What is Rosacea?

Man with rosacea
Photo courtesy of A.D.A.M.

You've got pimples across your cheeks, nose, and chin. You assume your adult breakouts are just run-of-the-mill acne. But could it actually be rosacea instead?

Is Rosacea a Type of Acne?

Rosacea is not a form of acne vulgaris, although it sometimes can be hard to distinguish from common acne. To confuse the matter, rosacea is sometimes called "acne rosacea," or even "adult acne."

Like acne vulgaris, rosacea is a disorder of the pilosebaceous unit or what we commonly call the pore.

It can cause tiny pimples, just like acne does.

But rosacea is not caused by the same factors as acne vulgaris and is a skin disorder in its own right.

Where acne can occur anywhere on the face, neck, back, upper arms, and shoulders, rosacea is confined to the center of the face (cheeks, nose, chin, and forehead.) Acne is all too common in the teen years, but rosacea typically doesn't appear before age 30.

If you have fair skin, you're more prone to developing rosacea. Interestingly, it is more common in women, but men tend to develop more severe forms.

What Does Rosacea Look Like?

Rosacea often begins as redness or flushing of the face. Small, red, pimple-like bumps can form on the face, but unlike with common acne, there typically are no blackheads or comedones. Capillaries may be visible on the skin, contributing to the red appearance of the face.

If rosacea isn't treated it can progress, and the redness and bumpiness becomes more severe.

The skin takes on a coarse, lumpy look, and the nose can become larger and more bulbous (think W.C. Fields).

Luckily, most cases of rosacea don't become this serious. For many people rosacea stays mild, and the redness never progresses to papules and general skin bumpiness.

How Do I Know If I Have Rosacea?


Many people who have the beginning stages or mild rosacea oftentimes don't even realize they have the disorder. They chalk up redness to a ruddy complexion, and women may get used to covering it with makeup. Or they assume the papules are adult acne breakouts, and buy an over-the-counter acne treatment.


Most people are shocked when they finally see a dermatologist and discover what they have is not acne, but rosacea.


Although there is no lab test for either skin condition, your dermatologist will be able to make a diagnosis through a simple visual inspection.


Sometimes it's hard to tell if you have adult acne or rosacea. If you've noticed changes in your skin, you should make an appointment with a dermatologist.

Some people with rosacea also develop redness and grittiness in the eyes, called ocular rosacea. Eye problems are sometimes over-looked, so make it a point to tell your doctor if you have redness of the eyes, tearing, blurred vision, sore or gritty feeling eyes.

What Causes Rosacea?

Doctors still aren't sure exactly what causes rosacea.

But there are a few theories.

Some experts believe that rosacea appears because of sensitive blood vessels that dilate too easily. Other research suggests that the Helicobacter pylori bacterium or the microscopic Demodex mite plays a role. We do know that rosacea tends to run in families.

While we don't know exactly what causes rosacea, we do know for certain that certain things can trigger it and make rosacea worse. Common rosacea triggers include: sun exposure, eating spicy foods, drinking hot beverages or alcohol, and exposure to extremely hot or cold weather. Emotional stress is another major trigger.

How Can Rosacea Be Treated?

Rosacea can't be cured, but it can be successfully controlled. Treatment for rosacea can include oral or topical antibiotics, and some acne medications like azelaic acid.

But don't try to treat rosacea on your own with over-the-counter acne products. Some can aggravate rosacea and leave your skin feeling even worse.

Your best option is to see a dermatologist. Whether you have adult acne or rosacea, your dermatologist will help you create the perfect treatment plan to clear your skin.


Chen W, Plewig G. "Are Demodex mites principal, conspirator, accomplice, witness or bystander in the cause of rosacea?" American Journal of Clinical Dermratology. 16.2 (2016): 67-72.

Feldman SR, Huang WW, Huynh TT. "Current drug therapies for rosacea: a chronic vascular and inflammatory skin disease." Journal of Managed Care and Specialty Pharmacy. 20.6 (2014): 623-629.

Lanoue J, Goldenberg G.  "Therapies to improve the cosmetic symptoms of rosacea." Cutis. 96.1 (2016): 19-26.

Lavers, I. "Rosacea: Clinical Features and Treatment." Nursing Standard 30.31 (2016): 52-60.

Continue Reading