Understanding Rosacea · Chapter 3
The Subtypes of Rosacea
Rosacea takes several overlapping forms. Recognising which type, or combination of types, you have is the first step towards the right treatment.
What are the four types of rosacea?
The four recognised subtypes are erythematotelangiectatic rosacea (persistent redness, flushing and visible blood vessels), papulopustular rosacea (spots and pustules on a red background), phymatous rosacea (skin thickening, usually of the nose) and ocular rosacea (eye and eyelid involvement). Many people have features of more than one.
How can I tell rosacea from acne?
Rosacea usually starts after the age of 30, has no blackheads or whiteheads, sits on a background of redness and visible vessels in the centre of the face, and is triggered by things like heat and alcohol. Acne typically starts in the teens and is defined by comedones.
What is rhinophyma?
Rhinophyma is thickening and enlargement of the skin of the nose caused by phymatous rosacea. It is much more common in men and, once established, is best treated with procedures such as ablative laser.
What are the symptoms of ocular rosacea?
Common symptoms include dry eyes, light sensitivity, watering, a gritty feeling, red eyes and blurred vision, often with inflamed eyelid margins. Ocular rosacea affects roughly 1 in 10 to 1 in 5 people with rosacea and is often missed.
Does rosacea always get worse over time?
No. Rosacea can progress, usually from redness to spots and, less often, to skin thickening, but this is not inevitable. Most people with the redness type never develop the other forms, and good long-term control may reduce the risk.
Can rosacea be mistaken for lupus?
Yes. Cutaneous lupus can look very similar. Joint pain, fatigue, a scarring rash or poor response to rosacea treatment should prompt a skin biopsy and blood tests to clarify the diagnosis.
Key takeaways
- There are four subtypes, and they often overlap.
- Papulopustular rosacea is often confused with acne.
- Rhinophyma is much more common in men.
- Eye symptoms should always prompt a check for ocular rosacea.
This page summarises Chapter 3 of Understanding Rosacea: Your Complete Guide. The full chapter, with references, is in the free PDF.
Download the free 108-page Rosacea Guide (PDF) →
Written and medically reviewed by Professor Vishal Madan, MBBS (Hons), MD, FRCP, MBA, Consultant Dermatologist, Laser and Dermatological Surgeon (GMC 6036936).
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This page provides general information about rosacea and is not a substitute for personal medical advice. Please discuss your symptoms and treatment with a qualified healthcare professional.