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Rosacea 101: Signs, Triggers, and Treatments

April 20, 2023

What is Rosacea?

Mostly affecting the face, rosacea is a chronic skin disorder that causes redness, irritation, blemishes/bumps, and visible blood vessels. In addition, it can impact the eyes, causing redness and dryness. Rosacea can affect everyone, although those with fair skin and those over 30 are more likely to develop it. Although the precise etiology of rosacea is uncertain, researchers believe that a mix of hereditary and environmental factors may be responsible. Although rosacea has no known cure, it can be treated with medication, dietary adjustments, laser treatments, and avoiding triggers that may make symptoms worse.

The 4 Types of Rosacea 

There are four different subtypes of rosacea, each with a unique set of signs and symptoms.

Erythematotelangiectatic Rosacea

The most common form of rosacea is called erythematotelangiectatic rosacea, sometimes referred to as subtype 1 rosacea, is characterized by persistent face flushing, redness, and visible blood vessels (telangiectasia). 

Symptoms of erythematotelangiectatic rosacea may include:

• Facial redness that persists for weeks or months
• Flushing or blushing easily 
• Visible blood vessels (telangiectasia) on the cheeks, nose, or other areas of the face
• Dry or sensitive skin
• Burning or stinging sensations 
• Swelling or edema 

Papulopustular Rosacea 

The second most common form of rosacea is called papulopustular rosacea, sometimes referred to as subtype 2 rosacea, is characterized by bumps and pimples on the face that resemble acne together with facial redness and flushing. 

Symptoms of papulopustular rosacea may include: 

• Acne-like bumps and pimples on the face 
• Facial redness and flushing 
• Burning or stinging sensations 
• Dry or rough skin
• Visible blood vessels (telangiectasia) 

Phymatous Rosacea

The skin of the nose is predominantly affected by phymatous rosacea, commonly referred to as subtype 3 rosacea, however, it can also affect the chin, forehead, cheeks, and ears. It is distinguished by the skin’s thickness and expansion as well as the emergence of observable blood vessels.

Symptoms of phymatous rosacea may include: 

• Thickened, bumpy skin on the nose, known as rhinophyma 
• Enlarged pores 
• Visible blood vessels (telangiectasia) 
• Rough, uneven skin texture
• Burning or stinging sensations 
• Dry or sensitive skin

Ocular Rosacea

Rosacea involving the eyes and surrounding areas is referred to as ocular rosacea, also known as subtype 4 rosacea. It is characterized by a variety of symptoms that may impact the cornea, conjunctiva, and eyelids.

Symptoms of ocular may include: 

• Redness and inflammation of the eyelids (blepharitis) 
• Dry, irritated, burning eye 
• Sensitivity to light 
• Blurred vision
• Grittiness or foreign body sensation in the eyes 
• Conjunctivitis (pink eye) 
• Styes or other eyelid bumps 

It is significant to remember that symptoms can range in severity and that some persons may have a combination of these subtypes. Based on the distinct subtype and symptoms, a dermatologist can make a diagnosis and suggest a course of action.

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Rosacea and Genetics 

It’s possible that genetics contribute to the emergence of rosacea. According to studies, people who have rosacea in their family are more likely to get the disorder. Yet, it is still unclear exactly what hereditary factors contribute to the onset of rosacea.

Genes involved in inflammation, the immune system, and blood vessel function, among others, have been linked in certain studies to an increased chance of developing rosacea. To fully comprehend the genetic pathways underlying rosacea, more study is necessary.

It’s crucial to remember that environmental variables like nutrition, stress, and sun exposure can also contribute to the onset and progression of rosacea. Genetics alone do not always cause the illness. Furthermore, not everyone who has rosacea in their family will also have the disease.

Therefore, it is believed that a mix of genetic and environmental variables contribute to the pathogenesis of rosacea, even if genetics may play a role in its development.

Rosacea and Mental Health 

A person’s mental health may be significantly impacted by rosacea. Rosacea can cause redness, pimples, and thickening skin, which can be undesired and have a negative impact on one’s self-esteem. If associated with depression and anxiety, it can also lead to social retreat and isolation.

Chronic skin conditions like rosacea can be stressful to manage and have an adverse effect on the quality of life. It can be emotionally draining to deal with the physical symptoms, control triggers, and seek therapy. It’s crucial for rosacea sufferers to take care of their mental health requirements and seek assistance if they need it.

There are lifestyle adjustments that can help manage symptoms and enhance mental health in addition to getting medical attention. Both physical and mental health can benefit from behaviors like stress management, regular exercise, a healthy diet, and getting enough sleep. 

How to Get a Diagnosis 

A dermatologist would often diagnose rosacea based on the patient’s medical history and skin appearance. In order to make a diagnosis, the dermatologist will conduct a physical examination and may inquire about the patient’s symptoms, family history, and lifestyle.

While there is no specific test for rosacea, the dermatologist may occasionally carry out further tests to rule out other skin illnesses that may present with a similar set of symptoms, such as lupus or eczema. A skin biopsy, blood testing, or allergy tests may be part of these examinations.

To aid in an appropriate diagnosis, patients should give their dermatologists as much information as they can. Included in this are any skincare regimens or drugs patients are taking, as well as any triggers that can exacerbate their symptoms.

The dermatologist will collaborate with the patient to design a treatment plan based on the subtype and severity of the problem once rosacea has been diagnosed. This could entail taking medication, making lifestyle adjustments, and avoiding triggers that might make symptoms worse. To monitor the condition and modify treatment as appropriate, routine follow-up sessions may be required.

Vascular Laser Treatment for Rosacea 

In particular, the subtype of erythematotelandiectatic rosacea, which is marked by persistent redness and visible blood vessels, is routinely treated using vascular lasers. Vascular lasers function by concentrating on the damaged area’s blood vessels and decreasing them, which lessens inflammation and enhances the skin’s look.

The vascular laser treatment can be performed by any of our board-certified dermatologists and our facial plastic surgeons at SkinDC. Patients may need multiple sessions depending on the severity of their condition.

Vascular laser treatment is generally safe and effective, but not everyone is a good candidate. It might not be suitable for patients with specific medical issues or skin types, and it might not work for all rosacea subtypes. Before getting vascular laser treatment, patients should talk with their dermatologist about the procedure’s advantages and disadvantages.

It’s also crucial to remember that vascular laser therapy is just one of several rosacea treatment choices and that for best results, it may be used with other treatments including prescription drugs and lifestyle modifications.

Common Triggers for Rosacea 

Rosacea triggers are particular elements that might aggravate or exacerbate rosacea symptoms. The frequency and severity of flare-ups can be decreased by recognizing and avoiding triggers. The following are some typical rosacea triggers:

1. Sun Exposure: Use sunscreen and protective clothing to prevent flare-ups of rosacea caused by exposure to the sun or other sources of UV radiation.
2. Severe temperature changes, such as traveling from a warm room to a chilly outdoor setting, should be avoided because hot and cold temperatures can aggravate rosacea.
3. Hot Foods: Some people who have rosacea may experience flushing from spicy foods and hot drinks.
4. Alcohol and Caffeine: Both alcohol and caffeine can widen blood vessels, causing flushing and other symptoms.
5. Stress: Some people’s rosacea symptoms can be brought on by emotional stress or anxiety, so it’s crucial to practice stress-relieving exercises like yoga or meditation.
6. Skincare Products: Certain skincare items, such as those that include alcohol, perfumes, or other irritants, might exacerbate the symptoms of rosacea.
7. Exercise: It’s crucial to keep cool and drink enough of water while engaging in physical activity because intense exercise or other hot-weather activities can exacerbate rosacea symptoms.

Rosacea sufferers must recognize their unique triggers and take action to manage or prevent them. It can be useful to uncover patterns and adjust one’s lifestyle by keeping a journal to record symptoms and likely triggers.

How to Identify Your Triggers 

It can take some trial and error to find rosacea triggers, but keeping a diary or journal can be a useful tool. To determine your rosacea triggers, follow these steps:

1. Maintain a Journal or Diary: List your symptoms and possible triggers in a journal or diary. Take note of the day, time, and specifics of what you consumed, drank, applied to your skin, or engaged in prior to the onset of your symptoms.
2. Look for Patterns: Review your journal after a few weeks or a month to see if you can see any patterns or trends. Do you notice any recurring patterns or common denominators that are connected to your flare-ups?
3. Test Possible Triggers: After you’ve discovered potential triggers, evaluate whether your symptoms improve by removing each one at a time for two to four weeks. If you believe spicy foods cause your rosacea, for instance, try abstaining from them for a few weeks to see if your symptoms get better.
4. Be Patient: Finding triggers may need persistence and time. It’s crucial to keep in mind that triggers can build up over time and that a flare-up may require more than one trigger.
5. Get Expert Assistance: If you need assistance managing your symptoms or recognizing your triggers, speak with a dermatologist at SkinDC. They can offer advice and suggest suitable treatment choices.

By identifying and avoiding triggers, you can help reduce the frequency and severity of your rosacea symptoms and improve your quality of life.