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Rosacea, sometimes called adult acne, is a chronic inflammation of the face of unknown cause and without a permanent cure. Four different types of rosacea have been described:

  • “Redface” rosacea, with a tendency to face flushing (or blushing), which can progress to a persistent redness of the nose or central face

  • “Acne”-like bumps and/or pus-filled lesions (papulopustular rosacea), with or without a red face or flushing

  • Rhinophyma – slow enlargement of oil glands and skin thickening of the nose and sometimes other face areas, usually in men

  • Eye problems (ocular rosacea), which may occur before skin changes – a burning or gritty feeling may be present as well as reddening of the eyes and lids


Adults between 30 and 60 are most often affected by rosacea; it is more common in women and in fair-skinned individuals, although dark-skinned people may also be affected. About 14 million Americans have rosacea. In most people rosacea comes and goes periodically; in some, it gets worse with time.

Frequent triggers (things that increase face blood flow) of rosacea include sunlight, hot drinks, spicy foods, alcohol, exercise, hot baths or saunas, temperature extremes, and emotional stress. Prolonged use of cortisone creams on the face can also lead to rosacea. Some drugs may worsen flushing (nasal steroids, amiodarone, high doses of some B vitamins, tamoxifen, and rifampin).

  • Persistent or recurrent redness of the central face (“high color”, “ruddy”), sometimes with swelling

  • Pimples or red bumps on the face (but no blackheads or whiteheads)

  • Red, bulb-shaped nose

  • Small blood vessels (or veins) on the central face

  • Burning or gritty feeling in eyes with or without red eyelids

Mild rosacea – occasional blushing and/or only rare pimples
Moderate rosacea – frequent blushing, persistent facial redness, and/or a few pimples almost all the time
Severe rosacea – lots of pimples or bumps all the time and/or red, uncomfortable eyes all the time and/or large bulbous nose and/or lots of blood vessels on the face, all of which can be bothersome in appearances.

If you have severe changes in appearance or symptoms that interfere with your daily life, you should seek care. If you have severe, persistent flushing, there are other possible causes of flushing requiring laboratory tests and should be evaluated by our clinicians at Smart Skin Dermatology.