Acne Rosacea
BASICS
DESCRIPTION
- Rosacea is a chronic condition characterized by recurrent and sometimes fixed episodes of facial flushing, erythema (due to dilatation of small blood vessels in the face), papules, pustules, and telangiectasia (due to increased reactivity of capillaries) in a symmetric, central facial distribution; sometimes associated with ocular symptoms (ocular rosacea)
- Four subtypes:
- Erythematotelangiectatic rosacea (ETR)
- Papulopustular rosacea (PPR)
- Phymatous rosacea
- Ocular rosacea
- System(s) affected: skin/exocrine
- Synonym(s): rosacea
Geriatric Considerations
- Chronic inflammatory dermatosis with middle-age onset
- Effects of aging might increase the side effects associated with oral used for treatment (at present, data are insufficient due to lack of clinical studies in elderly patients aged ≥65 years).
EPIDEMIOLOGY
Prevalence
- Predominant age of onset: 30 to 50 years
- Predominant sex: female > male. However, males are at greater risk for progression to later stages.
- More common in Fitzpatrick skin types I and II, however, it may be underreported in other skin types due to background pigmentation. This may lead to a delay in diagnosis for patients with darker skin types (1).
ETIOLOGY AND PATHOPHYSIOLOGY
- No proven cause
- Possibilities include the following:
- Thyroid and sex hormone disturbance
- Immune system and neurocutaneous dysregulation (2)
- Alcohol, coffee, tea, spiced food overindulgence (unproven)
- Demodex follicular parasite (suspected)
- Exposure to cold, heat
- Emotional stress
- Dysfunction of the GI tract (possible association with Helicobacter pylori)
Genetics
- People of Northern European and Celtic background commonly afflicted
- Associated with three human leukocyte antigen (HLA) alleles: HLA-DRB1, HLA-DQB1, and HLA-DQA1 (MHC class II)
RISK FACTORS
- Exposure to spicy foods, hot drinks
- Environmental factors: sun, wind, cold, heat
GENERAL PREVENTION
No preventive measures known however avoidance of patient specific triggers can minimize severity of flare ups (3).
COMMONLY ASSOCIATED CONDITIONS
- Seborrheic dermatitis of scalp and eyelids
- Keratitis with photophobia, lacrimation, visual disturbance
- Corneal lesions
- Blepharitis
- Uveitis
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Citation
Domino, Frank J., et al., editors. "Acne Rosacea." 5-Minute Clinical Consult, 34th ed., Wolters Kluwer, 2026. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116005/all/Acne_Rosacea.
Acne Rosacea. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2026. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116005/all/Acne_Rosacea. Accessed July 16, 2025.
Acne Rosacea. (2026). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (34th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116005/all/Acne_Rosacea
Acne Rosacea [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2026. [cited 2025 July 16]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116005/all/Acne_Rosacea.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Acne Rosacea
ID - 116005
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116005/all/Acne_Rosacea
PB - Wolters Kluwer
ET - 34
DB - Medicine Central
DP - Unbound Medicine
ER -