Four Types of Rosacea
Rosacea, the skin condition characterized by redness of the face, is a progressive disease that starts with minor symptoms that can advance to more significant skin changes if left untreated.
Not everyone experiences every type, and each type of rosacea can affect people differently. "Some get one, all four, or somewhere in between," says Dr. Johnson. However, itâ€™s important to be aware of all the different types and their distinctions as you work to manage your rosacea.
What used to be referred to as the initial phase, or pre-rosacea, is now the first type of the condition, known as erythematotelangiectatic rosacea or vascular rosacea. It's characterized by frequent flushing and chronic redness of facial skin. Some people also notice visible blood vessels creeping across the bridge of the nose and the cheeks.
Vascular rosacea symptoms are minor, and topical or oral rosacea medications, such as doxycycline (Oracea),can treat the condition in this stage. Laser treatment can be used to zap broken blood vessels, says Johnson., though this wonâ€™t cure your rosacea, only fix a symptom.
The second type of rosacea is called papulopustular rosacea or inflammatory rosacea. Its key symptom is chronic redness of the face, as well as an outbreak of red bumps and pimples. These bumps, known as pustules and papules, are different from actual acne and require a different treatment.
Johnson notes that inflammatory rosacea is most often treated with topical gels, including metronidazole (MetroGel and others) and azelaic acid (Finacea and Azelex) or oral medications, including Oracea. (doxycycline).
When left untreated, rosacea can worsen and can lead to the third type, phymatous rosacea. A bulbous, lumpy, and very red nose is the classic symptom of this type of rosacea. This overgrowth of thickened skin on the nose is known as rhinophyma. Excess skin may also grow on the cheeks or forehead, giving it a thickened appearance. Phymatous rosacea occurs more frequently in men.
The thickened skin of this third type of rosacea is most often addressed with laser and surgical treatments, notes Johnson. These procedures remove the excess skin to reduce the thickened appearance.
Rosacea can affect not just the skin, but also the eyes. Ocular rosacea can provoke a long list of symptoms, from dryness or a gritty sensation in the eyes to tearing, burning, itching, or stinging. You might have bloodshot eyes, frequent styes, swelling of the eyelids, or redness on the margins of the lids. Ocular rosacea can be serious, resulting in damage to the cornea. It can blur vision, worsen vision problems, and lead to blindness if unchecked.
Ocular rosacea is typically treated with long-term, low dose oral antibiotics from the tetracycline family of drugs; prompt treatment is important to prevent significant damage.
Itâ€™s possible to experience any combination of types of rosacea at the same time or to experience these types in succession if the skin disorder progresses untreated. Symptoms of individual types may range from mild to more severe. No matter what type or severity of rosacea you have, itâ€™s important to be treated and monitored by a dermatologist.
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