Rosacea will always present at least one of these four primary signs:²

• Flushing, which is the earliest sign of rosacea and can come and go

• Persistent redness that resembles a blush or sunburn and doesn’t go away

• Bumps and pimples that are red and sometimes resemble acne

• Visible blood vessels that look like thin, red lines on the skin

Additional symptoms of rosacea include:

• Eye irritation

• Burning or stinging

• Dry appearance

• Raised red patches (plaques)

• Skin thickening on the nose

• Swelling

Itching is not a common symptom of rosacea, but the dryness or irritation sometimes caused by rosacea may lead to some itchiness.³

There are the four types of rosacea classifications and common symptoms for each:⁴ 

• Vascular rosacea: Red areas of skin on the face, sometimes with visible blood vessels.

• Inflammatory rosacea: Red bumps (papules) and pus-filled spots (pustules) accompany the facial redness.

• Phymatous rosacea: Skin thickens and may become bumpy, most often on the nose.

• Ocular rosacea: Inflammation of the eyes and eyelids (blepharitis) that can occur with or without skin symptoms.
  

The cause of rosacea is unknown. Research suggests that the following could be causes and vary between individuals:⁵ 

• An underlying condition that affects your blood vessels, immune or nervous system

• Microscopic skin mites (Demodex)

• An infection of the H. pylori bacteria

• A malfunctioning of cathelicidin, a protein that protects the skin from infection

Triggers of rosacea can vary widely from person to person. Common rosacea triggers include:⁶ 

• Sun exposure

• Hot or cold temperatures

• Stress

• Alcohol consumption

• Spicy foods

• Skin or hair products

• Hormonal changes

Rosacea primarily affects the skin on the face, including cheeks, chin, forehead, eyes and nose. Less frequently, rosacea can affect the scalp, back of the neck and chest.⁷

Rosacea and acne share some common signs like redness and bumps. However, there are some key differences to help you tell the two conditions apart.

Signs exclusive to acne include:⁸

• A variety of breakouts, including whiteheads, blackheads, pimples, cysts and nodules

• Redness around the breakouts only

• Oily skin, especially on the forehead, nose and chin

• Bumpy skin texture from breakouts and scars

Signs exclusive to rosacea include:

• Pimple-like breakouts with no blackheads

• Eye irritation and/or redness

• Redness on cheeks, nose, forehead and chin that often comes and goes

• Visible blood vessels

• Sensitive skin that can react to skincare and beauty products

Both rosacea and the “butterfly rash” caused by lupus create redness across the center of the face. Both can also flare up because of sun exposure. The differences are in the texture of the rash and the long-term effects. Rosacea causes a red, swollen and bumpy rash and is a harmless condition. A lupus rash is red, scaly and itchy. Lupus rashes can also cause scarring and hair loss long term.⁹ 

No, rosacea is not contagious and is not spread by contact.¹⁰

Because the underlying cause of rosacea is unknown, you can’t prevent rosacea. However, you can help prevent a flare-up by avoiding triggers like:¹¹ 

• Sun exposure

• Hot or cold temperatures

• Stress

• Alcohol consumption

• Spicy foods

• Skin or hair products

There is no cure for rosacea. Treatment can reduce visible signs and symptoms.¹² 

1. Cleveland Clinic

2. Cleveland Clinic

3. American Academy of Dermatology

4. National Library of Medicine

5. Cleveland Clinic

6. Cleveland Clinic

7. National Library of Medicine

8. American Academy of Dermatology

9. Cleveland Clinic

10. National Rosacea Society

11. Cleveland Clinic

12. Cleveland Clinic
    

There is no cure for rosacea, but treatments are available to reduce symptoms. Treatment options include:¹³ 

• Topical medications such as creams, gels and ointments containing brimonidine, azelaic acid, ivermectin, metronidazole and clindamycin phosphate.

• Oral medications, including antibiotics like doxycycline. 

• Laser treatment to remove visible blood vessels and reduces redness.¹⁴

• Light therapies such as red light therapy, which helps your cells repair and grow skin more efficiently, and intense pulsed light (IPL) therapy, which reduces redness, flushing and visible blood vessels.^15,16

Prescription medications that treat the symptoms of rosacea include:¹⁷ 

• Brimonidine Cream

• Azelaic Acid 15% Gel

• Ivermectin Cream

• Metronidazole Cream

• Metronidazole Gel

• Clindamycin Phosphate 1% Gel

• Clindamycin Phosphate 1% Solution

• Doxycycline Oral Antibiotic

Results will vary for individuals and the type of medication you use, but typical timelines for common rosacea medications include:^18,19,20

• Brimonidine cream: May see results within one hour, with the effect lasting around 12 hours total.

• Azelaic acid 15% gel: Results may take two to six weeks.

• Ivermectin cream: Results may take six weeks or more.

• Metronidazole cream or gel: Results may take two to six weeks.

• Doxycycline oral antibiotic: Results may be seen in two weeks, but it may take additional weeks or months for some people.
  

The difference between over-the-counter (OTC) and prescription medications primarily comes down to access, medical oversight and how they’re regulated.

OTC drugs are considered safe to use without a doctor’s supervision, which means they can be purchased directly off the shelf and used based on the instructions on the label. Because of this, they will contain lower strength active ingredients and will likely not be as effective for treating rosacea.

Prescription drugs have been more rigorously tested to ensure they are safe and effective, and they are only to be used under a doctor’s guidance.²¹

FDA-approved rosacea treatments are medications that have gone through rigorous clinical trials to prove they are safe, effective and consistent. The U.S. Food and Drug Administration reviews data on dosing, side effects and outcomes before approving them for public use. These drugs are manufactured under strict quality standards to ensure consistent strength and predictable results.²²

Compounded medications are custom-mixed by a pharmacist to meet an individual patient’s needs (such as combining multiple ingredients into one cream or adjusting strengths). While this can be useful in certain cases, compounded drugs are not FDA-approved and have not undergone large-scale testing for safety and effectiveness.²³

RedBox Rx allows you to connect online with a licensed medical provider. If prescribed, we can ship prescription treatment for rosacea to all 50 U.S. states, or you can select pickup at your local pharmacy. Start an online consult today.

13. National Library of Medicine
14. Cleveland Clinic
15. Cleveland Clinic
16. National Library of Medicine
17. National Library of Medicine
18. National Library of Medicine
19. Mayo Clinic
20. Verywell Health
21. U.S. Food and Drug Administration
22. U.S. Food and Drug Administration
23. U.S. Food and Drug Administration

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