Rosacea is a chronic inflammatory skin condition that can cause flushing, blushing, and skin irritation, usually on the face. People may mistake rosacea for acne, eczema, or an allergic skin reaction. It may stem from inflammation in the blood vessels.

The main symptoms of rosacea are facial flushing, irritated skin, and pimples. Other symptoms include blushing easily and eye problems.

Rosacea is common, affecting 1% to 20% of the population. However, people often receive the wrong diagnosis when they have rosacea, so the true incidence may be much higher.

There is currently no cure for rosacea. However, symptoms can be treated using creams and medications.

Some foods and beverages may worsen the symptoms, such as dairy products, spicy foods, caffeine, and alcohol. Sun exposure can also worsen symptoms in some people.

Rosacea is more common in women, and it usually develops after age 30.

This article provides an overview of rosacea, including its treatments, causes, symptoms, home remedies, and possible complications.

Although rosacea cannot be cured, various treatments can help relieve its symptoms. A combination of medications and lifestyle changes generally gives the best results.

Let’s take a look at some possible treatment options for rosacea.

Skin creams

Skin creams can help reduce inflammation and skin discoloration. Doctors may recommend using them once or twice per day. Examples include topical antibiotics, tretinoin, benzoyl peroxide, and azelaic acid.

People with rosacea may need to take care with tretinoin as it may cause irritation on sensitive skin. Doctors may prescribe it in certain cases, such as rhinophysma or acne rosacea with acne vulgaris.

If a person wishes, a doctor can also suggest camouflage makeup to mask blemishes. These are typically higher coverage than standard makeup and are specifically designed for scars, birthmarks, or conditions such as vitiligo.

Eye drops

Eye drops can relieve ocular rosacea symptoms.

A doctor may recommend a type of steroid eye drop called blephamide. This might be prescribed for a few days to a week, followed by a break or tapering off.

Antibiotics

Oral antibiotics tend to give faster results than topical antibiotics. They can also improve skin symptoms of papules and pustules

Tetracyclines are antibiotics that can help with eye symptoms. Doxycycline is an example that helps improve dryness, itching, blurred vision, and sensitivity to light in people with ocular rosacea.

Isotretinoin

Isotretinoin (Accutane) is an oral medication that people use in severe cases of rosacea (if other treatments have not worked). This is a powerful drug that prevents the skin from making oil. The side effects can be severe.

This medication is not helpful for people with erythematotelangiectatic rosacea.

Laser treatment

Dermatologists can use laser treatment to help reduce visible blood vessels, or telangiectasia. This treatment uses intense pulsed light to shrink them. Other treatments include vbeam (pulsed-dye laser) and KTP

Although the procedure may cause some pain, most people will not need an anesthetic. Laser treatment can sometimes cause bruising, skin crusting, swelling, tenderness, and, very rarely, infection.

If a person wishes to remove thickened skin caused by rosacea, speak with a cosmetic surgeon. Laser treatment or scalpel surgery can remove excess skin. A carbon dioxide laser can also shrink thickened tissue.

There are four main types of rosacea, according to the American Academy of Dermatology (AAD):

  • Erythematotelangiectatic rosacea: Symptoms include skin discoloration, flushing, and visible blood vessels.
  • Papulopustular rosacea: Symptoms include flushing, swelling, and breakouts that resemble acne.
  • Phymatous rosacea: Symptoms include thickened, bumpy skin.
  • Ocular rosacea: Symptoms include eye redness and irritation, and swollen eyelids.

A condition known as steroid rosacea can result from long-term corticosteroid use, particularly when used to treat dermatitis and vitiligo.

Neurogenic rosacea is a lesser-known subtype of the condition.

The signs and symptoms of rosacea can vary considerably from person to person.

Rosacea is more common in people with lighter skin. However, the symptoms of rosacea are more noticeable in these skin tones, and few studies have examined its prevalence among people with darker skin tones.

The following symptoms tend to be present in most cases of rosacea:

  • Persistent skin discoloration: This may look like a blush or sunburn that does not go away. It happens when hundreds of tiny blood vessels near the skin’s surface expand.
  • Skin thickening: The skin may become thicker due to excess skin tissue. This usually affects the nose and can cause rhinophyma, which is more common in males than in females.
  • Flushing: This occurs when the face temporarily darkens. It may spread from the face down to the neck and chest, and the skin may feel unpleasantly hot.
  • Skin bumps and pimples: Small, red, acne-like bumps may develop. These may contain pus.
  • Visible blood vessels: Also called spider veins or telangiectasia, this condition commonly affects the cheeks, the bridge of the nose, and other parts of the central face.
  • Eye irritation: People may have irritated, watery, or bloodshot eyes. The eyelids can become red and swollen (blepharitis), and styes are common. Rosacea affects the eyes in around 50% of people with the condition. Rarely, vision can become blurred.

People may also have the following secondary symptoms of rosacea:

  • burning or stinging sensations in the skin
  • facial swelling, due to excess fluid and proteins leaking out of the blood vessels
  • dry or rough facial skin

The following symptoms may be useful indicators of rosacea in darker skin:

  • a warm feeling most of the time
  • dry, swollen skin
  • patches of darker skin, or a dusky brown discoloration to the skin
  • persistent acne-like breakouts
  • hard, yellowish-brown bumps around the mouth, eyes, or both
  • a burning or stinging sensation when applying skin care products
  • swollen or thicker skin on the forehead, nose, cheeks, or chin

Rosacea is uncommon in children, but if a child does have it, symptoms may differ from those in adults.

Experts are not sure what causes rosacea. However, many believe that the following factors may contribute:

  • Abnormalities in the blood vessels: Skin specialists suggest that facial flushing and spider veins are due to abnormalities in the facial blood vessels. However, they are unsure what causes inflammation in blood vessels.
  • A skin mite called Demodex folliculorum: This mite lives on the skin and usually causes no problems. However, people with rosacea tend to have more of these mites than others. It is unclear whether mites cause rosacea or whether rosacea increases mite levels.
  • Helicobacter pylori bacteria. These gut bacteria stimulate the production of a chemical that causes blood vessels to dilate. Experts suggest that this bacterium may play a role in the development of rosacea.
  • Family history of the condition: Many people with rosacea have a close relative with the condition. This suggests there may be a genetic component.

For some people, dietary factors can worsen rosacea symptoms. The following foods and beverages may trigger or worsen symptoms:

  • hot foods and beverages
  • caffeine
  • dairy products
  • spices and seasonings that contain capsaicin, such as hot sauce, cayenne pepper, and red pepper
  • alcohol, including wines and hard liquors
  • foods containing cinnamaldehyde, such as tomatoes, chocolate, and citrus fruits

Avoid or limit foods that worsen symptoms.

Other factors can exacerbate rosacea by increasing blood flow to the skin’s surface. These include:

  • extremes of temperature
  • sunlight, humidity, and wind
  • stress, anxiety, anger, or feeling embarrassed
  • vigorous exercise
  • hot baths and saunas
  • some medications, such as corticosteroids and drugs for treating high blood pressure
  • acute medical conditions, such as a cold, cough, or fever
  • some chronic medical conditions, such as hypertension
  • hormonal changes, such as in menopause or pregnancy

Each person is different, so it’s important to consider individual triggers to avoid over-limiting a person’s lifestyle. It can help to discuss concerns with a doctor for a holistic and tailored management approach for rosacea.

Minimizing exposure to rosacea triggers will help prevent its symptoms. Adopting good skin care practices can also help.

The following strategies may help manage symptoms alongside medical treatments:

  • Avoid rubbing or touching the face. Avoid exfoliating if this worsens symptoms.
  • Wash with a gentle cleanser and avoid products containing irritating ingredients or alcohol.
  • Avoid comedogenic products. These can block the openings of oil and sweat glands.
  • Keep the skin hydrated with a gentle moisturizer. Wait for medicated creams to dry before applying moisturizer.
  • Wear a broad-spectrum sunscreen when outdoors and avoid excessive sun exposure.
  • Avoid extreme temperatures. In cold weather, protect the face with a scarf or ski mask.
  • Avoid or limit foods and beverages that appear to worsen symptoms. A nutritionist or dietitian can help a person determine if any foods or drinks affect them.
  • Some people try supplements to help manage their symptoms. Speak with a doctor to see if they may be suitable.
  • Avoid using over-the-counter steroid creams unless a doctor has recommended them. These may worsen symptoms in the long term.
  • Use an electric shaver when shaving, as this is less likely to trigger flare-ups.
  • Try strategies to reduce stress.

There is no clinical test for rosacea. A doctor can make a diagnosis after examining the person’s skin and asking about their symptoms and triggers. The presence of enlarged blood vessels will help the doctor distinguish it from other skin conditions.

The presence of a scalp or ear rash usually indicates a different or coexisting diagnosis. Rosacea signs and symptoms occur mainly on the face.

Early diagnosis and prompt treatment can help a person find relief sooner and stop the condition from worsening. If the doctor suspects an underlying medical condition that’s causing the symptoms, such as lupus, they may order blood tests or refer the person to a dermatologist.

Rosacea is a chronic inflammatory skin condition. Symptoms include facial flushing, skin thickening, and eye symptoms.

Although there is currently no cure, people can take medications to treat the symptoms. Home remedies can also help. Discuss potential treatment options with a doctor.