Types of Rosacea

Types of Rosacea featured photo

Everyone has their fair share of skin issues and one of the most common is the chronic condition rosacea. Though we’re yet to find out the exact cause and cure for it, patients and doctors alike try their best to understand the condition. And a way to do this is by learning about the types of rosacea.

Rosacea is a common chronic skin condition that is currently affecting more than 16 million Americans. There are four types of rosacea: erythematotelangiectatic rosacea (ETR), papulopustular (acne) rosacea, phymatous rosacea, and ocular rosacea.

Each subtype of rosacea presents various symptoms. These symptoms can either be unique to a specific type or overlap with other types of rosacea. Usually, a rosacea patient exhibits more than one subtype.

In this article, we’ll dive deep into the four types of rosacea and their symptoms. We’ll also go over the basics of rosacea, what could possibly cause it, who’s at risk of developing the condition, and common treatments to keep the symptoms at bay.

What is Rosacea?

Rosacea is a common chronic skin condition that mostly affects the cheek and nose area. It can also develop on the chin, forehead, ears, chest, and back. Learn how to pronounce rosacea for your visit to the doctor.

Rosacea is a common skin condition. In fact, according to the American Academy of Dermatology (AAD), more than 16 million Americans are currently affected and live with it.

Rosacea is often associated with chronic blushing. And while it’s one of the most common symptoms, much more complex symptoms can develop due to the condition.

Additional symptoms could include pus-filled bumps, visible blood vessels, and thickening skin. Rosacea skin can also be irritable, dry, swollen, flaky, sensitive, or burn.

The intensity of symptoms could depend on the sensitivity of a patient’s skin.

Rosacea symptoms and how it shows up on the skin would vary depending on the person and the subtype they have.

Rosacea is a long-term, chronic condition. Patients experience the symptoms periodically in a cycle. This means they can suffer from a flare-up after a certain trigger, control the symptoms, then it can go away for a while.

After some time and after exposing themselves to another or the same trigger, it could flare up again, restarting the cycle.

Rosacea symptoms last for weeks or months at a time.

Anyone can develop rosacea but women are more likely to develop it than men. Men, however, are more likely to get severe rosacea if they do develop it.

Is rosacea an autoimmune disease?

An autoimmune disease means your immune system mistakenly attacks the healthy cells in your body.

When someone has an autoimmune disease, the body’s natural defense can’t tell the difference between its own cells and foreign, dangerous cells. This leads to the body attacking its own healthy cells by mistake.

It’s hard to tell whether rosacea is an autoimmune disease or not, simply because there’s not a lot known about the disease to make the conclusion.

To this day, the exact causes and possible cures for rosacea remain a mystery.

Is rosacea contagious?

Rosacea is not contagious but its symptoms can take a great toll on patients.

Patients can follow various treatments and management plans prescribed by their doctors to help keep the symptoms at bay.

Causes of Rosacea

Doctors and researchers are yet to pinpoint exactly what causes rosacea. For now, it would be safe to say that the causes of rosacea can be a combination of genetic predispositions and various environmental factors.

What triggers rosacea flare-ups?

While there isn’t an exact cause of developing rosacea, it’s important to keep in mind what environmental factors can possibly trigger a rosacea flare-up. Diet can play a factor, but triggers can be different for each person.

  • Spicy foods
  • Hot beverages
  • Sun exposure
  • Hot or cold temperatures
  • Humidity, dryness, or strong winds
  • Alcohol
  • Caffeine
  • Stress, anger, anxiety, embarrassment, and other emotional responses
  • Hot showers and baths
  • Allergies
  • Excessive sweating (due to exercising or spending time in the sauna)

Who are at risk of developing rosacea?

On top of these environmental factors and triggers, a person’s genetic predispositions may also be a major factor in developing rosacea. Those who are at risk of developing rosacea include the following:

  • Those with fair or light skin (often those with blonde hair and blue eyes as well)
  • Those between the ages of 30 and 50
  • Women (though severe cases are more likely in men)
  • Those with one or two family members with rosacea as well
  • Those with Celtic or Scandinavian ancestry
  • Those with abnormal blood vessel development and function
  • Those with an intestinal bacteria called Helicobacter pylori
  • Those with an excessive amount of the skin mite called Demodex (this is present in everyone but people with rosacea have them in excess amounts)

Types of Rosacea

There are four types of rosacea. To understand what your skin is going through, it’s important to get to know what these are. And it’s also worth noting that rosacea patients often experience symptoms of more than one type.

The four subtypes of rosacea are as follows:

Subtype 1: Erythematotelangiectatic Rosacea (ETR)

Erythematotelangiectatic rosacea or simply known as ETR is the most common and often the mildest type of rosacea.

ETR is characterized by flat flushing and persistent facial redness across the cheeks, nose, and forehead. Other areas that may be affected include the chin, neck, chest, and scalp.

In ETR, the small blood vessels on the face become dilated and enlarged, appearing more visible with some skin redness. Aside from these physical symptoms, ETR can cause some warmness, stinging, tingling, or burning sensation in the affected areas.

Some ETR patients also develop some swelling. The skin can appear dry, rough, or scaly as well. And generally, the skin becomes more sensitive than ever.

If left untreated, ETR symptoms can get more persistent, occur more frequently, last longer, cover more skin, and even become permanent.

Subtype 2: Papulopustular (acne) Rosacea

Papulopustular rosacea has the general symptoms of ETR with acne-like breakouts. This is why it’s often referred to as acne rosacea. It’s also often mistaken and misdiagnosed as acne.

This subtype is characterized by pus-filled pustules, papules, blemishes, and bumps. These acne-like bumps develop deep within the skin. They’re also very painful and appear very red. Broken blood vessels or spider veins also appear visible.

While these bumps appear mostly on the center of the face, severe cases also develop on the scalp, neck, chest, and back.

Affected areas feel very sensitive, often with a burning or stinging sensation. It also causes patches of extremely oily skin with some extremely dry patches that if left untreated, can become thick, scaly, rough, and raised patches called plaques.

Unlike acne which often occurs in our teenage years, papulopustular rosacea often develops in middle-aged adults.

Subtype 3: Phymatous Rosacea

Phymatous rosacea often occurs only after suffering from other types of rosacea first.

This subtype starts off with the thickening of the skin or small patches of plaques like in papulopustular rosacea. Over time, the affected areas become bumpy, raised, and protruded. Affected areas also appear thick, scaly, and red.

Though it’s not the same for all patients, it’s quite common for this subtype to develop into rhinophyma. Rhinophyma refers to the thickening of the skin on the nose, resulting in a bulbous nose.

Rhinophyma is more common in men than in women. Though it’s important to note that its occurrence is mostly due to untreated rosacea.

Phymatous rosacea is the most severe subtype, but it’s also the least common of the four subtypes.

Subtype 4: Ocular Rosacea

Ocular rosacea is characterized by either ETR or papulopustular rosacea  symptoms affecting the eye and eye area. Patients with this type of rosacea often experience red, inflamed, and bloodshot eyes.

There may also be bumps or cysts, similar to styes, on the eyelids. There may also be visibly broken blood vessels on the eyelids.

Ocular rosacea patients often experience watery and irritated eyes with some burning and stinging sensation.

Other symptoms include general dryness, itching, swollen eyelids, and sensitivity to light. In some cases, patients can experience blurry vision along with other symptoms.

Ocular rosacea is the most misdiagnosed subtype due to its similarities with other eye conditions.

Rosacea Treatments

Rosacea is not at all contagious, but its appearance on the skin and most especially on the face can cause a lot of self-consciousness and confidence issues in the affected individual.

To this day, doctors and scientists are yet to find a cure to make the skin condition go away for good.

The good news is, there are ways to treat, control, manage, and get on top of these symptoms. Rosacea treatment plans would usually depend on the type or types of rosacea a person has.

But generally, here are some common rosacea treatments:

  • Topical treatments
  • Oral medications
  • Avoiding alcohol consumption
  • Staying away from direct sunlight
  • Protecting the skin with sunscreen
  • Laser and light therapy
  • Microdermabrasion
  • Chemical peels
  • Finding out triggers and avoiding them at all costs
  • Modifying skincare routines to be rosacea-friendly
  • Consulting with a medical dermatologist to start a specifically-designed treatment plan


Rosacea is a common and chronic skin condition that affects more than 16 million Americans, even some of your favorite celebrities. There is no cure for it but it’s treatable and manageable. In finding the best treatment options, it’s important for you and your doctor to determine the type of rosacea you have.

There are four subtypes of rosacea: erythematotelangiectatic rosacea (ETR), papulopustular (acne) rosacea, phymatous rosacea, and ocular rosacea. These four subtypes present varying rosacea symptoms and patients often have overlapping subtypes.

And that has been our detailed guide on the different types of rosacea. If you have more questions for us, don’t hesitate to reach out to us below!