What is Rosacea?

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Last updated: March 6, 2025View editorial policy

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From the Guidelines

Rosacea is a chronic relapsing facial skin disease characterized by recurrent flushing, erythema, inflammatory lesions, phymas, and telangiectasias, affecting an estimated 16 million people in the USA, with many more undiagnosed cases, especially in skin of color 1.

Definition and Prevalence

Rosacea is a chronic skin condition that presents with various symptoms, including recurrent flushing, erythema, inflammatory lesions, phymas, and telangiectasias, as noted in a 2024 review of the current treatment landscape 1. The condition affects a significant number of people, with estimates suggesting that 16 million individuals in the USA have rosacea, and many more cases remain undiagnosed, particularly in individuals with skin of color 1.

Impact on Quality of Life

The condition can have a profound impact on an individual's quality of life, as it affects the face and can lead to social and professional stigma, with a global perception survey showing that individuals with central facial redness are judged more negatively than those without 1.

Management and Treatment

Management of rosacea involves long-term avoidance of common triggers, use of gentle skin care, and adherence to pharmacologic treatment, with phenotype-based medical management being a recommended approach, as endorsed by the global Rosacea Consensus (ROSCO) panel in 2020 1. Topical therapy is often the preferred initial treatment, with newer agents such as encapsulated benzoyl peroxide 5% (E-BPO 5%) and minocycline foam offering effective and well-tolerated options for patients with rosacea 1.

From the Research

Definition of Rosacea

  • Rosacea is a chronic inflammatory skin condition associated with four distinct subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular 2, 3, 4
  • It is characterized by flushing, redness, pimples, pustules, and dilated blood vessels on the face, with possible eye involvement and skin thickening 3, 4

Subtypes of Rosacea

  • Erythematotelangiectatic rosacea: characterized by flushing and redness 2, 3
  • Papulopustular rosacea: characterized by pimples and pustules 2, 3
  • Phymatous rosacea: characterized by skin thickening, especially on the nose 2, 3
  • Ocular rosacea: characterized by eye involvement, including redness and irritation 2, 3

Pathogenesis of Rosacea

  • The exact pathogenesis of rosacea is unknown, but it is believed to be an inflammatory disorder with different pathogenic factors contributing to each subtype 3
  • Triggers such as ultraviolet light, heat, and certain medications can exacerbate symptoms 2, 3

Treatment Options for Rosacea

  • Topical treatments: metronidazole, azelaic acid, ivermectin, brimonidine, and others 2, 3, 4, 5
  • Systemic treatments: oral antibiotics, such as doxycycline, and isotretinoin 2, 3, 4, 5
  • Light-based therapies: pulsed dye laser, intense pulsed light, and others 2, 3, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Rosacea Management.

Skin appendage disorders, 2016

Research

Rosacea: a review of current topical, systemic and light-based therapies.

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, 2009

Research

Interventions for rosacea.

The Cochrane database of systematic reviews, 2015

Research

Rosacea: an update on medical therapies.

Skin therapy letter, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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