Rosacea (say “roh-ZAY-sha”) is a skin disease that causes redness and pimples on your nose, cheeks, chin, and forehead. The redness may come and go. People sometimes call rosacea "adult acne" because it can cause outbreaks that look like acne. It can also cause burning and soreness in the eyes and eyelids.
Rosacea can be embarrassing. And if it is untreated, it can get worse. If the symptoms bother you, see your doctor and learn ways to control rosacea.
Experts are not sure what causes rosacea. It tends to affect people who have fair skin or blush easily, and it seems to run in families.
Rosacea is not caused by alcohol abuse, as people thought in the past. But in people who have rosacea, drinking alcohol may cause symptoms to get worse (flare).
Rosacea often flares when something causes the blood vessels in the face to expand, which causes redness. Things that cause a flare-up are called triggers. Common triggers are exercise, sun and wind exposure, hot weather, stress, spicy foods, alcohol, and hot baths. Swings in temperature from hot to cold or cold to hot can also cause a flare-up of rosacea.
People with rosacea may have:
Without treatment, some cases of rosacea can cause knobby bumps on the nose and cheeks that can multiply. This is advanced rosacea, known as rhinophyma (say “ry-no-FY-muh”). Over time, it can give the nose a swollen, waxy look. But most cases of rosacea don't progress this far.
Doctors can prescribe medicines and other treatments for rosacea. There is no cure, but with treatment, most people can control their symptoms and keep the disease from getting worse.
There are some things you can do to reduce symptoms and keep rosacea from getting worse.
Frequently Asked Questions
Learning about rosacea:
Living with rosacea:
The exact cause of rosacea is unknown. One theory is that it may result from oversensitive blood vessels in the face. Because rosacea causes increased warmth in the skin, bacteria may grow, causing the pimples and bumps.
Tiny mites (Demodex folliculorum) that normally live on our skin may also play a role. People who have rosacea have more of these mites on their faces than those who don't have the disease.
Flare-ups often start when certain triggers cause the blood vessels in the face to dilate, which causes redness. Common triggers are sun, exercise, hot weather, emotional stress, spicy foods, alcohol, and hot baths. Swings in temperature from hot to cold or cold to hot can also trigger a flare-up of rosacea.
Many people with this skin condition have a family history of rosacea.1
There may be a link between rosacea and Helicobacter pylori bacteria, which causes an infection in the stomach, although studies are unclear.
Alcohol and poor hygiene do not cause rosacea, as was believed in the past. But drinking alcohol may trigger facial flushing and can cause symptoms to get worse.
Some people may notice that their skin has become very sensitive or that they blush easily before they notice other symptoms of rosacea. For example, facial products may burn their skin.
As rosacea develops, redness on the cheeks lingers, like a slight sunburn. This redness and other symptoms of rosacea come and go. The main symptoms include:
Rosacea may be mistaken for some other conditions with similar symptoms, such as acne or lupus.
Rosacea develops in phases. The first sign may be the tendency to blush often. Rosy cheeks or patches of red appear on the face. Facial skin may be more sensitive and may react to skin products, such as lotions or soaps. Some people notice eye irritation before they note any skin symptoms.
See a picture of rosacea.
As rosacea progresses, facial redness comes and goes on the cheeks, forehead, or chin. Facial flushing occurs when there is a sudden increase of blood flowing through the blood vessels under the skin. This causes the blood vessels to relax and get wider (dilate), which results in skin redness. In time, ongoing dilation may cause blood vessels to get larger and look like small red lines on the skin.
Tiny pimples may begin to appear on and around the area of redness. As flare-ups continue, the redness increases, and flare-ups occur more often. Later on, if rosacea is untreated, the redness and red lines may become permanent.
Along with the redness and pimples of the face, rosacea can also affect the eyes. Eye symptoms may develop before you notice facial symptoms, and they include redness, dryness, infection, and burning (conjunctivitis). If eye problems are not treated, they can lead to more serious complications. In some cases, vision may be blurry, but vision is damaged only in severe cases.
Treatment can help control rosacea symptoms and prevent the condition from getting worse. If untreated, rosacea may lead to a condition called rhinophyma, in which long-term (chronic) inflammation causes the nose to appear enlarged and bulbous, red, and with thick bumps. This is due to the oil-producing (sebaceous) glands and the tissues of the nose getting larger. Rhinophyma is more common in men than women. It often takes several years to develop. But most cases of rosacea do not progress this far.
Certain triggers can cause flushing of the skin and a flare-up of rosacea symptoms. These triggers include sun, stress, hot weather, alcohol, caffeine, spicy food, exercise, hot baths, and cold weather. Triggers produce a sudden increase in blood flow through the blood vessels in the face. This causes the blood vessels to expand and the face to flush. A trigger that affects one person may not affect another.
Call your doctor if you notice symptoms that could be caused by rosacea, such as:
If you notice any symptoms of rosacea, such as redness, redness with pimples, eye irritation, or large, swollen bumps on your nose, call your doctor. If you start treatment when you first notice symptoms, it is likely that your symptoms will improve and your condition will not get worse.
Your family doctor or general practitioner can diagnose and treat rosacea. You may be referred to a specialist, such as a dermatologist or ophthalmologist (for eye treatment in rosacea). You may be referred to one of the following health professionals for treatment of moderate to severe cases of rosacea that may require surgery:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Your doctor will diagnosis rosacea after a physical examination. You probably will not have medical tests unless the diagnosis is unclear. In that case, tests will rule out other conditions, such as lupus or a fungal infection.
During an examination, your doctor will check your eyes and the skin on your face, neck, and upper chest for any symptoms of rosacea. Tell your doctor when you first noticed symptoms and how often they occur. This information, along with your family history, is usually enough for a diagnosis.
There is no cure for rosacea. Treatment often helps keep symptoms under control and prevents the disease from getting worse. If left untreated, rosacea symptoms can get worse, can recur more often, and eventually may become permanent.
Treatment for the four main forms of rosacea vary depending on your symptoms:1
With treatment, symptoms usually improve in 2 to 4 weeks. You'll see the best results in about 2 months.
Identifying and avoiding triggers that cause rosacea flare-ups is an important part of treatment. Keep a list or diary of triggers to help you avoid those foods, products, or activities that might cause flare-ups. Even people who are using medicine to control rosacea benefit from avoiding triggers.
The cause of rosacea is unknown, and there is no way to prevent it.
But there are steps that you can take to prevent flare-ups of rosacea, and this can help stop the condition from getting worse. You can find out what triggers your flare-ups by making a list of what you were eating or doing around the time you had a breakout. Some triggers include sun and wind, hot and cold temperatures, stress, spicy foods, skin care products, and exercise.
There are several things you can do to reduce symptoms of rosacea and prevent the condition from getting worse.
You can use antibiotic creams to relieve the redness on your face and help eye symptoms that result from rosacea. Antibiotic pills may help clear the pimples, and can reduce the swelling or irritation in your eyes. Mild cases often respond to treatment with antibiotic creams. But symptoms usually improve faster with antibiotics you take as pills or capsules. Long-term use of oral antibiotics may cause side effects, such as stomach upset and vaginal yeast infections. So oral medicine may be used first, then tapered off and followed by antibiotic cream.
With antibiotic treatment, symptoms usually improve in 3 to 4 weeks, with greater improvement in 2 months.
Swollen bumps on the nose (rhinophyma) do not respond well to antibiotic treatment.
Medicines used to treat rosacea include:
Note: Women who are pregnant or may become pregnant should not take isotretinoin, because of the risk of serious side effects such as miscarriage and birth defects.
Doctors may prescribe other medicines, including benzoyl peroxide.
Medicines often work well to help improve the symptoms of rosacea.
You may need to keep taking medicine for rosacea if you have symptoms that are hard to control.
Some types of skin problems respond better to surgery than others. People with lighter skin who limit their time in the sun and use sunscreen after the procedure tend to have better results than people with sun-darkened skin and people who continue to spend lots of time in the sun.
Surgery options include:
You may not be a good candidate for surgery if you are using isotretinoin or have used it within the last 6 to 12 months, because it may increase the risk of scarring after the procedure.
Cosmetic counselling is often helpful for people with rosacea. Ask your dermatologist to recommend someone in your area.
|Canadian Dermatology Association|
|1385 Bank Street|
|Ottawa, ON K1H 8N4|
The Canadian Dermatology Association promotes research and education for dermatologists, provides information and support for dermatology patients, and offers public education materials on sun awareness and skin care.
|Canadian Society for Aesthetic (Cosmetic) Plastic Surgery|
|2334 Heska Road|
|Pickering, ON L1V 2P9|
The Canadian Society for Aesthetic (Cosmetic) Plastic Surgery is a professional organization that promotes and develops surgical techniques and provides educational information for the public.
|Rosacea Awareness Program|
|368 Notre-Dame Street West|
|Montreal, QC H2Y 1T9|
The Rosacea Awareness Program is a public awareness program established in 1995 to provide information on rosacea to people affected by rosacea, their families, and health professionals. The Rosacea Awareness Program offers a wide range of resources to promote awareness leading to the proper diagnosis, treatment, and overall management of the condition.
- Powell FC (2005). Rosacea. New England Journal of Medicine, 352(8): 793–803.
- Blount BW, Pelletier AL (2002). Rosacea: A common, yet commonly overlooked, condition. American Family Physician, 66(3): 435–440.
Other Works Consulted
- Habif TP, et al. (2005). Rosacea (acne rosacea). In Skin Disease Diagnosis and Treatment, pp. 98–101. St. Louis: Mosby.
- Maddin WS (2007). Rosacea. In J Gray, ed., Therapeutic Choices, 5th ed., pp. 1021–1028. Ottawa: Canadian Pharmacists Association.
- Van Zuuren EJ, et al. (2007). Systematic review of rosacea treatments. Journal of the American Academy of Dermatology, 56(1): 107–115.
|Primary Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Specialist Medical Reviewer||Alexander H. Murray, MD, FRCPC - Dermatology|
|Last Revised||December 8, 2009|
Last Revised: April 8, 2012
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