Rosacea (roe-ZAY-she-uh) is a common skin condition that causes redness in your face and often produces small, red, pus-filled bumps. Although rosacea can occur in anyone, it most commonly affects middle-aged women who have fair skin.
Left untreated, rosacea tends to worsen over time. Rosacea signs and symptoms may flare up for a period of weeks to months and then diminish before flaring up again. Rosacea can be mistaken for acne, an allergic reaction or other skin problems.
While there's no cure for rosacea, treatments can control and reduce the signs and symptoms. If you experience persistent redness of your face, see your doctor for a diagnosis and proper treatment.
Signs and symptoms of rosacea may include:
- Facial redness. Rosacea usually causes a persistent redness in the central portion of your face. Small blood vessels on your nose and cheeks often swell and become visible.
- Swollen red bumps. Many people who have rosacea also develop bumps on their face that resemble acne. These bumps sometimes contain pus. Your skin may feel hot and tender.
- Eye problems. About half of the people who have rosacea also experience eye dryness, irritation and swollen, reddened eyelids. In some people, rosacea's eye symptoms precede the skin symptoms.
- Enlarged nose. Rarely, rosacea can thicken the skin on the nose, causing the nose to appear bulbous (rhinophyma). This occurs more often in men than in women.
When to see a doctor
If you experience persistent redness of your face, see your doctor or a skin specialist (dermatologist) for a diagnosis and proper treatment.
The cause of rosacea is unknown, but it could be due to some combination of hereditary and environmental factors.
A number of factors can trigger or aggravate rosacea by increasing blood flow to the surface of your skin. Some of these factors include:
- Hot foods or beverages
- Spicy foods
- Temperature extremes
- Stress, anger or embarrassment
- Strenuous exercise
- Hot baths or saunas
- Corticosteroids, such as prednisone
- Drugs that dilate blood vessels, including some blood pressure medications
Although anyone can develop rosacea, you may be more likely to develop rosacea if you:
- Are a woman
- Have fair skin
- Are between the ages of 30 and 60
- Have a family history of rosacea
In severe and rare cases, the oil glands (sebaceous glands) in your nose and sometimes your cheeks become enlarged, resulting in a buildup of tissue on and around your nose — a condition called rhinophyma (ri-no-FI-muh). This complication is much more common in men and develops slowly over a period of years.
You're likely to start by seeing your family doctor or a general practitioner. However, in many cases when you call to set up an appointment, you may be referred to a skin disease specialist (dermatologist).
It's a good idea to prepare for your appointment. Here's some information to help you.
What you can do
Preparing a list of questions will help you make the most of your appointment time. For rosacea, some basic questions to ask your doctor include:
- What might be causing the signs and symptoms?
- Do I need tests to confirm the diagnosis?
- What is the best treatment?
- Is this condition temporary or chronic?
- Is there a generic alternative to the medicine you're prescribing?
- I have other medical problems; how can I manage them together?
- Can I wait to see if the condition resolves on its own?
- What are the alternatives to the approach that you're suggesting?
- What skin care routines do you recommend I use?
Don't hesitate to ask any other questions that come up during your appointment.
What to expect from your doctor
Your doctor is likely to ask you several questions, including:
- When did you begin experiencing symptoms?
- How often do you experience these symptoms?
- Have your symptoms been continuous or occasional?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to trigger or worsen your symptoms?
There's no specific test for rosacea. Instead, doctors rely on the history of your symptoms and a physical examination of your skin. In some cases, your doctor may need to rule out other conditions, such as other forms of acne, psoriasis, various forms of eczema or lupus, which can sometimes cause similar signs and symptoms.
Although there's no cure for rosacea, treatments can control and reduce the signs and symptoms. Most often this requires a combination of prescription treatments and certain lifestyle changes on your part.
Prescription drugs used for rosacea may include:
- Antibiotics. The antibiotics used for rosacea also have anti-inflammation effects. They may come in the form of creams, gels or lotions to spread on the affected skin or in pills that you swallow. Antibiotic pills are generally more effective in the short term, but they can also cause more side effects.
- Acne drugs. If antibiotics don't work, your doctor might suggest trying isotretinoin (Amnesteem, Claravis, others). This powerful drug is most commonly used for severe cystic acne, but it also often helps clear up acne-like lesions of rosacea. Don't use this drug during pregnancy as it can cause serious birth defects.
The duration of your treatment depends on the type and severity of your symptoms, but typically you'll notice an improvement within one to two months. Because symptoms may recur if you stop taking medications, long-term regular treatment is often necessary.
Surgical and other procedures
Enlarged blood vessels, some redness and changes due to rhinophyma often become permanent. In these cases, surgical methods, such as laser surgery and electrosurgery, may reduce the visibility of blood vessels, remove tissue buildup around your nose and generally improve your appearance.
One of the most important things you can do if you have rosacea is to minimize your exposure to anything that causes a flare-up. Find out what factors affect you so that you can avoid them. Other suggestions to prevent flare-ups include:
- Wear broad-spectrum sunscreen with an SPF of 30 or higher
- Protect your face in the winter with a scarf or ski mask
- Avoid irritating your facial skin by rubbing or touching it too much
- Wash problem areas with a gentle cleanser (Dove, Cetaphil)
- Avoid facial products that contain alcohol or other skin irritants
If you wear makeup, consider using green-tinted foundation creams and powders because they're designed to counter skin redness.
Many alternative therapies — including colloidal silver, emu oil, laurelwood, oregano oil and vitamin K — have been touted as possible ways to treat rosacea. However, there's no conclusive evidence that any of these alternative therapies are effective.
If you're considering dietary supplements or other alternative therapies to treat rosacea, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies.
Rosacea can be distressing. You might feel embarrassed or anxious about your symptoms and become withdrawn or self-conscious. You may be frustrated or upset by other people's reactions. Talking to a counselor about these feelings can be helpful.
A rosacea support group, either in person or online, can connect you with others facing the same types of problems — which can be especially comforting.
Aug. 17, 2013
- Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=740. Accessed June 5, 2013.
- Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7234-3541-9..X0001-6--TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed June 5, 2013.
- Dahl MV. Rosacea: Pathogenesis, clinical features and diagnosis. http://www.uptodate.com/home. Accessed June 5, 2013.
- Ferri FF. Ferri's Clinical Advisor 2013: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-08373-7..00002-9&isbn=978-0-323-08373-7&about=true&uniqId=343863096-23. Accessed June 5, 2013.
- Maier LE. Management of rosacea. http://www.uptodate.com/home. Accessed June 5, 2013.
- AskMayoExpert. Rosacea. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. June 6, 2013.