About Rosacea

Symptoms and Clinical Signs of Rosacea

What is Rosacea?

Rosacea is a chronic inflammatory disorder involving mostly the central portions of the face, gradually involving the cheeks, chin, forehead and nose. It may also involve the chest and back. It is associated with diffuse sebaceous gland abnormalities and increased reactivity of capillaries that develops over time, forming small pimples and blood vessels around the reddened area. Sometimes it can be mistaken with adult acne but there are no blackheads.

What are the clinical signs of Rosacea?

  • Erythema (redness) of the areas involved
  • Inappropiate flushing and persistent redness of the face due to increased blood flow
  • Broken blood vessels (telangiectasias) on the cheeks and nose
  • Inflammation that causes red bumps, also called papules or pustules
  • Enlargement of the volume and size of the nose which occurs primarily in men (Rhinophema)
  • Enlarged cushion-like swelling of the forehead (Metophyma)
  • Swelling of the eyelids related to enlargement of sebaceous glands (Blepharophyma)
  • Swelling of the chin (Gnatophyma)
  • No comedones (blackheads or whiteheads, as opposed to acne)

What are the symptoms of Rosacea?

  • Stinging, burning sensation on the face.
  • Persistent redness developing after blushing
  • Episodic facial redness with increased skin temperature in response to stimuli
  • Appearance of "pimples" on the face
  • Appearance of "blood vessel lines" on the face
  • Gritty and uncomfortable feeling in the eyes. These may be signs of conjunctivitis and it occurs in about 50% of the patients with Rosacea. If this is not recognized and treated, it may cause more serious eye problems.
  • Thickening of the skin, particularly on the nose.

What conditions can Rosacea be confused with?

  • Acne vulgaris- typically presents with comedones, and it is not associated with the diffuse redness and telangiectasia which are characteristic of rosacea.
  • Seborrheic dermatitis, perioral dermatitis, systemic lupus- these conditions will not produce the typical flushing, telangiectasias, papules and pustules of rosacea.
  • Sarcoidosis- closely mimics with red papules on the face, but it involves other organs as well.