Rosacea is an inflammatory skin condition that mostly affects the skin on the face, though it can appear elsewhere. Symptoms include a rash, small bumps, and thickened areas of skin and can sometimes be mistaken for acne or allergies.
While rosacea is a progressive condition with no cure, you can keep it under control by recognizing the signs early and working with a doctor on a treatment plan.
The visible signs of rosacea primarily appear on the skin, though their specific look and feel can vary from person to person.
Here are the most frequent skin-related signs.
- Persistent discoloration: This is often the most recognizable symptom. On lighter skin tones, it appears as a lasting redness or flush. On darker skin tones, the discoloration can be dusky, violet, or brown.
- Bumps and pimples: Many people develop small, red, solid bumps (papules) and pus-filled pimples (pustules). Unlike acne, however, rosacea does not cause blackheads.
- Visible blood vessels: Over time, tiny blood vessels, sometimes called spider veins, may become visible on the skin's surface (telangiectasia).
- Skin thickening: In some cases, the skin may develop a thicker, bumpy, or rough texture. This can sometimes form raised, firm patches called plaques.
- Stinging, burning, or itching: The affected skin often feels sensitive and may burn or sting, especially when touched or when using skincare products. Itching (pruritus) is also a common complaint, affecting around 42 percent of people with rosacea.
While rosacea most commonly appears on the face (often on the cheeks, nose, chin, and forehead), these symptoms can sometimes show up on other parts of the body, such as the neck, chest, scalp, or ears.
Dermatologists classify rosacea into four main subtypes based on their primary symptoms. While you may be diagnosed with one specific type, it's common to experience symptoms from more than one type at a time.
Erythematotelangiectatic Rosacea (ETR)
ETR is one of the most common forms of rosacea.
- Lasting redness or a dusky, violet-brown discoloration in the central part of the face
- A tendency to flush or blush easily
- Enlarged and visible blood vessels
- Sensitive skin that may sting or burn
- Skin that feels swollen, dry, or rough
Papulopustular Rosacea (PPR)
Also very common, this type is often referred to as inflammatory rosacea because it involves acne-like breakouts.
- Persistent facial discoloration
- Red, swollen bumps (papules) and pus-filled blemishes (pustules)
- Sensitive skin that may burn or sting
Phymatous Rosacea
This is a rarer subtype that causes the skin to thicken and develop excess tissue. It is much more common in men than in women.
- Skin that gradually becomes thick, bumpy, and irregular
- Enlarged pores
- Oily skin
Most often, this condition affects the nose, causing it to appear enlarged and bulbous (a condition known as rhinophyma), but it can also develop on the chin, forehead, cheeks, and ears.
Ocular Rosacea
Studies show that 58 to 72 percent of people who have skin rosacea also develop ocular rosacea.
- Eyes that feel dry, gritty, sandy, or itchy
- A burning or stinging sensation in the eyes
- A watery or bloodshot appearance
- Recurrent eye or eyelid infections, such as pink eye (conjunctivitis) and blepharitis
- Sensitivity to light
- Blurry vision
Many people successfully manage their rosacea with treatment, but without treatment, some serious or lasting complications do sometimes occur, including the following.
Permanent skin changes (rhinophyma): In some rare cases, untreated phymatous rosacea can lead to rhinophyma. This is a condition where the skin on the nose becomes thick, bumpy, and enlarged from excess tissue growth.
Severe, sudden flare-ups (rosacea fulminans): This is a rare and severe variant of rosacea that causes a sudden eruption of large, painful nodules and sores on the face. It requires immediate medical attention and primarily affects young women.
Links to other health conditions: The chronic inflammation associated with rosacea is also associated with other health problems, including:
- Gastrointestinal diseases like celiac disease, Crohn's disease, and irritable bowel syndrome (IBS)
- Cardiovascular conditions like hypertension and coronary artery disease
- Neurological disorders like migraine and an increased risk for Parkinson's disease
If you have lasting symptoms of facial flushing, discoloration, or bumps that don't go away, it's a good idea to see a dermatologist. An accurate diagnosis is the first step to effective rosacea management.
Since there isn’t a single test for rosacea, your doctor will use a few steps to identify the condition and rule out other possibilities.
- Visual exam and health history: The first step is a close examination of your skin and eyes. Your doctor will look for the telltale signs of rosacea, like a specific pattern of discoloration or bumps without blackheads. Be prepared to talk about your symptoms, your family history, and what you think might be triggering your flare-ups.
- Tests to rule out other conditions: If your symptoms overlap with other health issues, your doctor may order a blood test or skin biopsy to get a clearer picture. These tests are not for rosacea but are used to eliminate conditions that can look similar.
