Rosacea is a chronic and common skin disorder causing redness, flushing, and acne-like lesions on the face. Occasionally it can affect the eyes, causing redness and eye irritation. People with fair skin are most commonly affected but it can occur in any skin type. Most often rosacea is an adult-onset condition with the most cases seen in adults greater than 30 years old, however it can start in adolescence or childhood.

The cause of rosacea is not well understood and researchers believe that there may be many contributing factors including immune dysfunction, reactions to microorganisms, sun damage and vascular dysfunction. Immune system dysfunction can increase inflammation and blood vessel abnormalities due to being more susceptible to sun damage and microorganisms over time. Microorganisms that are believed to be related to rosacea include mites and several bacteria. Demodex mites, which are present on almost all normal skin, have shown to be increased in patient’s with rosacea. Bacillus olenorium, is a type of bacteria which may cause inflammation with rosacea. Other bacteria such as staph epidermidis have been linked to rosacea in a few studies but this has not been fully studied. Increased UV damage increases risk for disease severity and is a common exacerbating factor. Vascular hyperreactivity, or increased blood flow to the skin, is a possible cause of rosacea. This contributes to increased flushing in rosacea patients. Lastly, rosacea can also be genetic. People with family history of rosacea are much more likely to develop it over time.

There are four subtypes of rosacea: erythematotelangiectatic, papulopustular, phymatous and ocular rosacea. There are several different features of rosacea. Patients may have chronic redness of the nose and cheeks, otherwise known as centrofacial erythema. Phymatous changes may occur as well, which is thickening of the skin, most commonly seen on the nose. Acne-like lesions may develop but are not true white-heads or black-heads like in traditional acne. 

Frequent flushing is a common symptom, causing redness and warmth throughout the face when exposed to a trigger. Superficial blood vessels visible on the skin are also common, mostly seen on the cheeks. Eye features occur in about half of rosacea cases, which may cause eye burning, irritation, light sensitivity and redness. If you experience eye involvement with your rosacea it is recommended to be seen regularly by an ophthalmologist. Lastly, patients with rosacea have very sensitive skin with skin care products often causing burning, itchy and even swelling of the skin on the face.

Triggers for rosacea vary based on person. Some common triggers include extremes of temperature, sunlight, spicy foods, alcohol, chocolate, exercise, emotions, medications, hot beverages, etc. Paying attention to what triggers your rosacea will be important for management over time. It is recommended to avoid triggers when possible. All triggers will not be able to be avoided.


There is no definitive cure for rosacea, but there are treatments that can improve existing symptoms and ease disease progression. Avoiding triggers whenever possible is one of the most important treatments for rosacea. We encourage patients to keep a diary of flares and when possible to link to them.