Rosacea

What is rosacea?

Rosacea (pronounced “roh-zay-shuh”) is a long-term skin condition which mainly affects the face. It tends to be characterised by redness in the affected areas and often begins with prolonged and excessive blushing.

It is more common in women and people with white skin. However, when it occurs in men, symptoms can be worse. It tends to begin between the ages of 30 and 40, but early signs may appear in your 20s.

If you have rosacea, you may feel self-conscious about the way it affects your appearance. On this page, we look at the different types of rosacea and how they can be treated, and provide support and guidance to help you manage the impacts of living with rosacea.

Signs and symptoms

Rosacea tends to affect the nose, cheeks, forehead and chin, although the neck and shoulders may be affected in some cases. At first, you may appear to be blushing. However, as the condition develops, the redness can become longer-lasting or permanent.

Other symptoms include:

• Small bumps and pus-filled spots
• Dry skin
• Swelling (“lymphoedema”) of the facial skin, particularly around the eyes
• Thickening and swelling of the skin on the nose, known as rhinophyma. This is caused by an overgrowth of the oil-secreting glands on the nose. It tends to be more common in men and usually happens after many years

In some cases, rosacea may cause eye or eyelid problems:

• Sore eyelids or crusts around the roots of eyelashes, which may be blepharitis
• “Rosacea keratitis” is a painful inflammation of the front part of the eye. Keratitis may cause blurred vision and can be serious, and you should see your GP if you think you have it

There are four types of rosacea and symptoms are different in each variant. Have a look at the section “types of rosacea” below for more information.

Causes of the condition

The characteristic redness of rosacea is caused by dilated blood vessels. However, the root cause of the condition is unknown, although there are many theories.

You may find that your rosacea is triggered or worsened by certain foods, drinks or activities. Known triggers include:

• Aerobic exercise, such as brisk walking, swimming, running or cycling (also known as “cardio”)
• Alcohol
• Caffeine
• Cheese
• Hot drinks
• Spicy food
• Stress

Your triggers may not include all or any of these things, but you may find it useful to try to identify your own triggers and avoid them.

Is rosacea genetic?

Although rosacea appears to run in some families, there is no known genetic link.

Types of rosacea

There are four types of rosacea:

Erythematotelangiectatic rosacea

This causes flushing in the central portion of the face, often with a burning, stinging or itching sensation. There may also be scaliness of the skin, which may be caused by low-level dermatitis. Creams and gels may worsen the discomfort.

Papulopustular rosacea

This causes redness and small pustules in the central portion of the face. It may look a bit like acne. You may experience burning and stinging sensations.

Phymatous rosacea

This type of rosacea causes the skin surface to become thick and irregular. Most often, it affects the nose (this is known as “rhinophyma”). However, it can also affect the chin, forehand, one or both ears and/or the eyelids.

Ocular rosacea

In ocular rosacea, the patient’s eyes or eyelids are also affected. It causes eye or eyelid conditions including blepharitis, conjunctivitis, inflammation of the eyelids and meibomian glands. Have a look at the NHS pages to find out more about these individual conditions. Symptoms may include a stinging or burning sensation in the eyes, dryness, sensitivity to light or the feeling of having something in your eye.
In roughly one in five cases, symptoms occur in the eyes before the skin is affected. Ocular rosacea may therefore be difficult to diagnose before skin symptoms occur.