea under control.
Contact with Dr. (Prof.) Anil Arora for Best Treatment
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Dr. (Prof) Anil Arora
Vice Chairman & Head of Department Orthopaedics & Joint Replacement Surgery, Max Super Speciality Hospital, Patparganj, Delhi
Chairman & Chief Surgeon, Prof. Arora's Knee & Hip Surgery Clinics, NCR
Education & Training:
Hospital: Max Super Specialty Hospital
Clinic: Prof. Arora’s Knee & Hip Surgery Clinics, Delhi NCR
Experience: 33+ Years
- Commonwealth Academic Staff Fellowship in Primary, Complex & Revision Joint Replacement Surgery: Royal National Orthopaedic Hospital - Stanmore, London (UK)
- Professor at University College of Medical Sciences & GTB Hospital, New Delhi
- Assistant Professor at Dr SN Medical College & Mahatma Gandhi Hospital, Jodhpur
- Senior Resident at University College of Medical Sciences & GTB Hospital, New Delhi
Specialty: Orthopaedic Joint Replacement (Robotic Knee & Hip Replacement) Max Super Specialty Hospital
About: Dr. (Prof.) Anil Arora, Guinness world record holder and Limca book of records holder, is a Senior Robotic Total Knee & Hip Replacement surgeon. He is an Internationally known figure in Orthopedics and joint replacement. He has been performing joint replacements since 1988, experience of more than 33 years and 12,000 Knee & Hip Replacement surgeries. Teaching in medical college and training Orthopedic surgeons has provided him with vast surgical and clinical experience and expertise. He has wide-ranging skills in knee and hip replacement surgeries. He is known for his sound clinical judgment and fine surgical skills. He was the first surgeon to start pinless computer navigated total knee replacements in north India. He is regularly performing primary, complex and revision (Robotic & pinless computer navigated) knee and hip replacement surgeries. He is also performing primary and revision elbow and shoulder replacements. He is the immediate past president of Delhi Orthopedic association.
What causes rosacea?
The exact cause of rosacea is still a mystery. However, research points to a few possible reasons:
- It might be linked to problems with your blood vessels, immune system, or nervous system.
- Tiny skin mites called Demodex naturally live on your nose and cheeks. When there are too many of these mites, they can trigger rosacea symptoms.
- An infection caused by H. pylori bacteria could play a role. Some studies show that people with this infection are more likely to develop rosacea.
- A protein called cathelicidin usually helps protect your skin from infections. If this protein isn’t working properly, it may lead to rosacea symptoms.
Is rosacea an autoimmune disease?
Scientists are still trying to figure out the exact cause of rosacea and whether it’s an autoimmune disease. In some cases, rosacea happens because the immune system goes into overdrive. Normally, your immune system protects you from things like bacteria that can make you sick.
But in some people with a type of rosacea called papulopustular rosacea, a certain bacteria called Bacillus oleronius can make the immune system react too strongly. This causes the immune system to attack healthy skin by mistake—this kind of reaction is called an autoimmune response, and it leads to rosacea symptoms.
In other cases, rosacea may happen because the immune system is very sensitive to changes around you, like sunlight or temperature shifts. When this happens, the immune system works too hard to deal with these changes, which can also cause rosacea symptoms.
Diagnosis and Tests
How is rosacea diagnosed?
To figure out if you have rosacea, your doctor will carefully look at your symptoms and ask about your medical history. It’s important to tell them about any skin issues you’re experiencing—like redness, bumps or pimples, burning, itching, or anything else that feels unusual. There isn’t a single test that can confirm rosacea, so your doctor might suggest seeing a dermatologist, who is a skin specialist, for a closer look.
Management and Treatment
How is rosacea treated?
What medications treat rosacea?
Your doctor might suggest different medicines to help with your rosacea symptoms, such as:
- Antibiotics like doxycycline (available as pills, gels, or creams) to help reduce bumps and pimples.
- Brimonidine gel, which can help calm redness.
- Creams or gels containing azelaic acid, ivermectin, or metronidazole to shrink bumps and pimples.
Before you start any new medicine, make sure to ask your doctor about how much to take, when to take it, and any side effects that you might expect. Also, tell your doctor about any other medicines you’re already taking, so they can avoid any possible interactions.
What foods should I avoid if I have rosacea?
Some research suggests that spicy foods—like hot wings or jalapeños—can trigger rosacea symptoms. But everyone is different, and what causes a flare for one person might not affect another. If you notice that spicy foods seem to make your rosacea worse, it’s a good idea to avoid them to keep flare-ups at bay.
How soon after treatment will I feel better?
It usually takes a few weeks to a few months before you start seeing improvements. If your doctor gives you medicine, they’ll keep an eye on how well it’s working. As your symptoms get better, your doctor might lower your medicine dosage.
Prevention
How can I prevent rosacea?
Since we don’t know exactly what causes rosacea, it can’t really be prevented. But you can lower your chances of a flare by figuring out what triggers your symptoms and avoiding those triggers.
Be careful when you’re outside in the sun because UV rays can make rosacea worse and slow down healing. Always use sunscreen every day and reapply it throughout the day. Wearing hats and clothes that protect you from the sun is also a good idea.
Outlook / Prognosis
What can I expect if I have rosacea?
Rosacea is a long-term condition, and symptoms can come and go without warning. If you learn what triggers your symptoms, try to avoid those things to prevent flare-ups.
While rosacea isn’t dangerous, it can cause discomfort and change how your skin looks. In severe cases, untreated rosacea can change the shape of your nose. Surgery can help with those severe cases, but most people find relief with medicines or over-the-counter creams and lotions for milder symptoms.
Does rosacea ever go away?
There’s no cure for rosacea yet, but treatments can help control symptoms and keep flare-ups from coming back. Talk to your doctor about your symptoms—they’ll help you manage the condition and keep it under control.
Living With
Can I cover rosacea with makeup?
Yes! Over-the-counter makeup can help cover rosacea. Here are some options:
- Green-tinted moisturizers that help neutralize redness.
- Oil-free concealers or foundations that are one shade lighter than your natural skin tone.
- Mineral powders, which often have fewer irritating ingredients.
- Fragrance-free or sensitive-skin products to avoid irritation.
- Some topical creams can help with redness and small pimples.
- Sunscreen is important too because sun exposure can trigger rosacea. Many makeup products now include sunscreen as well.
When should I see my healthcare provider?
Make an appointment if you notice signs of rosacea, especially if your skin feels painful or uncomfortable.
What questions should I ask my doctor?
- How can I prevent flare-ups?
- Which skincare products are best for me?
- When and how often should I take my medicine?
- Can I wear makeup with my symptoms?
- Do I need surgery to treat my rosacea?
Additional Common Questions
What’s the difference between rosacea and a lupus rash?
Rosacea and lupus rash can look similar since both affect your face, especially your cheeks and nose, and can get worse with sun exposure. The main difference is how they look and feel: lupus rash usually causes red, scaly, itchy patches, while rosacea makes your skin look red, swollen, and bumpy. Rosacea isn’t harmful, but lupus rash can cause lasting damage like scarring or hair loss.