Rosacea Resources

Rosacea is a common, chronic condition of the skin that is estimated to affect over 16 million people in the United States and over 45 million people worldwide. The disorder appears most commonly in fair-skinned individuals of northern, eastern European or Celtic origin between 30 and 50 years of age, and women are affected 2-3x more often than men. Rosacea typically occurs in a central facial distribution (cheeks, nose, forehead, and chin) and is most commonly associated with a history of flushing or blushing (transient erythema), persistent facial redness (nontransient erythema), papules and/or pustules which may resemble acne, and facial telangiectasias (dilated blood vessels). Each of these signs may be transient or persistent and may occur individually or in combination.

In 2002, the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea issued its Standard classification of rosacea in which it described four distinct subtypes of rosacea (Table 1):

 

Table 1: Rosacea Subtypes

Subtype	Characteristics
I. Erythematotelangiectatic (ETR)	Flushing and transient or persistent facial redness (erythema) Dilated blood vessels (telangiectasias) may be present May be accompanied by 'stinging' or 'burning' ('sensitive skin')
II. Papulopustular	Characterized by facial redness (erythema) with papules (red bumps) and/or pustules May resemble and be confused with acne vulgaris Dilated blood vessels (teleangiectasias) may be present 'Stinging', 'burning' or generally 'sensitive skin' are common
III. Phymatous	Thickening of the areas of affected skin which may have an irregular, nodular, or 'bumpy' surface More common on the nose (rhinophyma), though may affect other areas including the cheeks, chin (gnatophyma), forehead (metophyma), eyelids (blepharophyma) ears (otophyma) Dilated blood vessels (telangiectasias) and/or facial erythema may be present More common in males
IV. Ocular	Eye symptoms that may include red ('bloodshot') eyes, and/or eyelids, itching, watering, burning, stinging, light sensitivity, blurred vision and/or a foreign–body sensation Dilated blood vessels in/around the eyes Eyelid swelling May occur with or without signs and symptoms of rosacea on the skin
Variant Type (Granulomatous Rosacea)	Characterized by firm, yellow to brownish or redish papules, nodules or plaques May be accompanied by marked erythema (redness) Other as of yet unclassified variants of rosacea are recognized

 

The actual cause of rosacea remains uncertain, however, the abnormal flushing/blushing and persistent redness (erythema) are thought to result from a gradual loss of the ability of the blood vessels of the face to constrict normally. This results in persistent dilation of the facial blood vessels and increased circulation in the skin which then may lead to facial redness and the development of larger dilated facial blood vessels.

Though the cause is unknown, there are many potential treatments available that may alleviate some of the signs and symptoms of rosacea. Rosacea may be difficult to diagnose and many other medical conditions may resemble rosacea. If you suspect you may have rosacea, you should visit your physician.