Rosacea will always present at least one of these four primary signs:¹

• Flushing is the earliest sign of rosacea. This 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.

There are four types of rosacea classifications:² 

• Vascular rosacea. Red areas of skin on the face. Small blood vessels are sometimes visible.

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

• Phymatous rosacea. Skin thickens and may become bumpy. Most often occurs on the nose. 

• Ocular rosacea. Inflammation of the eyes and eyelids (blepharitis). 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:³ 

• 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:⁴ 

• 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.⁵

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:⁶

• 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, no blackheads.

• Eye irritation and/or redness.

• Redness on cheeks, nose, forehead and chin. 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.⁷ 

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:⁸ 

• 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.⁹ 

1. Cleveland Clinic

2. National Library of Medicine

3. Cleveland Clinic

4. Cleveland Clinic

5. National Library of Medicine

6. American Academy of Dermatology

7. Cleveland Clinic

8. Cleveland Clinic

9. Cleveland Clinic

There is no cure for rosacea, but treatments are available to reduce symptoms. Treatment options include:¹⁰ 

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

• Oral medications. Antibiotics like doxycycline. 

• Laser treatment. Removes visible blood vessels and reduces redness.¹¹

Prescription medications that treat the symptoms of rosacea include:¹² 

• Brimonidine cream

• Azelaic acid 15% gel

• Ivermectin cream

• Metronidazole cream

• Metronidazole gel

• Clindamycin phosphate solution

• Doxycycline oral antibiotic

Results will vary for individuals, but most people respond well to treatment. It may take three months or longer to see significant improvement in symptoms.¹³

Yes, there are over-the-counter medications for rosacea. Azelaic acid is available without a prescription in 10% strength.¹⁴ 

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.

10. National Library of Medicine

11. Cleveland Clinic

12. National Library of Medicine

13. National Library of Medicine

14. Mayo Clinic

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