Rosacea is a common chronic skin condition, the main symptoms of which are: a burning or tingling sensation in the face, an erythematous rash (red spots) on the face, with flushing. This may be accompanied by pimples, papules, bumps or pustules on the face. The small visible blood vessels under the skin are called ‘couperose’ (veins on the cheeks). It is a condition for which it is not known exactly how it arises. Treatment is aimed at controlling the symptoms and complaints and improving the appearance of the skin. This can be done, among other things, by avoiding triggering factors, but also by locally applying an ointment.

• What is rosacea?

• Chronic inflammatory skin condition
• Progressive course
• Rosacea fulminans

• Cause of rosacea

• Cause is unknown
• Factors that worsen rosacea

• Symptoms of rosacea: red spots on face, neck and throat

• Phenomena
• Complications of the eyes
• Cauliflower nose
• More common in women

• Treatment of rosacea

• Avoidance of triggering factors
• Medication

• Prognosis

 Rosacea is a progressive skin condition that affects the central part of the face: the cheeks, forehead, chin and nose / Source: JNL, Wikimedia Commons (FAL)

What is rosacea?

Chronic inflammatory skin condition

Rosacea is a chronic inflammatory skin condition characterized by red spots on the face, especially the cheeks, nose, chin, forehead or eyelids. Sometimes the rash can also manifest itself on the chest, ears, neck or hairline. Furthermore, chronically dilated vessels in the face (telangiectasia), papules and papulopustules (pimples) may be visible. This is a bit like acne.

Progressive course

Rosacea has a progressive course and untreated it gets worse, but even despite treatment it keeps coming back. Rosacea can spread to the eyes and cause inflammatory reactions.

Rosacea fulminans

There is also a rare, severe variant of rosacea, called ‘rosacea fulminans’, which is characterized by the abrupt appearance of bumps and pustules (papules and pustules) and redness (erythema) in the face. The condition mainly affects young adult women and occurs more often during pregnancy.

Cause of rosacea

Cause is unknown

In 2023, it is not clear how the condition arises. However, English research in 2007 showed that rosacea is closely related to an excessive concentration of two enzymes in the skin. These enzymes do belong there, but not in the high concentrations that have been found in rosacea patients, which gives rise to the symptoms.Alcohol can cause flushes / Source: Istock.com/karelnoppe

Factors that worsen rosacea

The exact cause of rosacea is not yet known, but certain factors cause the condition to worsen. These are called ‘triggers’. Hot foods and drinks, emotions and highly spicy foods and alcohol can trigger flushes. Other factors that may worsen rosacea include exposure to high or low temperatures and weather conditions, wind and sunlight exposure. Physical exercises or high-intensity exercise can also worsen the symptoms.

Symptoms of rosacea: red spots on face, neck and throat

Phenomena

Rosacea is characterized by red skin, flushes, telangiectasia (couperose, small visible blood vessels are visible under the skin) to papulopustules (pimples), furuncles (skin abscesses) and cysts. With rosacea there are no comedones (blackheads), as is the case with acne. The patient may experience a burning or tingling sensation in the face.Blepharitis / Source: Clubtable, Wikimedia Commons (Public domain)

Complications of the eyes

About half of the patients develop eye complications, such as blepharitis (inflammation of the eyelid margin), conjunctivitis (inflammation of the conjunctiva), iritis (inflammation of the iris, iris) or keratitis (inflammation of the cornea).

Cauliflower nose

Rhinophyma, also called ‘cauliflower nose’, ‘bunny nose’ or ‘red nose syndrome’, which in fact only occurs in older men, is considered a variant of rosacea.

More common in women

Rosacea is more common in women than in men. Men often have more severe symptoms. People with rosacea often have fair skin, but the disease rarely occurs in people with dark skin. It usually affects people between 30 and 60 years old.

Treatment of rosacea

Avoidance of triggering factors

Rosacea cannot be cured, but it can be controlled. First of all, it is important to avoid triggers for flushes by avoiding hot foods and drinks, alcohol and highly spicy foods. Furthermore, protect or avoid hot or cold ambient temperatures and exposure to wind or sunlight.

Medication

Depending on the extent and the complaints, one can proceed to the local application of ointment (metronidazole in a non-greasy base). In case of severe symptoms, an antibiotic may be prescribed. The vascular abnormalities can be treated with pulsed dye laser , which never damages the skin surface. With rhinophyma, excess tissue can be surgically removed, giving the nose a better appearance.

Prognosis

Rosacea is a harmless condition, but it can cause shame, insecurity and low self-esteem. The condition cannot be cured, but can be controlled with treatment.

read more

• Rosacea symptoms: red color cheeks, nose & spots on face
• Skin disorders AZ: symptoms, cause and treatment
• Rash on the face: on the cheeks, chin, nose and forehead
• Rosacea fulminans: bumps, pimples and redness on the face
• Red spots under eyes: eczema and rashes around the eyes