1. Erythematotelangiectatic ros acea (rosacea with redness) This is the most common variant of rosacea. The symptoms are periods of redness in parts, usually the center, of the face. Over time, this chronic redness can cause the blood vessels under the surface of the skin to enlarge, leading to permanent redness (erythema).
   
   
2. Papulopustular rosacea (rosacea with pimples) This type involves a permanent reddening of the skin with occasional pimples.
   
   
3. Phymatous rosacea (rosacea with enlarged nose) This type is characterized by enlarged pores and redness leading to a swollen, enlarged nose.
   
   
4. Ocular rosacea (eye rosacea) Ocular rosacea results in inflammation of the outer parts of the eye, with symptoms such as a dry feeling, redness around the eyelashes, increased tear production and wobbling.  

If you think you have rosacea, you should always see a dermatologist or doctor to get a correct diagnosis.

Who influences it?

Rosacea affects both men and women and is most common after the age of 30. From a global perspective, it can be seen that rosacea is much more common in the northern parts of Europe from .

Rosacea not only affects people physically but also mentally. Recent research shows that its psychosocial impact can be very serious, leading to social anxiety and depression. Interestingly, men tend to experience worse psychological effects than women.

Why do you get rosacea?  

The exact cause of rosacea is still unknown. Genetics seems to play a role, e.g. if your mother has rosacea, you are more likely to get it too. Rosacea has also been linked to immune system disorders and increased nerve sensitivity.

There are indications that rosacea patients have higher levels of Demodex mites (a type of parasite) living in the skin. We all have a number of mites in our skin and, as many people know, mites thrive in both bedding and skin. Demodex mites can also live in our hair follicles and sebaceous glands. According to one theory, their droppings trigger an inflammatory response in our skin.

There is also a medical link between rosacea and autoimmune diseases such as diabetes, coeliac disease (gluten intolerance) and rheumatism.

Skin care habits can also be a cause of rosacea. A large study showed that cleaning habits can influence the onset and development of rosacea. Over-cleaning appeared to be a major risk factor and we have written a summary article on this very interesting study here.   

Psychological stress also seems to be a high contributor to rosacea. In fact, dermatologists in Sweden reported an increased number of rosacea cases in the spring of 2020, i.e. during the covid19 pandemic. It is believed that the reason behind this increased incidence of rosacea is due to higher levels of psychological stress.

How to treat rosacea?

There is no cure for rosacea, but there are several treatments available. Today, the condition is often treated with antibiotics and topical drugs that have anti-inflammatory properties. Many of those affected by more severe rosacea need to be prescribed treatment by a doctor. The main treatments are: 

Treatments that reduce redness, such as brimonidine and oxymetazoline. These treatments reduce the blood supply to the skin, so the skin does not redden as much. Brimonidine is also used in eye drops to treat ocular rosacea.  

Anti-acne drugs, such as azelaic acid and tretinoin. They are used to treat papulopustular rosacea. Exactly how these substances work is not fully understood, but it is thought that their anti-inflammatory properties help reduce the inflammation caused by rosacea.   

Antibiotics such as metronidazole and tetracyclines. It is not known exactly why antibiotics affect rosacea, but one possible explanation is that antibiotics kill bacterial growth in the skin potentially caused by mite feces.

Ivermectin, an insecticide that kills Demodex mites, is one of the newer treatments for rosacea.