What is rosacea and what are the symptoms? Rosacea is a skin condition that affects parts of the face. It is sometimes called acne rosacea, as it can look similar to acne. However, it is a different condition to acne. Symptoms of rosacea include one or more of the following:

• Frequent flushing of the face, similar to blushing. This is often the first symptom and may be the only symptom for months or years before anything else develops.
• Redness (erythema) of parts of the face. This can look similar to sunburn.
• Small lumpy red spots (papules) and small cysts (pustules) on the face. The spots and cysts look similar to acne. These may come and go in some cases but, in others, remain long-term unless treated.
• Telangiectasia on the face. These are tiny blood vessels under the skin, which you can see and can become quite prominent on the face.
• Eye symptoms (also called ocular rosacea) occur in about half of cases, but are often mild. They can include:
  • A feeling of something in the eye.
  • Burning, stinging or itchy eyes.
  • Dryness.
  • Sensitivity to light.
  • Eyelid problems such as cysts, styes or eyelid inflammation (blepharitis).
  • Inflammation and infection of the cornea (the front of the eye) is an uncommon but serious complication that can affect vision. See a doctor urgently if you develop eye pain or visual problems.
• Thickening of the skin occurs in some cases. The most well-known example of this is called a rhinophyma (a bulbous, bumpy nose). This is uncommon.

What causes rosacea? The exact cause is not known. A number of factors may be involved. However, none of these factors has definitively been proven to be the cause. For example:

• Tiny blood vessels under the affected skin may become abnormal or leaky.
• Sun damage.
• A tiny mite called demodex folliculorum may be involved. It lives harmlessly on the skin of many people but has been found in higher numbers in those with rosacea.
• Abnormal immune reactions in the skin, which lead to inflammation.
• Genetics may also be involved, as rosacea may run in some families.

How is rosacea diagnosed? Rosacea is usually diagnosed by your typical symptoms and its typical appearance on your face. There are no specific investigations that are needed to confirm the diagnosis. However, sometimes your doctor may do a test such as a blood test to help exclude other problems that may cause redness of the skin.

Who gets rosacea? Symptoms may first appear in your early 20s, but the usual age that symptoms appear is in your 30s-50s. Rarely, rosacea can affect children. Women are more commonly affected than men. However, rosacea is often less severe in women than in men. Rosacea is more common in fair-skinned than dark-skinned people.