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Rosacea

Understanding Rosacea and Treatment Options

Rosacea is a chronic inflammatory skin condition that primarily affects the central face.

It can cause persistent redness, flushing, visible blood vessels, inflammatory lesions and skin sensitivity. Symptoms can vary between individuals and may fluctuate over time.

Facial redness and inflammatory changes associated with rosacea

Pathogenesis

The exact cause of rosacea is not fully understood. It is thought to involve a combination of:

01

Vascular hyperreactivity

Increased reactivity of the blood vessels, contributing to flushing and persistent redness.

02

Immune Dysregulation

Immune system imbalance and inflammation that may contribute to skin symptoms.

03

Demodex Overactivity

Increased Demodex activity, which may contribute to inflammation in some patients.

04

Skin Barrier Dysfunction

Impaired skin barrier function, resulting in increased sensitivity and irritation.

Pathogenesis

The exact cause of rosacea is not fully understood. It is thought to involve a combination of:

01

Vascular hyperreactivity

Increased reactivity of the blood vessels, contributing to flushing and persistent redness.

02

Immune Dysregulation

Immune system imbalance and inflammation that may contribute to skin symptoms.

03

Demodex Overactivity

Which may contribute to inflammation in some patients.

04

Skin Barrier Dysfunction

Resulting in increased sensitivity and irritation.

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Types of Rosacea

Rosacea can present in several different clinical forms, including:
Erythematotelangiectatic rosacea (ETR)

Erythematotelangiectatic rosacea (ETR)

Characterised by persistent facial redness and flushing, often with visible small blood vessels (telangiectasia), particularly across the cheeks, nose and central face.
Papulopustular rosacea (PPR)

Papulopustular rosacea (PPR)

Persistent redness along with acne-like papules and pustules, typically affecting the central face.

Phymatous rosacea

Thickening and enlargement of the skin due to excess tissue growth. It most commonly affects the nose (rhinophyma), but can occur in other areas.

Ocular rosacea

Affects the eyes and surrounding area, causing symptoms such as dryness, irritation, redness, burning or a gritty sensation.

Some patients may experience features of more than one subtype.

Contributing Factors

Rosacea can be aggravated by a range of environmental and lifestyle factors. Common triggers include:
  • Heat
  • Sun exposure
  • Alcohol
  • Spicy foods
  • Exercise
  • Stress
  • Irritating skincare products

Genetic factors and Demodex may also contribute in some individuals.

How Rosacea is Assessed

Rosacea is assessed according to a number of clinical features, including:

  • Severity and persistence of erythema
  • Frequency of flushing
  • Inflammatory papules and pustules
  • Presence of telangiectasia
  • Ocular involvement
  • Skin thickening or phymatous change
  • Impact on quality of life
Facial redness and visible inflammation affecting the cheeks and chin in rosacea
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How We Can Help

Rosacea can present differently from person to person and may involve a combination of redness, flushing, visible blood vessels, inflammatory breakouts and skin sensitivity.

At Fremantle Skin Cancer Clinic, your skin can be assessed to better understand the features of your rosacea and identify factors that may be contributing to flare-ups.

Management may include advice around skincare and trigger reduction, medical treatment where appropriate and treatment options designed to address concerns such as persistent redness, visible blood vessels or inflammatory symptoms.

Because rosacea is a chronic condition that can change over time, ongoing management and regular review may also be recommended.

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