Rosacea is a common skin condition, typically arising in fair-skinned individuals between 30-50 years of age. There are two main types of rosacea:

  1. Papulopustular – This type of rosacea looks very similar to acne with red spots and small pustules.

  2. Erythrotelangiectatic – This presents with diffuse redness, flushing and broken blood vessels.

Often, patients experience both types and rosacea can even affect the eyes (with a feeling of grittiness and a bloodshot look).

Facial redness, flushing, broken capillaries as well as bumpy skin texture may be a sign of rosacea.

At Mittal Dermatology we will advise you on prescription medications, our exclusive topicals, as well as laser therapies.

Rosacea (rose-AY-sha) is a common skin disease. It often begins with a tendency to blush or flush more easily than other people.

The redness can slowly spread beyond the nose and cheeks to the forehead and chin. Even the ears, chest, and back can be red all the time.

Rosacea can cause more than redness. There are so many signs and symptoms that rosacea has four subtypes.

  1. Erythematotelangiectatic rosacea
    Redness, flushing, visible blood vessels

Signs and Symptoms

  • Flushing and redness in the center of the face

  • Visible broken blood vessels (spider veins)

  • Swollen skin

  • Skin may be very sensitive

  • Skin may sting and burn

  • Dry skin, roughness or scaling

  • Have a tendency to flush or blush more easily than other people

  1. Papulopustular rosacea
    Redness, swelling, and acne-like breakouts

Signs and symptoms

  • Acne-like breakouts, usually where the skin is very red

  • Acne-like breakouts tend to come and go

  • Oily skin

  • Skin may be very sensitive

  • Skin may burn and sting

  • Visible broken blood vessels (spider veins)

  • Raised patches of skin called plaques

  1. Phymatous rosacea
    Skin thickens and has a bumpy texture

Signs and Symptoms

This subtype is rare. When it does occur, the person often has signs and symptoms of another subtype of rosacea first. The signs of this subtype are:

  • Bumpy texture to the skin

  • Skin begins to thicken, especially common on the nose. When the skin thickens on the nose, it is called rhinophyma (rye-NO-fie-ma)

  • Skin may thicken on the chin, forehead, cheeks, and ears

  • Visible broken blood vessels appear

  • Pores look large

  • Oily skin


  1. Ocular rosacea

Signs and symptoms

Ocular rosacea: When rosacea affects the eye, it is called ocular rosacea. If rosacea affects your eye, you may need to see an ophthalmologist (doctor who specializes in treating eye diseases).

Some people get rosacea in their eyes. The eyes may have one or more of the following:

  • Watery or bloodshot appearance

  • Feel gritty, often feels like sand in the eyes

  • Eyes burn or sting

  • Eyes are very dry

  • Eyes itch

  • Eyes sensitive to light

  • Blurry vision

  • Visible broken blood vessels on an eyelid

  • Cyst on the eyelid

  • Person cannot see as well as before

Who gets rosacea?

Rosacea is common. According to the U.S. government, more than 14 million people are living with rosacea. Most people who get to

sacea are:

  • Between 30 and 50 years of age

  • Fair-skinned, and often have blonde hair and blue eyes

  • From Celtic or Scandinavian ancestry

  • Likely to have someone in their family tree with rosacea or severe acne

  • Likely to have had lots of acne — or acne cysts and/or nodules

Women are a bit more likely than men to get rosacea. Women, however, are not as likely as men to get severe rosacea. Some people are more likely to get rosacea, but anyone can get this skin disease. People of all colors get rosacea. Children get rosacea. 

What causes rosacea?

Scientists are still trying to find out what causes rosacea. By studying rosacea, scientists have found some important clues:

  • Rosacea runs in families. Many people who get rosacea have family members who have rosacea. It is possible that people inherit genes for rosacea.

  • The immune system may play a role. Scientists found that most people with acne-like rosacea react to a bacterium (singular for bacteria) called bacillus oleronius. This reaction causes their immune system to overreact. Scientists still do not know whether this can cause rosacea.

  • A bug that causes infections in the intestines may play a role. This bug, H pylori, is common in people who have rosacea. Scientists cannot prove that H pylori can cause rosacea. Many people who do not have rosacea have an H pylori infection.

  • A mite that lives on everyone’s skin, demodex, may play a role. This mite likes to live on the nose and cheeks, and this is where rosacea often appears. Many studies found that people with rosacea have large numbers of this mite on their skin. The problem is some people who do not have rosacea also have large numbers of this mite on their skin.

  • A protein that normally protects the skin from infection, cathelicidin, may cause the redness and swelling. How the body processes this protein may determine whether a person gets rosacea.

Rosacea can affect quality of life

Rosacea can affect more than the skin and eyes. Because rosacea is a chronic (long-lasting) skin disease, it can reduce a person’s quality of life. Many people report problems at work, in their marriage, and with meeting new people. Surveys and studies report that living with rosacea can cause: 

  • Feelings of frustration and embarrassment: In surveys conducted by the National Rosacea Society, 41 percent said their rosacea caused them to avoid public contact or cancel social engagements.

  • Worry: People worry that their rosacea will get worse or cause scars. People worry about side effects from medicine used to treat rosacea.

  • Low self-esteem: Surveys conducted by the National Rosacea Society found that almost 70 percent of people living with rosacea said that the condition lowered their self-confidence and self-esteem.

  • Work-related problems: Surveys conducted by the National Rosacea Society find that when rosacea is severe, 70 percent of people say the disease affects their interactions at work. Nearly 30 percent say that rosacea causes them to miss work.

  • Anxiety and depression: Living with a skin condition that flares unexpectedly can cause people to believe you have a drinking problem. This can cause anxiety and depression.

Treatment seems to improve a person’s quality of life. Studies show that when people have fewer signs and symptoms of rosacea, their quality of life improves.

Signs of rosacea in skin of color

If you have skin of color, dermatologists recommend that you make a dermatology appointment if you notice any of the following on your face:

  • A warm feeling most of the time

  • Dry, swollen skin and patches of darker skin

  • A dusky brown discoloration to your skin

  • Acne-like breakouts that acne treatment won’t clear

  • Yellowish-brown, hard bumps around your mouth, eyes, or both

  • Burning or stinging when you apply skin care products

  • Swelling and thickening skin on your nose, cheeks, chin, or forehead