4 Different Types of Rosacea

While estimates vary, as many as one in five people are believed to live with rosacea .¹ This chronic, inflammatory skin condition can affect not only your skin but your confidence, fueling self-consciousness and concern about your appearance. 

While the cause of rosacea isn’t always known, it may stem from certain skin microorganisms, immune system responses, or an helicobacter pylori (H. pylori) infection. Genetics may play a role, too – so if one or more of your blood relatives has rosacea, you’re likely to as well.

There are four main types of rosacea, all of which can be managed with appropriate treatment and lifestyle changes. Understanding the type you have may help you get on the path to healthier skin and fewer bothersome symptoms.

How to Tell if You have Rosacea 

If your skin frequently appears red or flushed, even when you aren’t embarrassed or exercising, you may be dealing with rosacea. Rosacea can also cause pus-filled bumps and enlarged blood vessels that show through your skin. Your symptoms may stay fairly steady or flare up in response to particular triggers. During an episode, symptoms can last for weeks or months .²

Rosacea can be mistaken for acne or dermatitis, but there are differences. Unlike acne, for example, rosacea bumps don’t leave scars – unless you pick at or attempt to “pop” them.¹²  And while dermatitis most often affects children and adolescents, rosacea flushing usually first appears between ages 30 and 50 .^3,4

Rosacea diagnosis typically involves a physical exam and review of your medical history by your primary physician or dermatologist. In some cases, a blood test is ordered to rule out other conditions, such as systemic lupus erythematosus (SLE).3 You may be diagnosed with one type of rosacea, though many people experience symptoms of more than one form.

1. Erythematotelangiectatic Rosacea: Persistent Flush and Vascular Patterns

Erythematotelangiectatic rosacea (ETR) is the most common rosacea type, affecting more than half of people with the disease .¹³ Characterized by persistent redness, flushing, and damaged blood vessels known as spider veins, ETR often runs in families. 

The redness and flushing usually appear in the center area of your face, particularly on your nose, forehead, and cheeks. Other possible signs of ETR include skin scales or dryness and swollen or stinging skin .⁵

2. Papulopustular Rosacea: Inflammatory Lesions

In addition to possible flushing, redness, and spider veins, papulopustular rosacea causes pimple-like bumps called papules. These inflamed lesions usually crop up on your cheeks, chin, or forehead. You might also develop pustules, or similar bumps that contain pus and have a white or yellow tip.

Papulopustular rosacea flare ups look a lot like acne breakouts. Acne medication, however, may irritate your skin and worsen matters. The bumps may linger for several days or weeks and feel tender to the touch.6 Your skin might also feel hot or itchy until symptoms subside.

3. Phymatous Rosacea: Skin Thickening, Facial Disfigurement

Phymatous rosacea, a relatively rare form, causes enlarged pores and swollen, thickened skin that can alter the shape and appearance of your face. These surface changes typically affect your nose, though chin, ear, and forehead changes are also possible. 

More common in men than women, phymatous rosacea often starts with more common rosacea symptoms before causing disfigurement, such as a “bulbous nose.”^7,8

4. Ocular Rosacea: Eye Irritation & Vision Complications

Ocular rosacea goes beyond skin changes and impacts both your eyes and your vision. You can experience ocular rosacea with or without developing rosacea symptoms on your skin.

When it unfolds, your eyes may become dry, itchy, irritated, and red. Light sensitivity, and blurred vision are also common ocular rosacea symptoms. Meanwhile, you might notice dilated blood vessels on the whites of your eyes, along with a gritty sensation, as though you have something in your eye. 

Linked with eye infections, ocular rosacea can fuel recurrent conjunctivitis (pink eye). You might also experience related blepharitis, or chronic eyelid inflammation. Ocular rosacea complications affecting your corneas can lead to permanent vision loss without treatment .¹⁰

Managing Rosacea Symptoms 

If you’re wondering how to get rid of rosacea permanently, there’s bad and good news. While there’s no known cure for the condition, appropriate rosacea treatment can go far. Depending on the type and severity of your symptoms, you may benefit from medication, laser treatment, or a topical cream. 

Thankfully, you don’t need a prescription to access an effective rosacea cream. Foundation Skincare’s Azelaic Acid 14% Cream was engineered by a dermatologist and chemist to reduce rosacea symptoms while limiting skin irritation caused by other azelaic acid products. Used once or twice a day, our cream destroys harmful skin bacteria, reduces inflammation, and brightens your complexion..A review of 20 rosacea studies showed that azelaic acid more effectively reduced inflammatory lesions than other treatments after 12 weeks .⁹ 

You can also manage your symptoms by avoiding your rosacea triggers. While each person is unique, common triggers include sun exposure, certain foods, alcohol, extreme temperatures, and heavy perspiration. Emotional stress, indoor heat, and irritating soaps and skin care products can also exacerbate rosacea. 

You probably don’t need to give up something triggering you love to manage your rosacea. While hot baths spur rosacea flares for some people, for example, warm baths are often well tolerated. If you find that dairy products set off your symptoms, swap out cow’s milk for almond, oat, or soy equivalents. And if you enjoy intense workouts, aim to exercise in a cool atmosphere, stay well hydrated, and take a shower or bath promptly afterwards. 

To manage ocular rosacea, gently cleanse your eyelids at least twice a day with warm water, or as often as your doctor recommends. Avoiding eye makeup during a flare up can also help .¹⁴

To determine your rosacea triggers, the National Rosacea Society recommends tracking your symptoms along with notes about your emotions, climate, activities, eating habits, and household chores .¹¹ Doing so can improve your own awareness while providing a useful tool for your dermatologist. 

Find more tips and resources on maintaining healthy hair and skin in the FS Blog.

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References: 

1. https://medlineplus.gov/genetics/condition/rosacea/frequency

2. https://www.mayoclinic.org/diseases-conditions/rosacea/symptoms-causes

3. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rosacea

4. https://www.niams.nih.gov/health-topics/atopic-dermatitis

5. https://www.healthline.com/health/rosacea/erythematotelangiectatic-rosacea

6. https://www.medicalnewstoday.com/articles/papulopustular-rosacea

7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828925/phymatousrosacea

8. https://revivalresearch.org/blogs/phymatous-rosacea-and-rhinophyma

9. https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.15923

10. https://www.mayoclinic.org/diseases-conditions/ocular-rosacea

11. 11.https://www.rosacea.org/patients/materials/coping-with-rosacea/identifying-rosacea-triggers

12. https://www.healthline.com/health/rosacea/can-you-pop-rosacea-bumps

13. https://jamanetwork.com/journals/jamadermatology/fullarticle/2790693

14. 14.https://www.mayoclinic.org/diseases-conditions/ocular-rosacea/diagnosis-treatment