Rosacea

The following page includes commonly asked questions and guidance about rosacea diagnosis and management.

About Rosacea

What is rosacea?

Rosacea is a common skin condition that typically affects the face, causing redness and visible blood vessels. It can also produce small, red, pus-filled bumps. These symptoms may flare up for weeks to months and then diminish for a while. While it can be bothersome, it's not dangerous or contagious. However, it can lead to feelings of embarrassment or self-consciousness.

Who typically gets rosacea?

Rosacea usually begins after the age of 30 and is more common in individuals with light skin, blond hair, and blue eyes. It's often seen in people of Celtic and Scandinavian ancestry. Although rosacea affects both men and women, it often appears in women during menopause. Men with rosacea often have more severe symptoms.

Is rosacea hereditary?

While there isn't a definitive link between genetics and rosacea, it does seem to run in some families, indicating a possible hereditary component. People with a family history of rosacea or who are of Northern European descent are more prone to developing it.

Can rosacea be cured?

Currently, there is no cure for rosacea, but there are effective treatments that can help manage symptoms and prevent them from getting worse. The goal of treatment is to control symptoms and improve the appearance of the skin. Most people experience periods when their symptoms are better or worse.

How does rosacea progress over time?

Rosacea is a chronic condition that tends to evolve over time. Initially, you may notice redness or blushing that comes and goes. As the condition progresses, these symptoms become persistent, and you might develop visible blood vessels and bumps on the skin. In severe cases, rosacea can affect the eyes or cause the nose to become swollen and bumpy.

What triggers rosacea flare-ups?

Individual triggers vary, but common ones include exposure to sunlight, stress, hot or cold weather, alcohol, spicy foods, exercise, hot baths, and certain skincare products. It's a good idea to identify and avoid your personal triggers to help control flare-ups.

Can rosacea be prevented?

While you can't prevent rosacea itself, you can prevent flare-ups by identifying and avoiding your personal triggers. Regular use of sunscreen and gentle skin care can also help manage rosacea.

Does diet affect rosacea?

Certain foods and beverages, particularly spicy foods and alcohol, are known to trigger rosacea flare-ups in some people. However, everyone is different, so it's about noticing if any particular foods seem to worsen your symptoms.

Is rosacea related to other skin conditions?

Rosacea can sometimes be confused with or occur alongside other skin conditions like acne, seborrheic dermatitis, or lupus. It's essential to get a proper diagnosis as the treatment and progression of these conditions can be different.

Diagnosis

How is rosacea diagnosed?

A diagnosis of rosacea is typically made by a dermatologist or other healthcare provider based on a physical examination of your skin and a discussion about your symptoms and medical history. There isn't a specific test for rosacea, but doctors can usually diagnose it by looking at the skin and asking about symptoms. In some cases, a skin biopsy or other tests may be done to rule out similar-looking conditions.

Can I diagnose rosacea myself?

While you might suspect you have rosacea based on symptoms or online research, it's important to get a professional diagnosis. Rosacea can be easily confused with other skin conditions, like acne, seborrheic dermatitis, or lupus. Proper treatment depends on accurate diagnosis, so it's best to consult a doctor if you suspect rosacea.

Are there different types of rosacea?

Yes, there are four main types of rosacea. They include Erythematotelangiectatic rosacea (redness and visible blood vessels), Papulopustular rosacea (similar to acne, with redness, swelling, and acne-like breakouts), Phymatous rosacea (skin thickens and becomes bumpy), and Ocular rosacea (affecting the eyes, causing irritation and redness).

How can I tell if I have rosacea or acne?

While rosacea and acne can look similar and both involve redness and bumps, there are key differences. Rosacea often comes with persistent redness, visible blood vessels, and it might affect your eyes. Acne, on the other hand, commonly includes blackheads and whiteheads, which are not features of rosacea. If you're uncertain, a doctor can help diagnose your condition.

Can rosacea affect other parts of the body?

Rosacea primarily affects the face, but it can also appear on the neck, chest, scalp, or ears. The eyes can be affected too, a condition known as ocular rosacea, causing redness, irritation, and swollen eyelids.

Do men and women experience rosacea differently?

Yes, while rosacea affects both genders, women are more likely to get rosacea, but men often have more severe symptoms, like rhinophyma (swelling of the nose). Rosacea can also flare up in women during menopause.

Does rosacea affect people of all skin tones?

While rosacea is most common in people with light skin, it can affect individuals of all skin tones. It might be underdiagnosed in people with darker skin because the redness might be less visible, but symptoms like flushing, pimples, and skin thickening can still occur.

Topical Treatments: Creams and Gels

How do topical treatments for rosacea work?

Topical treatments, or creams and gels applied directly to the skin, work in various ways to manage rosacea symptoms. Some help reduce inflammation and redness, others target bumps and pimples, and some can help reduce visible blood vessels. They act directly on the skin to alter immune responses, inhibit growth of certain bacteria, or constrict blood vessels.

How long do topical treatments take to show results?

The time it takes to see results from topical treatments varies, but it's generally a few weeks to a few months. Some people may notice a difference within a few weeks, while for others it may take up to three months. It's important to use the medication consistently and as directed by your healthcare provider.

Can I use makeup with topical rosacea treatments?

Yes, you can generally use makeup with topical rosacea treatments. It's usually recommended to let the treatment absorb into your skin for a few minutes before applying makeup. Always choose products that are non-comedogenic (won't clog pores) and suitable for sensitive skin to avoid worsening rosacea symptoms.

Are there any side effects to topical rosacea treatments?

Some people may experience side effects with topical treatments, although they're usually mild. These can include skin irritation, dryness, and itching. If you experience severe side effects, it's best to stop using the product and consult your healthcare provider.

Can topical treatments cure rosacea?

While topical treatments can significantly help manage rosacea symptoms, they can't cure the condition. Rosacea is a chronic skin condition, and while treatments can control and reduce the symptoms, they cannot entirely eliminate the condition.

When are oral medications used to treat rosacea?

Oral medications are often used for moderate to severe rosacea or when topical treatments aren't enough. They may also be used for specific types of rosacea, like ocular rosacea.

What types of pills are prescribed for rosacea?

Several types of oral medications can be prescribed for rosacea. These often include antibiotics like doxycycline, tetracycline, or erythromycin, which have anti-inflammatory effects. For severe cases, a drug called isotretinoin may be used.

Are there side effects to oral rosacea treatments?

Yes, oral medications can have side effects. These can include stomach upset, sensitivity to sunlight, and in rare cases, more serious issues like impact on kidney function. It's important to discuss potential side effects with your healthcare provider.

How long do I have to take oral medication for rosacea?

The duration of treatment depends on the severity of your symptoms, how well you respond to the medication, and your doctor's recommendation. It might range from several weeks to months. Even after symptoms improve, ongoing treatment may be needed to prevent flare-ups.

Can I use oral medication and topical treatments together?

Yes, often a combination of oral and topical treatments is used to manage rosacea, especially for moderate to severe cases. This combination can help manage different symptoms of rosacea more effectively. Always follow your healthcare provider's instructions when using these treatments together.

References

Del Rosso JQ, Tanghetti E, Webster G, Stein Gold L, Thiboutot D, Gallo RL. Update on the Management of Rosacea from the American Acne & Rosacea Society (AARS). J Clin Aesthet Dermatol. 2019 Jun;12(6):17-24. Epub 2019 Jun 1. PMID: 31360284; PMCID: PMC6624012.

Asai Y, Tan J, Baibergenova A, Barankin B, Cochrane CL, Humphrey S, Lynde CW, Marcoux D, Poulin Y, Rivers JK, Sapijaszko M, Sibbald RG, Toole J, Ulmer M, Zip C. Canadian Clinical Practice Guidelines for Rosacea. J Cutan Med Surg. 2016 Sep;20(5):432-45. doi: 10.1177/1203475416650427. Epub 2016 May 17. Erratum in: J Cutan Med Surg. 2021 Jul-Aug;25(4):466. PMID: 27207355.