While the health information and fact sheets on this website relate to world-wide situations, the drug names will vary between countries – therefore the advice of your local GP should be sought.
|The health information and factsheets on this website are produced by Bupa's health information team. The information is reviewed and approved by relevant healthcare professionals, including doctors, dentists, nurses, physiotherapists and dietitians.||
|Browse the a-z list of factsheets:||
Published by Bupa's health information team, April 2009.
This factsheet is for people who have rosacea, or who would like to know more information about it.
Rosacea (previously known as acne rosacea) is a common skin condition. It can cause redness on cheeks, bumps, pimples, spots. It's most common in middle-aged men and women.
Rosacea is a skin disorder that causes redness, bumps, flushing and noticeable blood vessels, usually on the centre of the face. Rosacea sometimes looks like acne and other skin disorders.
Women are more likely to get rosacea but the symptoms are often more severe in men. People who are fair-skinned and of Celtic or Northern European descent are more at risk of rosacea. People who blush easily are also believed to be at greater risk. Rosacea isn't contagious. It seems to run in families but it's not clear whether rosacea is hereditary.
Image showing rosacea on the cheek
Reproduced under licence from Wellcome Images
Symptoms of rosacea
Rosacea usually starts with flushing on the forehead, nose and cheeks. Over several months or even years, the flushing becomes a darker shade of red and the skin stays this colour all the time. After a while bumps and spots develop.
The symptoms of rosacea vary from person to person. If you have rosacea, you may have the following symptoms:
small red bumps (papules)
pus spots (pustules)
small blood vessels
skin feels sensitive and may burn, sting and itch.
Rosacea can also cause problems around your eyes. It often affects your eyelids and they may become red, itchy and sore.
Rosacea may cause the skin to become sensitive to light. This means that it may worsen after sun exposure.
Rosacea can make you self-conscious, embarrassed and anxious. It can also disrupt your social life.
Complications of rosacea
In severe cases the skin of your nose thickens and looks red and bumpy. This is known as rhinophyma and is more common in men than women.
You may get conjunctivitis and inflammation of your eyelids (blepharitis). In severe cases, rosacea can affect the eye itself, but this is rare.
Causes of rosacea
The cause of rosacea is not fully understood. It's thought that it could be caused by blood vessels in the skin of your face dilating too easily.
There are a number of triggers that can make rosacea worse, but they aren't thought to cause rosacea. These include:
hot and cold temperatures
If you think you have rosacea, you should visit your GP.
Diagnosis of rosacea
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.
Rosacea is usually fairly easily to recognise by examining the skin.
Treatment of rosacea
There are a range of treatment options available for rosacea. Rosacea can't be cured but treatment aims to control the symptoms. It's possibly best to start treatment when rosacea is at an early stage to try and prevent it from getting worse.
It's important that you identify and avoid the triggers that cause flushing such as certain hot foods, spicy food and sunlight.
If sunlight makes the rosacea worse, you should apply sunscreen to your face when you go out in the sunshine. Make sure it has a sun protection factor (SPF) of 30 or higher.
Cosmetics designed for rosacea or redness can be very effective. They usually have a green tint which hides the redness.
In more severe cases, camouflage creams can be used to improve the appearance of your rosacea. The waterproof creams last for around 12 to 18 hours on your face. The creams blend into your skin colour to make your rosacea less noticeable. Skin camouflage can help to build your confidence and self-esteem. If you're interested in skin camouflage you should speak to your GP. He or she can refer you to a member of the British Association of Skin Camouflage (BASC), or the Red Cross skin camouflage service. You will be shown how to apply the cream and how to match the colour to your skin tone. One visit is usually sufficient to give you information about skin camouflage and create a skin match.
When you wash your face, make sure that you use a mild and non-abrasive cleaner. Don't use washcloths or sponges on your face as these can irritate your skin. Apply the cleanser with your hands, rinse with lukewarm water and pat dry with a towel.
If you have mild rosacea, your GP may prescribe you an antibacterial cream or gel such as metronidazole. If your symptoms don't improve with metronidazole, your GP may prescribe azelaic acid. You may experience some burning or stinging when using these creams.
If your rosacea is more severe or the creams don't work, your GP may prescribe you an oral antibiotic such as tetracycline, oxytetracycline or erythromycin. You should take these daily for six to 12 weeks. Your GP will reduce your dose once the symptoms have been controlled. If the medication is effective you will be able to stop treatment. However, long-term treatment may be required if symptoms return.
Stronger treatment such as isotretinoin is occasionally given in severe cases. If your rosacea is this severe you will be referred to a dermatologist.
Eye symptoms of rosacea can be treated with oral antibiotics such as tetracycline and doxycycline. Your GP will refer you to an ophthalmologist, a doctor who specialises in eye health, if you have severe eye problems.
Laser treatment can be used in some cases to treat visible blood vessels and sometimes rhinophyma. It usually has no complications. You may need several treatments for it to be effective.
If you have a bulbous nose affected by rhinophyma, you may consider cosmetic surgery, but this is only advisable once the rosacea has been controlled. Your GP or dermatologist can give you more information.
See our answers to common questions about rosacea, including:
- Rosacea. British Skin Foundation. www.britishskinfoundation.org.uk, accessed 23 January 2009
- Rosacea. MERK. www.merck.com, accessed 23 January 2009
- Rosacea - management. Introduction. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 23 January 2009
- All about rosacea. National Rosacea Society. www.rosacea.org, accessed 23 January 2009
- Frequently asked questions. National Rosacea Society. www.rosacea.org, accessed 23 January 2009
- Rosacea. Clinical features. GP Notebook. www.gpnotebook.co.uk, accessed 23 January 2009
- Van-Zuuren EJ, Graber M, Hollis S et al. Interventions for rosacea. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD003262. DOI: 10.1002/14651858.CD003262.pub3. www.cochrane.org
- Simon C, Everitt H, Kendrick T. Oxford handbook of general practice. 2nd ed. New York: Oxford University Press, 2007:655
- Blount B, Pelletier A. Rosacea: a common, yet commonly overlooked, condition. Am Fam Physician 2002; 66:435-440. www.aafp.org
- Rosacea - management. What self-care advice should I give about rosacea? Clinical Knowledge Summaries. http://cks.library.nhs.uk
- Skin camouflage. British Red Cross. www.redcross.org.uk, accessed 4 November 2008
- Skin Camouflage Service. Irish Red Cross. www.redcross.ie, accessed 4 November 2008
- Camouflage consultations. British Association of Skin Camouflage. www.skin-camouflage.net, accessed 4 November 2008
- Consultations. British Association of Skin Camouflage. www.skin-camouflage.net, accessed 4 November 2008
- Rosacea. Management. GP Notebook. www.gpnotebook.co.uk, accessed 23 January 2009
- Joint Formulary Committee. British National Formulary. 56th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008:628
- Rosacea - management. How should I follow up a person with rosacea? Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 23 January 2009
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: April 2009