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Rosacea types and treatments

Because of the potential complexity of rosacea, it has been classified into 4 subtypes according to signs and symptoms that often occur together. It is possible to have the characteristics of more than one subtype at the same time.

If you think you have rosacea, it’s important to get medical care. Why? Because not only can this vascular, inflammatory condition get worse and potentially cause permanent damage to your skin, but it also has the ability to psychologically and emotionally impact your life. From avoiding social events to not feeling as self-confident as you once did, rosacea can affect life choices.

Subtype 1. Facial Redness

Medical name: Erythematotelangiectatic rosacea
Symptoms: flushing and persistent redness, may include visible blood vessels, stinging, burning, and swelling.

More facts

Erythema—the medical term for redness in rosacea—is associated with just about every subtype of rosacea, and for many people, the only symptom they may ever experience. In erythematotelangiectatic rosacea, the primary symptom of the disease is persistent facial redness. Visible blood vessels (telangectasia) can also occur with this subtype. People with these signs of rosacea tend to have very sensitive skin, and may feel as if their skin stings or burns at times.

Treatment options

Learn about a Prescription Treatment for Facial Redness.

Along with treatment, it’s important to identify and avoid lifestyle and environmental factors that trigger flare-ups or irritate your skin. The most common factors are covered in Rosacea Triggers.

  • Persistent redness can be treated with topical medication, so working with your dermatologist is a must.
  • Visible blood vessels may be reduced with lasers or intense pulsed light therapy. Several sessions are typically required for satisfactory results, and touch-up sessions may later be needed as the underlying disease process is still present.
  • Your doctor is the best resource to determine what will work for you.

Subtype 2. Bumps and pimples

(with some redness, sometimes with swelling and visible blood vessels)

Medical name: Papulopustular rosacea
Symptoms: bumps (papules) or pimples (pustules) that come and go, includes red patches.

More facts

Rosacea can often be confused with acne. However in rosacea, blackheads (oil-clogged pores) are not usually present and a burning or stinging sensation of the skin can be more common. Rosacea is also primarily found on people’s faces, while acne may also affect the back, shoulders, and chest. This type of rosacea occurs most commonly in middle age and affects more women than men.

Treatment options

Learn About a Prescription Treatment for Bumps & Pimples.

A number of medications have been extensively studied and approved for this common form of rosacea, and may also be used on a long-term basis to prevent recurrence of symptoms.

  • Doctors often prescribe oral and topical rosacea therapy to bring the condition under control. Topical metronidazole, azelaic acid, and sodium sulfacetamide/sulfur have all been approved by the FDA to treat papulopustular rosacea.
  • An oral therapy that has not been clinically shown to contribute to microbial resistance has also been approved specifically for rosacea and has been shown to be safe and effective for up to 9 months.
  • While not approved by the FDA for treating rosacea, higher doses of oral antibiotics may also be prescribed, and other drugs may be used for patients who are unresponsive to conventional treatments.
  • Your doctor is the best resource to determine what will work for you.

Subtype 3. Skin thickening

Medical name: Phymatous rosacea
Symptoms: excess tissue often results in enlargement of the nose and irregular surface nodules (bump-like lesions).

More facts

This form of rosacea is defined by thickened skin, typically around the nose. Many times this type of rosacea is mistakenly identified as “alcoholics’ nose” due to the thick, red skin around the nostrils.

Treatment options

There are currently no treatments available to treat this symptom of rosacea, which is why it is important to try to prevent the progression to this point. Moderate to severe manifestations typically require surgery. Surgical options include:

  • Cryosurgery
  • Radiofrequency ablation
  • Electrosurgery tangential excision combined with scissor sculpturing and skin grafting
  • A surgical laser can also be used as a bloodless scalpel to remove excess tissue and recontour the nose, often followed by dermabrasion
  • Your doctor is the best resource to determine what will work for you.

Subtype 4. Eye irritation

Medical name: Ocular rosacea
Symptoms: watery or bloodshot eyes, tearing and burning, swollen eyelids, recurrent styes.

More facts

Ocular rosacea is characterized by any one of many eye symptoms, including a watery or bloodshot appearance, foreign body sensation, burning or stinging, dryness, itching, light sensitivity, and blurred vision.

Treatment options

While nothing is approved to treat ocular rosacea, the following may provide some symptom relief for mild to moderate cases:

  • Artificial tears
  • Oral antibiotics
  • The daily cleansing of the eyelashes with baby shampoo on a wet washcloth

Suspected cases of ocular rosacea should be examined by an eye specialist, who may prescribe ophthalmic treatments. Your doctor is the best resource to determine what will work for you.

If you think you have rosacea, it’s important to speak to your doctor about your treatment options and thoroughly understand your choices.

Not sure if you have acne or rosacea? Rosacea is typically found on a person’s face, while acne may also affect their back, shoulders, and chest.