Actions for this page Listen Print. Summary Read the full fact sheet. On this page. Symptoms of rosacea Risk factors for rosacea Complications of rosacea Diagnosis of rosacea Treatment for rosacea Where to get help. Rosacea, or acne rosacea, is a non-contagious skin inflammation that exclusively affects the face. The small surface blood vessels capillaries of the skin enlarge, giving the appearance of a permanent flush. The forehead, cheeks and chin may develop yellow-headed pimples.
Unlike acne, rosacea does not scar. The condition first appears between the ages of 30 and 50 years. Frequent flushing or blushing is commonly the first sign. Over time, permanent redness erythema may develop as the capillaries enlarge and pustules begin to form. In men, severe rosacea can cause the nose to become reddened and enlarged rhinophyma. The symptoms tend to worsen with advancing age.
The cause is unknown and there is no permanent cure. Be sure to see a healthcare provider about it because the condition could cause lasting cosmetic changes or it could even affect your eyes and eyesight. When you have signs of rosacea, such as pink bumps and telangiectasia visible blood vessels on your face, be sure to pay attention to recent changes in your diet or environment. Keep track of these things because they could be triggers. You also need to check other areas of your skin—such as your hands, legs, back, and neck—to know if you have other lesions besides those on your face.
Consider taking a photo of your skin changes to show your healthcare provider because the pattern may evolve over the next few days, especially if your condition is newly emerging. Not only will your rosacea vary a little over time, but you can also experience bouts when the effects are more prominent due to triggers like sun exposure, or spicy food, or inhalation of cigarette smoke due to your own smoking or via secondhand smoke.
This condition, described as ocular rosacea, can damage your vision if left untreated. If you have any of the signs of rosacea, be sure to look at your eyes carefully and tell your healthcare provider about any problems with your eyes.
Typically, rosacea is diagnosed based on a physical examination. There is no specific test that can rule in or rule out the condition. Your healthcare provider will look at the areas of your skin that you are complaining about and inspect other areas of your skin as well. Your healthcare provider will also examine your eyes or send you to a specialist for an eye examination. There are four types of rosacea, and they each correspond to the pattern of skin or eye changes.
Also described as type one or vascular rosacea , this is one of the more common types of rosacea. Flat patchy areas of redness on the cheeks and forehead are the predominant symptom with this type of rosacea. Small blood vessels may be visible, and the symptoms tend to be persistent, although they can also flare up and worsen at times. This type is often designated as type two or inflammatory rosacea. The patchy areas of redness are characterized by tiny bumps that may or may not be filled with pus.
The most commonly affected areas are the skin on the cheeks, forehead, chin, and neck. The lesions often appear similar to pimples, and the condition can be mistaken for acne. Type three rosacea is the least common. It is characterized by hardened or swollen bumpiness of the skin, possibly with scarring and discoloration.
Type four rosacea affects the eyes and eyelids, and may or may not affect the skin as well. Successful treatment of the erythema and flushing of rosacea using a topically applied selective alpha1-adrenergic receptor agonist, oxymetazoline.
Arch Dermatol. Layton A, Thiboutot D. Emerging therapies in rosacea. A randomized, double-blind, placebo-controlled, pilot study to assess efficacy and safety of clindamycin 1. Two randomized phase III clinical trials evaluating anti-inflammatory dose doxycycline mg doxycycline, USP capsules administered once daily for treatment of rosacea.
Use of oral isotretinoin in the management of rosacea. Ocular rosacea: common and commonly missed. Oltz M, Check J. Rosacea and its ocular manifestations. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
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Rosacea: Diagnosis and Treatment. Author disclosure: No relevant financial affiliations. C 13 , 15 , 16 First-line therapy for mild to moderate inflammatory rosacea includes topical metronidazole Metrolotion, Metrocream, Metrogel or azelaic acid Finacea. A 19 Brimonidine Mirvaso can be used to treat persistent facial erythema associated with rosacea.
A 17 , 21 Topical ivermectin Soolantra may be used for the treatment of papulopustular rosacea. B 18 Subantimicrobial-dose doxycycline Oracea can be used to treat inflammatory lesions of papulopustular rosacea. A 19 , 27 Subantimicrobial-dose doxycycline in combination with topical azelaic acid or metronidazole can be used to treat moderate to severe inflammatory lesions or mild inflammatory lesions that have not responded to initial therapy. C 17 , 26 , 29 Mild ocular rosacea should be treated with eyelid hygiene and topical antibiotic agents, such as metronidazole and erythromycin.
C 30 , 31 Topical ophthalmic cyclosporine drops Restasis are more effective than artificial tears in the management of mild ocular rosacea. Enlarge Print Table 1. Table 1. Enlarge Print Table 2. Table 2. Enlarge Print Table 3. Guidelines for the Diagnosis of Rosacea Presence of one or more of the following primary features : May include one or more of the following secondary features : Flushing transient erythema Burning or stinging Nontransient erythema Plaque Papules and pustules Dry appearance Telangiectasia Edema Ocular manifestations Peripheral location Phymatous changes Reprinted with permission from Wilkin J, Dahl M, Detmar M, et al.
Table 3. Enlarge Print Figure 1. Figure 1. Enlarge Print Figure 2. Figure 2. Enlarge Print Table 4. Skin Conditions That Share Similar Features with Rosacea Condition Distinguishing features Acne vulgaris Comedone formation No ocular symptoms Contact dermatitis Associated with itching and often improves over time when causative agent is removed Photodermatitis Rash appears on multiple body parts with sunlight exposure Seborrheic dermatitis Has distinct distribution pattern involving the scalp, eyebrows, and nasolabial folds Systemic lupus erythematosus Rarely has pustules.
Table 4. Enlarge Print Table 5. Management of Rosacea Central facial erythema Phymatous Ocular Without papulopustular lesions With papulopustular lesions Mild to moderate Moderate to severe General measures Evaluate severity of erythema, inflammation, telangiectasia, and associated symptoms Begin mild nonalkaline skin cleansing and moisturizing regimen Avoid astringents, toners, abrasives, fragrances, and sensory stimulants e. Table 5. Enlarge Print Table 6.
Table 6. Enlarge Print eTable A. Enlarge Print Figure 3. Figure 3. Enlarge Print Figure 4. Figure 4. Read the full article. Get immediate access, anytime, anywhere.
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Navigate this Article. Flushing and persistent central facial erythema with or without telangiectasia. Certain skin care products. Certain cosmetics comedogenic. Medications topical steroids, niacin, beta blockers. Flushing transient erythema. Nontransient erythema. Rash appears on multiple body parts with sunlight exposure. Seborrheic dermatitis. Systemic lupus erythematosus. General measures. Evaluate severity of erythema, inflammation, telangiectasia, and associated symptoms Begin mild nonalkaline skin cleansing and moisturizing regimen Avoid astringents, toners, abrasives, fragrances, and sensory stimulants e.
Same as for mild to moderate. First-line therapy. Topical metronidazole Metrogel, Metrocream, Metrolotion ; azelaic acid Finacea , or brimonidine Mirvaso for erythema Vascular laser therapy pulsed dye laser, intense pulsed light, Nd:YAG laser for erythema and telangiectasia. Topical metronidazole or azelaic acid for inflammation and erythema Topical brimonidine for erythema if needed as adjunctive therapy; may be used in combination with metronidazole or azelaic acid for erythema Topical ivermectin for inflammation; may be used in combination with azelaic acid or metronidazole Vascular laser therapy pulsed dye laser, intense pulsed light, Nd:YAG laser for telangiectasia.
Rosacea can be distressing. You might feel embarrassed or anxious about your appearance and become withdrawn or self-conscious. You may be frustrated or upset by other people's reactions. Consider talking with a counselor about these feelings.
A rosacea support group, either in person or online, can connect you with others facing the same types of problems — which can be comforting. You're likely to start by seeing your family doctor. Or when you call to set up an appointment, you may be referred to a skin disease specialist dermatologist.
If your condition affects your eyes, you may be referred to an eye specialist ophthalmologist. Preparing a list of questions will help you make the most of your appointment time. For rosacea, some basic questions to ask your doctor include:.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis No specific test is used to diagnosis rosacea.
More Information Light therapy for rosacea? Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Kang S, et al. In: Fitzpatrick's Dermatology. McGraw-Hill; Accessed June 13, Habif TP. Acne, rosacea, and related disorders. Saunders Elsevier; Accessed May 19, Dahl MV.
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