Q. What causes rosacea?

A. The cause of rosacea is not known; however, different theories exist regarding the cause. One theory is that rosacea might be a component of a more generalized disorder of the blood vessels. Other theories suggest that the condition is caused by microscopic skin mites, fungus, psychological factors, or a malfunction of the connective tissue under the skin. Although no one knows for sure what causes rosacea, some circumstances and conditions can trigger it.

Q. How is rosacea diagnosed?

A. Your doctor will conduct a thorough exam of your signs and symptoms, and will take a medical history. During your exam, you should tell your doctor about any problems you are having with your face (redness, bumps or pimples, burning, itching, etc.). There is no specific test to diagnose rosacea.

Q. Who is likely to get rosacea?

A. People who have fair skin and who tend to blush easily might be at a higher risk for the disorder. Rosacea appears more often among women, but men tend to have the more severe symptoms. A possible reason for this could be that men delay medical treatment until rosacea becomes advanced.

Q. What are the signs and symptoms of rosacea?

A. Rosacea’s appearance can vary greatly from one individual to another. Most of the time, not all of the potential signs and symptoms appear. Rosacea always includes at least one of the primary signs listed below. Various secondary signs and symptoms might also develop.

Primary signs of rosacea
  • Flushing—Many people who have rosacea have a history of frequent blushing or flushing. The facial redness, which might come and go, often is the earliest sign of the disorder.
  • Persistent redness—Persistent facial redness might resemble a blush or sunburn that does not go away.
  • Bumps and pimples—Small red solid bumps or pus-filled pimples often develop. Sometimes the bumps might resemble acne, but blackheads are absent. Burning or stinging might be present.
  • Visible blood vessels—Small blood vessels become visible on the skin of many people who have rosacea.
Other potential signs and symptoms of rosacea
  • Eye irritation—The eyes might be irritated, and appear watery or bloodshot in some people with rosacea. This condition, called ocular rosacea, can also involve styes as well as redness and swelling of the eyelids. Severe cases, if left untreated, can result in corneal damage and vision loss.
  • Burning or stinging—Burning or stinging sensations might occur on the face, and itchiness or a feeling of tightness might also develop.
  • Dry appearance—The central facial skin might be rough, and thus appear to be very dry.
  • Plaques—Raised red patches (plaques) might develop without changes in the surrounding skin.
  • Skin thickening—In some cases of rosacea, the skin might thicken and enlarge from excess tissue, resulting in a condition called rhinophyma. This condition often occurs on the nose, causing it to have a bulbous appearance.
  • Swelling—Facial swelling (edema) can occur independently or can accompany other signs of rosacea.
  • Signs beyond the face—Signs and symptoms might develop beyond the face, affecting areas including the neck, chest, scalp, or ears.

Q. Is there a cure for rosacea?

A. While there is no cure for rosacea and the cause is unknown, medical therapy is available to control or reverse its signs and symptoms. If you suspect that you might have rosacea, meet with your doctor.

Q. How is rosacea treated?

A. Treatment methods vary because the signs and symptoms of rosacea vary from person to person. The following are some treatments used for rosacea:

  • Medicines—Sometimes, doctors prescribe oral and topical medicines to treat the disorder’s associated bumps, pimples, and redness. Medicines can bring the condition under control and then maintain its state of remission.
  • Surgical procedures—Doctors can remove visible blood vessels, limit the amount of extensive redness on the face, or correct nose disfigurement in some cases.

When appropriate, treatments with lasers, intense pulsed light sources, or other medical and surgical devices might be used to remove visible blood vessels, reduce extensive redness, or correct disfigurement of the nose.

Q. Can rosacea be prevented?

A. As the cause of rosacea is not known, the condition cannot be prevented. However, rosacea sufferers can improve their chances of maintaining remission by identifying and avoiding lifestyle and environmental factors that aggravate individual conditions or trigger rosacea flare-ups. Some triggers include:

  • Sun/wind exposure
  • Emotional stress
  • Hot/cold weather
  • Heavy exercise
  • Alcohol consumption
  • Hot baths/beverages

Q. I’m a fair-skinned 42-year-old woman. I get red blotches on my face that I thought was acne, but a friend said it might be a condition called rosacea. How can I tell which it is?

A. Rosacea afflicts about 13 million Americans, but it often is mistaken as adult acne. Most common in women between ages 30 and 50, rosacea begins with redness in the center of the face that gradually covers the cheeks and chin. As it progresses, tiny pimples begin to appear on and around the reddened area.

There are ways to differentiate rosacea from adult acne. First, acne tends primarily to inflame oil glands and hair follicles, whereas rosacea initially dilates facial blood vessels.

In addition, acne pimples – blackheads and whiteheads – may be painful and can appear anywhere on the body. Rosacea pimples are small, solid red bumps and pus-filled bumps that mainly appear on the forehead, chin and lower half of the nose. The pimples often are accompanied by thin, red lines caused by enlarged blood vessels on the surface of the skin. Also, with rosacea, drinking coffee, tea and alcohol or eating spicy foods may cause the face to flush. Severe rosacea may cause permanent enlargement of the nose (rhinophyma).

The symptoms usually come and go in cycles, and about half of all patients experience burning and grittiness of the eyes. The cause of rosacea is unknown, but in many cases, it appears to be an inherited disease. Your first step, however, should be to see a qualified dermatologist who can properly diagnose your condition.

Reviewed by a Cleveland Clinic medical professional.

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