5 common questions about rosacea, answered by dermatologists
April is Rosacea Awareness Month, a time dedicated to educating the public about this common and sometimes severe skin disorder and encouraging those living with it to develop an effective therapeutic plan with their dermatologist.

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According to the National Rosacea Society, an estimated 16 million Americans live with this skin condition. Adam Wallach, MD, one of the newest Providers at the Skin Cancer & Dermatology Institute, who has been treating rosacea for more than 20 years, describes rosacea as “a chronic inflammatory acne-like condition that often causes flushing of the cheeks and commonly stimulates the development of excessive blood vessels. As a result, some patients become self-conscious about their appearance, and can suffer a loss of self-esteem.” Dr. Wallach answers some of the most-asked questions about the skin disorder:
Q: What causes rosacea?
A: There are no known causes of rosacea. According to The American Academy of Dermatology, scientists have uncovered clues to a few potential causes through research, including:
- Genes. Often, those who suffer from rosacea have at least one person in their family who also has it.
- Immune system. Most people with papulopustular rosacea react to bacillus oleronius, a bacterium, causing the immune system to overreact. A conclusion on this theory has not been reached.
- Demodex, a mite that lives on the skin, specifically the nose and cheeks. Studies have found that some people with rosacea have an abundance of mites on their skin, but it is not a conclusive theory because there are people who have many mites but no rosacea.
- Cathelicidin, a protein that typically safeguards the skin from infection, may cause redness and swelling and determine if someone gets rosacea.
Q: Are there different types of rosacea?
A: Yes, there are four variants of rosacea; all forms affect mostly the face, and all have no known cure.
Erythematotelangiectatic Rosacea (ETR) is the most common form, identified by red or flushed cheeks. The skin often is swollen and may be rough.
Papulopustular (Acne) Rosacea gets its name as it mimics an acne outbreak with pimples and bumps. Redness, swelling, and oily skin are typical characteristics.
Rhinophyma Rosacea is considered a subtype of severe rosacea; in this form, skin in areas around the chin, nose, forehead, and cheeks may thicken. For some patients, rosacea can lead to overgrowth of cartilage, resulting in a bumpy red nose, which can be treated surgically or with laser treatments.
Ocular Rosacea affects the eyes and eyelids, causing them to be itchy, dry, bloodshot, and sensitive. In some cases, this form of rosacea has been known to cause blurred vision in additional to the development of cysts (or styes) in the eyelash area.
Rosacea usually presents in adults; however, some cases have affected children, primarily in the form of eye styes.
Q: What triggers rosacea?
A: Rosacea can be worsened by certain triggers, including alcohol, spicy foods, and even caffeine. Knowing your triggers can help reduce your flares. The National Rosacea Society lists other common triggers, including sun exposure, stress, weather, wind, exercise, and certain skincare products. Rosacea patients should consult their dermatologist when choosing skin care products, to avoid any aggravation to the skin.
In a world where we wear face masks nearly every day, some people have found that frequent use of masks may trigger their rosacea.
Q: Are rosacea and eczema similar?
A: No, while there are similarities in symptoms, the overall conditions differ. The main difference being eczema is more common in those who have dry skin, is frequently itchy, and can appear all over the body, whereas rosacea tends to stay near or around the face and may feel warm or tender.
Q: Are there any treatments for rosacea?
A: Thanks to the advances in dermatologic science, several products help soothe and treat rosacea. Topical creams such as Ivermectin, Azelaic Acid, and Metronidazole, as well as oral antibiotics, can help reduce inflammation significantly. BroadBand Light (BBL™) can help reduce flares and even your skin tone, while KTP and pulse-dye lasers can eliminate the excessive blood vessels often accompanying chronic rosacea. For those looking for a cosmetic cover-up, green-tinted makeup can help camouflage excess redness. SkinCeuticals® gentle cleanser, Phyto Corrective Gel, and Phyto Corrective Masque are skincare products commonly recommended to help with treating rosacea.
It is important to be aware that not all facial redness is caused by rosacea – sometimes it can be a more serious condition. If you struggle with any of the symptoms mentioned here, it is best to consult your trusted dermatologist.
Visit SkinCancerDerm.com or call 775.324.0699 to schedule an appointment with Dr. Wallach at Skin Cancer & Dermatology Institute’s Truckee location.
Bringing you patient-centered, world-class dermatological care with nine locations in the Reno-Tahoe area. Skin Cancer & Dermatology Institute specializes in Medical Dermatology, Mohs Skin Cancer Surgery, and Cosmetic Dermatology.

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