The Four Subtypes of Rosacea Explained

Do you suffer with red blotchy facial skin? Rosy cheeks could be a result of anxiety, anger, or other forms of emotional stress. Alternatively, it could be a sign of an underlying skin condition known as rosacea. Public flare-ups of flushed, burning skin can be a nuisance and embarrassing for those who suffer with rosacea. Rosacea is a chronic skin condition that affects more than 16 million Americans.

The Bryn Mawr Skin & Cancer Institute and Cirillo Cosmetic Dermatology Spa teams provide expert advice regarding medical and cosmetic dermatological conditions in the Philadelphia area for patients with rosacea. The teams explain that rosacea is a chronic skin disorder that can have a detrimental effect on self-esteem and confidence, possibly leading to social withdrawal. While the chronic condition has no cure, symptoms can be managed effectively.

Rosacea is sometimes mistaken for other common skin conditions, like acne or perioral dermatitis. A consult with a board-certified dermatologist will help to make the correct diagnosis and recommend the best targeted therapy.

Increased blood flow to the cheeks is caused by enlarged blood vessels that have an exaggerated response to normal stimuli. Some of the symptoms associated with rosacea are flushing and blushing, pustules, red bumps, increased skin sensitivity, burning, stinging, dryness, visible dilated blood vessels, and irritated dry eyes. When symptoms go untreated, they can become more severe and more difficult to treat.

Symptoms vary depending on the type and severity of the rosacea. There are four subtypes of rosacea. It is possible to experience more than one subtype:

Subtype One: Erythematotelangiectatic (ETR) Rosacea

The main characteristics associated with ETR, otherwise known as vascular rosacea, are the trademark persistent flushing and visible blood vessels, which appear in the center of the face. ETR rosacea is often accompanied by burning and stinging. Flares may be triggered by consumption of alcohol, spicy foods, physical exercise, and weather changes. This is the most common form of rosacea.

Subtype Two: Papulopustular (Acne) Rosacea

Papulopustular rosacea is characterized by red bumps and pustules that may resemble and be mistaken for acne. Facial flushing and diffuse redness often accompany papulopustular rosacea and not acne. The most common areas affected are the nose, cheeks, and forehead. This type often affects middle-aged women.

Subtype Three: Phymatous Rosacea

Phymatous rosacea is a rare type of rosacea that mainly affects the nose, making it appear larger and more bulbous (which is also referred to as rhinophyma). The skin texture becomes thick and bumpy. It is more frequently seen in male patients and is often accompanied by another subtype of rosacea.

Subtype Four: Ocular Rosacea

Ocular rosacea is a common form of rosacea that typically affects the eyes of those who have the skin disorder, causing redness and irritation. Some people have only ocular rosacea and do not have the other subtypes. People suffering from ocular rosacea may experience a number of symptoms, which can include swelling around the eyes, bloodshot eyes, eyes that feel gritty, watery eyes, dryness, and light sensitivity.

Rosacea is associated with a multitude of symptoms that occur in cycles: flaring up, diminishing, and then returning at a later date. Flare-ups are typically broken down into three main phases: pre-rosacea, vascular rosacea, and inflammatory rosacea. The condition tends to occur most commonly in adults between the ages of 30 and 60. People who have very fair skin or a family history of rosacea are more susceptible to the condition. Rosacea can affect the nose, cheeks, forehead, and eyes.

While there is no cure for rosacea, newer topical and oral medications as well as lasers and light treatments have made it possible to manage rosacea well. The best way to control the symptoms of rosacea is to take preventative measures to avoid flare-ups. A board-certified dermatologist can work with you to determine the most common triggers for your breakouts—such as skincare products, medications, alcoholic beverages, and spicy foods—and help you to develop a preventative skincare and sun protection plan. You can also benefit from in-office treatments, such as calming facials and lasers and lights.

Have questions or concerns about rosacea or other skin conditions in the Bryn Mawr, Newtown Square, and Philadelphia area? Contact The Cirillo Institute at 610.525.0500 or send a message directly online.