Rosacea Illustrated. Photo © A.D.A.M.
Updated June 16, 2014.
Question: What is Rosacea?
What is rosacea? Is it a type of acne?
Rosacea is not a form of acne vulgaris, although it sometimes can be hard to distinguish from common acne. To confuse the matter, rosacea is sometimes called “acne rosacea,” or even “adult acne.” Like acne vulgaris, rosacea is a disorder of the pilosebaceous unit. But rosacea is not caused by the same factors as acne vulgaris and is a skin disorder in its own right.
Rosacea often begins as redness or flushing of the face. Small, red, pimple-like bumps can form on the face, but unlike acne vulgaris there are no blackheads or comedones. Capillaries may be visible on the skin, contributing to the red appearance of the face.
And unlike with common acne, this redness can wax and wane. In those with rosacea, the tiny capillaries of the face are over-sensitive. Certain triggers cause the capillaries to dilate or swell, which makes redness much worse. Common rosacea triggers include: sun exposure, eating spicy foods, drinking hot beverages or alcohol, and exposure to extremely hot or cold weather. Emotional stress is another major trigger. Also, long-term use of oral or topical steroids can also cause a flare-up of rosacea when steroid treatment is stopped.
Where acne can occur anywhere on the face, neck, back, upper arms, and shoulders, rosacea is confined to the center of the face (cheeks, nose, chin, and forehead.) Acne is all too common in the teen years, but rosacea typically doesn’t appear before age 30. If you have fair skin, you’re more prone to developing rosacea. Interestingly, it is more common in women, but men tend to develop more severe forms.
If rosacea progresses, redness and bumpiness can become more severe. The skin takes on a coarse, lumpy look, and the nose can become larger and more bulbous (think W.C. Fields). Luckily, most cases of rosacea don’t become this serious. For others, rosacea remains very mild, and the redness never progresses to papules and general skin bumpiness.
About half of all people with rosacea also develop redness and grittiness in the eyes, called ocular rosacea. Eye problems are sometimes over-looked, so make it a point to tell your doctor if you have redness of the eyes, tearing, blurred vision, sore or gritty feeling eyes.
Many people who have the beginning stages or mild rosacea oftentimes don’t even realize they have the disorder. They chalk up redness to a ruddy complexion, and women may get used to covering it with makeup. Or they assume the papules are adult acne breakouts, and buy an over-the-counter acne treatment. Most people are shocked when they finally see a dermatologist and discover what they have is not acne, but rosacea.
There is no cure for rosacea, and as of yet no proven cause. But today rosacea can be successfully controlled. Treatment for rosacea can include oral or topical antibiotics, and some acne medications like azelaic acid. But don’t try to treat rosacea on your own with over-the-counter acne products. Some can aggravate rosacea and leave your skin feeling even worse.
If you’ve noticed changes in your skin, you should make an appointment with a dermatologist. Sometimes it’s hard to tell if you have adult acne or rosacea, and although there is no lab test for either skin condition, your dermatologist will be able to make a diagnosis through a simple visual inspection.
Gerson, Joel; Ph.D.. Standard Textbook for Professional Estheticians. 8th edition. Albany, NY: Milady Publishing, 1999.
American Academy of Dermatology. (2005). Rosacea [Brochure]. Schaumburg, IL: American Academy of Dermatology.