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Rosacea - Causes, Symptoms, Risk Factors, Types, and Treatment

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Rosacea is a skin condition that commonly occurs on the face due to enlargement of the blood vessels, but it is not contagious.

Written by

Dr. Preetha. J

Medically reviewed by

Dr. Barve Vaibhav Saidas

Published At February 10, 2021
Reviewed AtApril 10, 2024

What Is Rosacea?

Rosacea is a chronic inflammatory condition that can cause redness or noticeable blood vessels in the face. Rosacea does not get cured on its own, it can go into remission, and there can be time lapses between the flare-ups. If not treated, it can cause permanent damage to the skin. The damage can be endless, like redness of the skin due to long-lasting blushing, and the appearance of spider veins in the cheeks, and may affect the patient's eyes. Rosacea is not a contagious disease. It can persist for an extended period in any individual, but the severity tends to fluctuate. Rosacea can affect the cheeks, chin, forehead, and nose, and it is discriminated by persistent redness caused by dilated blood vessels, pus-filled spots, and small bumps similar to acne. There can also be painful inflammation of the outside of the eyes and eyelids.

What Can Cause Rosacea?

The cause of rosacea is unknown, but it can be a combination of environmental and hereditary factors, not due to poor hygiene. The common factors that can worsen the condition are:

  • Hot drinks and spicy foods.

  • Sunlight or wind.

  • Temperature extremes.

  • Red wine and other alcoholic beverages.

  • Emotions.

  • Exercise.

  • Drugs like blood pressure medications can dilate blood vessels.

  • Various cosmetic products.

  • Microscopic skin mites that carry bacteria.

What Are the Signs and Symptoms of Rosacea?

The signs and symptoms of rosacea are:

  • Bumpy texture to the skin.

  • Oily skin.

  • Skin begins to thicken, especially widespread on the nose. When the skin on the nose thickens, it is called rhinophyma.

  • The pores look large.

  • The skin may swell on the chin, forehead, cheeks, and ears.

  • Broken blood vessels may be visible on the nose and cheeks.

  • Red patches on the face, particularly on the central part of the face.

  • Small, red, and pus-filled bumps.

  • A hot and tender feeling of the skin.

  • Dryness or irritation in the eyes.

  • Reddened and swollen eyelids.

  • Enlarged nose, often seen in men.

  • Problems with seeing.

What Are the Signs of Ocular Rosacea?

  • Watery eyes and blood shots.

  • Broken blood vessels on eyelids.

  • Eyes that feel gritty.

  • Cysts on eyes.

  • Dry or itchy eyes.

  • Stinging or burning sensation in the eyes.

  • Eyes that are sensitive to light.

  • Diminished vision.

What Are the Types of Rosacea?

The types of rosacea are:

  • Erythematotelangiectatic rosacea is characterized by redness on the face.

  • Phymatous rosacea is associated with the thickening of the skin of the nose.

  • Papulopustular rosacea usually occurs in middle-aged women and is associated with acne-like breakouts.

  • Ocular rosacea usually shows symptoms in the eye area.

What Are the Risk Factors for Rosacea?

The risk factors for developing rosacea are:

  • Age.

  • In gender, women can develop rosacea more frequently than men, but men can also develop severe rosacea.

  • Sun exposure.

  • History of acne.

  • Family history.

  • Fair skin.

  • Blonde hair.

  • Blue eyes.

  • Ethnic background.

  • Smoking.

  • Hairspray.

How to Diagnose Rosacea?

For the diagnosis of rosacea, the doctor usually relies on the signs and symptoms of the patient. Skin biopsy can rule out skin conditions like psoriasis, lupus, or eczema because the signs and symptoms of these conditions are similar to those of rosacea.

What Are the Differential Diagnoses for Rosacea?

The differential diagnosis for rosacea are:

  • Acne vulgaris is a common skin condition that occurs due to any block in the hair follicles due to bacteria, dead skin cells, or oil. It can result in blemishes on the skin like blackheads, whiteheads, pimples, or cysts.

  • Lupus erythematosus is an autoimmune disease resulting in joint erosion, skin rash, and even kidney failure.

  • Contact dermatitis is the inflammation of the skin caused by contact with any substances.

  • Seborrheic dermatitis is a condition that affects the scalp and results in scaly skin.

  • Perioral dermatitis is the inflammatory rashes occurring on the skin around the mouth.

  • An eczema is a group of skin conditions causing red and itchy rashes.

  • Carcinoid syndrome occurs in a patient with a carcinoid tumor.

  • Psoriasis is a chronic skin condition resulting in scaly, itchy areas in patches.

  • Natural ruddiness.

What Are the Treatment Methods for Rosacea?

The treatment for rosacea mainly focuses on controlling the signs and symptoms. It can be a combination of prescription drugs and good skincare. Drugs like Metronidazole, Azelaic acid, and Ivermectin may have less effect on skin color, but they will control pimples.

Topical Treatment:

  • Metronidazole.

  • Azelaic acid.

  • Ivermectin (one percent) for mild to moderate rosacea, which has an anti-inflammatory effect, kills the Demodex mites that produce pustules to activate the local immune response.

  • Dapsone.

  • Cream or gel such as Brimonidine and Oxymetazoline reduces redness by constricting the blood vessels. The patient may see the results within 12 hours of use.

Oral Antibiotics:

  • Oral antibiotics like Doxycycline for moderate to severe rosacea, which has pimples and bumps.

Oral Acne Drugs:

  • Isotretinoin is a powerful drug that acts against acne and cleans up all the rosacea's acne-like lesions.


  • Laser or other light-based therapies may decrease the skin's redness due to enlarged blood vessels. Repeated treatments are required to get a better result.

Alternative Medicine:

The alternative methods of treating rosacea are:

  • Facial massage to reduce the swelling and inflammation of the face.

  • Having caffeine reduces the risk of developing rosacea.

  • Laurelwood, emu oil, and oregano oil are used to treat rosacea.

When to Visit a Physician?

Seek the diagnosis and treatment of a healthcare professional if one experiences persistent symptoms related to the face or eyes.

What Are the Home Cures and Lifestyle Changes to Prevent Rosacea?

The following self-care advice could help to soothe the skin and stop flare-ups:

  • Recognize and stay away from things that exacerbate the signs. Identify the triggers that cause flare-ups and steer clear of them.

  • Shield one's face. Even on days when it is cloudy, apply a moisturizer or broad-spectrum sunscreen with an SPF of no less than 30. It may be beneficial for people with rosacea to use sunscreens that include zinc, titanium dioxide, or both. Consider wearing a cap and avoiding the noon sun as additional measures to protect one's face.

  • Be gentle with the skin. Avoid trying to touch or rub the face excessively. Moisturize after using a nonsoap cleanser twice a day. Certain facial creams could aid in lowering redness.

  • Products containing skin irritants including alcohol, camphor, urea, and menthol should be avoided in favor of fragrance-free options.

  • Use cosmetics to lessen facial symptoms. Certain makeup items could lessen the typical rosacea facial flushing.

  • Limit the consumption of alcohol.

  • Protect the face from wind and cold.

  • Choose mild foods and cold beverages.

  • Minimize stress.

What Diet to Be Followed in Rosacea?

Foods to be avoided when individuals have rosacea are:

  • In any form, heat is a common triggering factor of rosacea outbreaks; therefore, eliminating heated up beverages such as tea, hot cider, coffee, and hot chocolate is essential.

  • Spicy foods.

  • Foods that contain histamine.

  • Alcohol.

  • Dairy.


Rosacea is a benign skin ailment that primarily affects the face and produces redness. Its exact etiology is unknown. Genetics, a hyperactive immune system, or anything going on in everyday life could be to blame. Rosacea has no known treatment. However, with medication, mild skin care, and avoiding triggers, one might be able to manage it.

Frequently Asked Questions


What Is the Main Cause of Rosacea?

The causes of rosacea are unknown, and scientists found that it can be due to the following:
- Hereditary factors - Family members of rosacea.
- Environmental factors - Overexposure to sunlight.
- Bacillus oleronius - Rosacea reacts to this bacterium, which makes the immune system overreact.
- H.pylori infection - Patients who have rosacea have had H.pylori infections.
- Demodex - This mite loves to live in cheeks and nose and is found in many people who have rosacea.
- Cathelicidin - This is a protein that may cause redness and swelling in rosacea.
- Hot drinks and spicy foods - Flares up rosacea.


What Is the Treatment for Rosacea?

- For mild to moderate rosacea, topical medications in the form of cream or gel can be applied to the affected areas.
- Oral antibiotics such as Doxycycline help with bumps and pimples for moderate to severe rosacea.
- Metronidazole reduces inflammation and is commonly used in the treatment of rosacea. It can be applied in the form of cream, gel, or lotion twice a day.
- Oral acne drug.


Can Rosacea Go Away?

Rosacea will not disappear, but it can show a reduction and lapses in flare-ups. If it is left untreated, it can cause serious damage and can affect the patient's eyes and skin permanently.


What Are the Signs of Rosacea?

Rosacea can be identified with,
- Frequent flushing.
- Facial redness.
- Blood vessels on the nose and cheek swell and become visible.
- Swollen red bumps on the face.
- Pimples on the face resembling acne.
- Flaking.
- Dryness.


What Foods Trigger Rosacea?

The foods that trigger rosacea are,
Spicy foods.
- Chilli.
- Jalapenos.
- Hot sauce.
- Pepper.
Dairy products.
Hot beverages.
- Coffee.
- Tea.
- Hot cider.
- Hot chocolate.
- Champagne.
- Bourbon.
- Gin
- Vodka.
- Beer.
Cinnamaldehyde foods.
- Cinnamon.
- Chocolate.
- Tomatoes.
- Citrus fruits.


What Are the Different Types of Rosacea?

The four different types of rosacea are,
- Erythematotelangiectatic rosacea - This type is associated with facial redness, visible blood vessels, and flushing.
- Papulopustular rosacea - This type is associated with acne breakouts.
- Phymatous rosacea - This type is associated with the thickening of the skin on the nose.
- Ocular rosacea - This type is associated with symptoms in the eye area.


Can Drinking Water Help Rosacea?

Drinking water helps to limit the symptoms of rosacea as our body is made up of plenty of water which helps to flush out the toxins in the body and skin.


What Can Be Mistaken for Rosacea?

Rosacea can be mistaken for several other skin conditions like,
- Acne.
- Contact dermatitis.
- Lupus erythematosus.
- Seborrheic dermatitis.
- Steroid rosacea.


What Should I Wash My Face With if I Have Rosacea?

It is best to wash the face with mild facial cleansers recommended by the dermatologists and do not use products that contain menthol, alcohol, witch hazel, eucalyptus oil, camphor, peppermint, and glycolic acid.


Does Rosacea Get Worse With Age?

As rosacea has a variable course, it is unpredictable in everyone and worsens with age, especially if untreated. So it is important to diagnose at its earlier stage as it may progress from early to middle stage within a year.


What Vitamins Should I Avoid With Rosacea?

It is said that vitamin B3 triggers rosacea by dilating the blood vessels leading to flushing, facial redness, and flares up the rosacea. Also, people with rosacea have higher vitamin D levels, so it is important to talk to the doctor before taking any supplements.


Can Laser Treatment Get Rid Of Rosacea?

Laser treatment helps to reduce rosacea by eliminating the visible blood vessels on the face. It reduces flushing, redness and improves the texture of the skin.
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Dr. Barve Vaibhav Saidas
Dr. Barve Vaibhav Saidas



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