What Is Acne Rosacea- Causes, Symptoms, Treatment Options & More

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    Have you ever envied people with permanent rosy cheeks? Well, you did not know that the permanent blush on their face could be a chronic and inflammatory skin condition known as acne rosacea. Though it usually looks like permanent blushing and flushing of cheeks, chin, forehead, and nose, the skin condition comes with small and red solid bumps and sometimes pus-filled pimples. 

    Sometimes people with acne rosacea experience stinging and burning sensations on their faces alongside tightness and itchiness. And more than half of people with acne rosacea also experience irritation and dryness in their eyes and swollen and reddened eyelids.

    This article discusses everything you need to know about acne rosacea, including its causes, symptoms, treatments, and prevention measures. Read this article till the end, and we are sure you will know how to deal with acne rosacea and the factors that trigger the symptoms. 

    Acne Rosacea

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    What Is Rosacea?

    Rosacea is a skin disorder that usually affects the facial skin. It causes redness on the cheeks, forehead, chin, and nose. Over time the redness of rosacea may intensify and can also take on a ruddy appearance. Many people with rosacea have seen that their small blood vessels are visible.

    In some cases, rosacea appears on the chest, neck, scalp, or ears. And if not treated for a longer time, the redness can turn into solid bumps or pus-filled pimples. If the disorder causes the nose to have a swollen appearance, it is called rhinophyma. Rosacea also affects the eyes and makes them feel irritated and watery.

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    What Is The Difference Between Rosacea And Acne Rosacea?

    Acne and rosacea cause bumps, redness, and pustules on the face. However, the redness generally appears around the pimple if it is acne. But for rosacea, the redness covers a larger area than acne. Acne commonly appears in teenagers and young adults, while rosacea frequently affects people over 30.

    What Are Different Types Of Acne Rosacea?

    In general, four types of acne rosacea are there:

    • Type 1: It is known as erythematotelangiectatic rosacea and has symptoms like facial redness, visible blood vessels, and flushing.
    • Type 2: It is known as papulopustular rosacea and has symptoms like breakouts. It affects middle-aged women.
    • Type 3: It is known as rhinophyma. In some cases, it is associated with the thickening of the skin on the nose. It usually affects men and sometimes is accompanied by another type of rosacea.
    • Type 4: It is known as ocular rosacea and is associated with symptoms that occur mainly in the eye.

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    What Are The Most Common Symptoms Of Acne Rosacea?

    The symptoms of acne rosacea are different between each type.

    Symptoms of type 1: 

    • Redness and flushing in the center of the face
    • Visible blood vessels
    • Swollen skin
    • Sensitivity
    • Burning and stinging skin
    • Rough, scaly, and dry skin

    Symptoms of type 2:

    • Red skin followed by acne-like breakouts
    • Oily skin
    • Sensitivity
    • Visibly broken blood vessels
    • Raised patches on the skin

    Symptoms of type 3:

    • Bumps on the skin
    • Thickened skin on the nose, forehead, cheeks, chin, and ears
    • Visible large pores
    • Visible blood vessels

    Symptoms of type 4:

    • Watery and irritable eyes
    • Burning and stinging sensation in the eyes
    • Itchy and dry eyes
    • Photosensitivity of eyes
    • Diminished vision
    • Broken blood vessels on the eyelids

    Causes Of Acne Rosacea

    The primary cause of rosacea is not entirely known. Rosacea is not contagious and can be caused by poor hygiene. But an overactive immune system can cause acne rosacea. Other hereditary and environmental factors or a combination of both cause acne rosacea.

    Here Are Some Common Triggers Of Acne Rosacea

    Sunlight: People with acne rosacea must focus on excessive sun protection, especially for their faces. Sunscreen of SPF 30 or higher is recommended when out in the sun. If possible, you must also limit your sun exposure and wear protective clothing, oversized sunglasses, and hats during peak hours to stay protected against ultraviolet radiation.

    Cold Weather: Cold and dry weather can be harsh on the skin, especially for people with acne rosacea. Excessive cold weather triggers the flare-up and flushing. Therefore, when going outdoors in winter, try to protect the face from the cold and wind with moisturizers and scarves.

    Hot Environment: Just as cold weather can trigger flare-ups and flashes, a hot indoor environment can do the same. Avoid staying in warm and crowded places. But if you are attending any social function, try to sip non-alcoholic cold drinks or chew on some ice chips to stay protected.

    Excessive Stress: Stress is a major contributing factor to acne rosacea flare-ups. Try out ways to reduce stress, such as meditation, relaxation techniques, and other problem-solving methods. Those might help in keeping the flare-ups at bay.

    Heavy Exercise: Exercising is mandatory to maintain a healthy lifestyle. But excessive and heavy exercise can have reverse effects on your skin, especially by triggering the acne rosacea symptoms. Wash your face immediately after exercising with cold water. Sip ice water in between exercising.

    Hot Bath: People with acne rosacea is very sensitive to extreme hot and cold environments. Therefore, hot showers, hot baths, and saunas can quickly bring on flashing. Bathe in moderately hot water.

    Medications: If you follow specific prescriptions containing potent topical steroids, they might cause acne rosacea flare-ups. If some of your drugs contain niacin prescribed for cholesterol treatment, it can cause acne rosacea flare-up. You will need to consult your doctor regarding your medication to analyze whether or not your medications are contributing to acne rosacea flare-ups.

    Alcohol: Alcohol is a common trigger of acne rosacea. Though red wine has many benefits, it is not suitable for your skin if you suffer from acne rosacea. On the contrary, red wine is considered the culprit.

    Spicy Food: Spicy foods, curries, sauces, and dressings must be avoided or minimized if you face acne rosacea flare-ups. Consume foods with fewer chilies to keep your acne rosacea in control.

    Hot Drinks: Hot drinks make you feel hot, and hence they bring a set of flushing. Let your drinks come to room temperature before sipping. 

    How Is Acne Rosacea Diagnosed?

    There is no specific test prescribed for the diagnosis of acne rosacea. Instead, your doctor examines your medical history and the symptoms and relies upon a visual examination of your skin to diagnose acne rosacea. If your doctor discovers other conditions such as psoriasis, they might ask you to get specific tests done. 

    Studies show that acne rosacea sometimes gets misdiagnosed as an allergic reaction in many people with dark skin. If you are experiencing symptoms such as eye irritation, your doctor can also refer you to an ophthalmologist for evaluation.

    What Are The Best Possible Treatment Options Available For Acne Rosacea?

    Before we talk about the best possible treatment options for acne rosacea, get one thing straight in your head acne rosacea is not completely curable. Therefore, your doctor generally focuses on controlling the signs and symptoms. And the treatment measures for acne rosacea include a combination of prescribed drugs and good skin care.

    The time it takes to keep the symptoms in control depends upon the type of acne rosacea you have and the severity of the science and symptoms. However, recurrence of the condition is widespread even after the treatment has started.

    We will talk about different treatment modalities commonly used to treat acne rosacea.

    Topical Medications For Acne Rosacea

    Azelaic Acid

    Most patients suffering from acne rosacea often use azelaic acid twice daily- in the morning and in the evening. Studies have found that more than 70% of people have noticed less acne rosacea after using azelaic acid for a few months. Some patients even saw complete clearance of the symptoms. After applying azelaic acid to your face, you might initially feel some burning or tingling effect. This feeling goes away when you continuously use the medication. But if it does not, see your dermatologist and share your experience.

    Another possible side effect of azelaic acid is skin lightening. If your acne rosacea appears like patches on your skin or has made your skin darker, you may not mind experiencing this side effect. But if your lightened skin is noticeable, share it with your dermatologist immediately.

    Sodium Sulfacetamide

    Many over-the-counter ointments available to treat acne rosacea might include sodium sulfacetamide, including cleanser, ointment, etc. Sodium sulfacetamide is very safe for treating the acne-like breakouts of rosacea. The ingredient has continuously proved its potency for the last 60 years. Though sodium sulfacetamide is a safe ingredient, it is better to talk to a dermatologist if you have kidney diseases or are sensitive to sulfur. Additionally, you need to mention if you are pregnant or planning to consume.

    Studies found that Sodium sulfacetamide can effectively treat acne-like breakouts and redness. According to the research findings, patients with acne rosacea could typically see up to a 78% decrease in acne breakouts after using sodium sulfacetamide for six to eight weeks. You can attain better results by following the treatment plan given by your dermatologist and avoiding the common triggers of acne rosacea.

    The most common side effects of sodium sulfacetamide are that it can dry your face and temporarily make it red and irritated. But the side effects tend to decrease with time. They will not occur when you continuously use the medication for a longer time.


    Metronidazole is available in gel or cream form. It has been used for more than 60 years to treat acne-like breakouts of rosacea. Research has found that it can effectively reduce redness and breakouts. Many patients, after using Metronidazole, could keep the results they have gained even after stopping applying the medication. One study has also found that around 25% of patients experienced acne rosacea flare-up after stopping Metronidazole for six months.

    If your condition with acne rosacea is more severe, your dermatologist might prescribe Metronidazole with other medications. The possible side effects of Metronidazole include skin irritation, blindness, itching, or stinging when you apply Metronidazole.

    Consumable Medications For Acne Rosacea


    Tetracycline is an antibiotic that can quickly reduce acne-like breakouts and the redness of rosacea. For more than five decades, dermatologists have prescribed tetracycline to patients with acne rosacea. Researchers have found that patients with acne rosacea have noticeably reduced the breakouts within one month of consuming tetracycline. Other antibiotics, including doxycycline, erythromycin, and minocycline, can effectively treat acne rosacea.

    But taking antibiotics for a long while can cause serious health problems. Many patients suffer from antibiotic resistance because they overuse antibiotics, making it hard for the medicines to treat deadly bacteria. That is why your dermatologist might prescribe you low-dose doxycycline as a treatment option.

    Low Dose Doxycycline          

    As mentioned earlier, doxycycline is another antibiotic used to treat acne rosacea. When you take this low-dose medication, it does not act exactly like an antibiotic because of its low power. But studies have found that doxycycline can reduce acne-like breakouts of rosacea. The Food and Drug Administration of the USA has also approved low-dose doxycycline to treat acne rosacea.

    But remember one thing you should not take this medication if you are pregnant or trying to conceive.


    Isotretinoin has shown its effectiveness in reducing redness and breakouts. Isotretinoin is also approved to treat severe acne problems and can also be considered an option for acne rosacea. But beware of their medication’s side effects, including severe birth defects.

    Cosmetic Procedures To Treat Acne Rosacea

    Laser Therapy

    Laser therapy is an effective cosmetic procedure to treat redness and acne-like breakouts of acne rosacea. However, it is essential to know a few things about this treatment option before you opt for it:

    • Laser therapy is not covered by insurance.
    • The cost of each laser therapy session generally costs thousands of rupees.
    • It takes one to five treatments to achieve the best results depending upon the severity of your condition.
    • Patients might need to go for follow-up laser sessions to maintain the results.
    • Ensure to find certified doctors with experience treating acne rosacea with laser therapy. Studies have found that performing laser procedures under a professional aesthetician’s guidance could effectively reverse the symptoms of acne rosacea. But if the person performing the procedure has little knowledge about skin, the procedure may end up scarring your skin.


    Though acne rosacea is not completely reversible, without treatment, the symptoms can worsen; therefore, it is essential to talk to a dermatologist and ask for the best possible solutions to keep the symptoms in control. You also need to understand the causes behind your condition and the flare-up to avoid those triggers. 

    Hope this article helped you learn about acne rosacea and its best possible treatment options. If you are suffering from acne rosacea, talk to your doctor as soon as possible. Take care of your health and follow us for many such articles.

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