Understanding Rosacea - Symptoms, Types, Triggers & Treatment

If you suffer from rosacea, you are in good company since it is a very common chronic inflammatory skin condition. It is often mistaken for adult acne, or is referred to as acne rosacea.

If you are reading this, then you may already have experienced how tricky and sensitive rosacea-prone skin is. I decided to turn my Rosacea ebook into this complete guide for easier access for all. Below I share with you what I have learned in my 35+ years of dermatology practice caring for thousands of different complexions that suffer from rosacea. I also have rosacea myself, giving me a first-hand opportunity to experience it and apply my dermatologic experience and medical knowledge against thousands of skin care products and their claims.

In this guide, my goal is to help you better understand rosacea and teach you how to identify some of the symptoms and more subtle signs. I'll give you my guidelines for choosing the right skin care products and treatments for your complexion and help you understand when you need to see a dermatologist for prescription treatments.

"There is no cure for rosacea, but it is possible to have rosacea AND have an attractive and healthy complexion. You just need to understand the triggers and unique skin care needs of this frustrating skin problem." - Dr. Bailey, Rosacea Expert and Dermatologist

What is Rosacea?

Rosacea [1] is a facial rash that starts in adulthood and is a common cause of ‘adult acne’. The rash typically manifests as:

• facial redness
• pimples and bumps
• skin sensitivity
• visible facial capillaries of various sizes
• a tendency for facial redness and flushing

Rosacea is characterized by persistent redness of the rounded convex areas of the face, including the cheeks, nose, chin and mid-forehead. It can involve non-facial skin such as the neck and chest, but often spares the skin around the eyes.

Although the skin looks red, hot, and inflamed, it is not infected. Rosacea is an inflammatory condition. The location and pattern of the inflammation determine the type or types of rosacea a person has. See more in the Types of Rosacea section below.

Rosacea may at times look like a form of acne, but it’s really a skin rash. This is an important distinction because the treatments that work for acne often don’t work for rosacea.

Approximately 10% of people in the world have rosacea. According to the National Rosacea Society, “well over 16 million Americans have rosacea- and most don't know it”. This common aspect of rosacea does not, however, mean that rosacea is well understood, or that there are surefire ways to control it.

Who is Affected?

• Any adult is at risk.
• More commonly seen in fair-skinned individuals, particularly those with Celtic or Northern European ancestry.
• Followed by Asian and dark-skinned complexions but all skin tones and ethnicities [2] can develop rosacea.
• Women are more affected than men.
• The peak age range for rosacea is 35-50 though it may start as early as the 20s.

Can You Get Rosacea All of a Sudden?

Yes, your propensity for it may have been there all along and then something tipped your skin over the edge and you developed the symptoms of acne rosacea. The symptoms may develop slowly over years or occur all of a sudden. Acne rosacea looks like a form of adult acne and typically comes on in the 20s or later in life. Bright red rosy cheeks in childhood may indicate a predisposition to rosacea later in life.

The good news is that you can also control it and revert your complexion back to how it was before.

Can You Get Rosacea Symptoms on Skin Other Than the Face?

Yes, rosacea symptoms can extend down your neck and onto your chest. On the neck and chest, I mostly see the enlarged, hyperactive capillaries. Occasionally, the skin breaks out in pimples and a red scaly rash. Rosacea can coexist with Pityrosporum folliculitis, a common cause of back and chest pimples.

Understanding the Symptoms of Rosacea

If you answer 'yes' to any of the following questions, then you probably have rosacea.

• Does your face get bright red when you exercise?
• Do you flush, blush, and have a rosy red nose when you're hot, eat spicy food, or have a glass of wine?
• Do you have adult acne and break out with pimples, but you don't seem to have a problem with blackheads?
• Does your skin have lots of broken capillaries in the crease of your nose and on your cheeks?

Skin Symptoms of Acne Rosacea?

• Pimples: Red, tender bumps, potentially with whiteheads. (see more below)
• Facial Redness: Blotchy, persistent redness on the cheeks, nose, chin, and mid-forehead. (see more below)
• Visible Blood Vessels: Enlarged capillaries causing flushing and blushing. (see more below)
• Skin Sensitivity: Increased sensitivity to products and environmental factors.
• Oily Skin: Excess oiliness in some cases.
• Sebaceous Hyperplasia: Enlarged oil glands, leading to small bumps or nose thickening (rhinophyma).
• Ocular Rosacea: Eye irritation, redness, and potential vision issues.

Main Skin Symptoms

There are a few main skin symptoms [3] you may notice. You don’t have to suffer from all of these to qualify for the diagnosis of rosacea.

1. Facial Pimples

Facial pimples and red spots, especially on the apples of the cheeks, mid-forehead, chin, and nose.

The pimples of adult acne rosacea [1] are:

• Most commonly tender red bumps which may or may not come to a whitehead.
• Usually occur on the central face including the central forehead, cheeks, nose, and chin.
• More like a tender inflammatory nodule than the puss-filled pimples characteristic of teenage acne vulgaris.
• May come up quickly or can take weeks to go away.
• Easily irritated if you apply harsh acne medicines, thus behaving more like a rash than acne.
• Unlike regular acne vulgaris, adult acne rosacea does not cause blackheads.

2. Facial Redness, Sensitivity, Swelling, and Scale

General blotchy skin redness, irritation, swelling and scale often accompany the pimples of acne rosacea making for a really frustrating facial skin mess.

It’s also common for people prone to rosacea to be prone to facial seborrheic dermatitis (a scaly red facial rash from dandruff). Both conditions may be present at the same time, and both need treatment in order for the skin to completely improve. And, my treatment recommendations for rosacea also work for seborrhea.

The inflammation of rosacea may be related to skin mite overgrowth with demodex mites. In one of my articles, I discussed some scientific information connecting mites to rosacea, and you can bet that I like to treat mites as part of my rosacea therapy.

3. 'Broken' Facial Capillaries Prone to Flush and Blush

Rosacea can cause the appearance of prominent blood vessels, facial flushing, or blushing on the face, often described as "broken capillaries", though they are actually just enlarged and visible. These are most commonly seen on the cheeks, chin, and nose and can be occasional or persistent.

Common triggers include spicy foods, alcohol, exercise, hot showers, menopausal hot flash, emotion, and extreme temperatures - all of which make facial redness worse.

Key points to understand about the blood vessels:

• Enlarged, not broken: The capillaries are simply wider and more visible than normal.
• Increased visibility over time: The longer you have rosacea, the more prominent these vessels can become.
• Abnormal reactivity: These enlarged capillaries tend to overreact and engorge easily in response to various stimuli (listed above) and sometimes just for no reason at all. The flushing of rosacea capillaries turns you as red as a beet, and at times, it is so intense that your skin hurts.
• Appearance varies: They can appear as:
  • Long, straight lines, especially in the creases of the nose.
  • A dense network of fine, branching vessels resembling a spider web.
• Location:
  • Most common in the central face (where other rosacea symptoms like bumps and pimples often occur).
  • I occasionally also see rosacea patients with large, dark and deep capillaries on the sides of the cheeks near the ears, too.

In essence, rosacea can make the normally invisible network of facial blood vessels become larger, more numerous, and overly responsive, leading to both visible lines and frequent, intense flushing.

4. Enlargement of Solitary Oil Glands

Most rosacea patients complain of excessively oily skin and clogged pores. But some have dry, sensitive skin. These two differences impact which rosacea treatment products I recommend.

Oily Skin

Oil gland enlargement from acne rosacea is annoying. It shows up in two ways:

1. Small yellow bumps on the skin surface (called sebaceous hyperplasia papules) seen in all rosacea types. These growths of an oil gland are lumpy and have a central indentation that's actually the opening of the pore. They can be surgically treated with electrocautery or laser. They are often misidentified as milia, which are small pinpoint skin cysts that can be lanced by a doctor. Unfortunately, sebaceous hyperplasia papules are solid and will not go away when lanced.
2. General enlargement, thickening and a bulbous shape to the nose due to a confluence of enlarged oil glands under the skin surface (this may be a subtle roundness of nasal shape or an extreme thickening and lumpiness like the nose of the actor W.C. Fields). Generalized sebaceous hyperplasia of the entire nose is called rhinophyma.

Rhinophyma

Severe, nasal enlargement from oil-gland growth isn't common. Most of the time, rhinophyma is simply a subtle rounding of the shape of the nose. That said, when well developed, a rhinophymatous nose can be bulbous, with irregular nodular areas that create asymmetry and significant nasal enlargement. See more on this below.

Knowledge is Power:

• Complete Guide to Treatment Options for Acne Rosacea

Science Nerd Digression

Sebaceous hyperplasia is fascinating because the skin bumps that you see actually look like big versions of what an oil gland looks like under the microscope; every pore has an oil gland, whether there's a hair coming out of the pore or not. Normally, the pore's oil gland is an invisible, microscopic creamy-colored lobular blob that sits on the side of the pore and opens into it. It's yellow and lumpy, much like the yellow sebaceous hyperplasia papules seen in rosacea. When the sebaceous gland grows in rosacea, it encircles the pore and becomes a donut-like bump with a central hole where the pore is. Understanding this explains one of my favorite ways to get rid of sebaceous hyperplasia papules.

Why Do People Get Rosacea?

We don’ t know! What we do know:

• The regulation of blood flow to the skin in rosacea is abnormal. People with rosacea have an abnormal "vasomotor" response of their facial capillaries to hot environments and other flushing stimuli, leading to easy and frequent flushing. This means that their facial capillaries open up too easily and allow excessive blood flow through their network. This leads to flushing and eventual enlargement in the size of the capillary.
• Free radical damage to skin cells and structures, and UV light are known to worsen the redness and symptoms.
• The exact role of demodex mites remains uncertain, however some studies suggest that protein on bacteria on the mites might be important; it's a to-be-continued-story because:
  • Pores with demodex are more likely to be inflamed, but 100% of the elderly have demodex in their pores though not all have rosacea.
  • The presence of demodex is most closely associated with inflammatory papulopustular rosacea.
  • Killing the demodex with medicine does not necessarily cure rosacea.
• Intestinal bacteria such as H. pylori have been implicated as well, but there is evidence both for and against this hypothesis. It may turn out that it's more important for some people than others.

Grow Your Knowledge:

• Demodex Mites and Rosacea: Treatment & Causes

4 Types of Rosacea

There are 4 different subtypes of rosacea: Type 1, Type 2, Rhinophyma, and Ocular Rosacea. It’s important to try to identify which type you have because it helps you understand your skin problem and find the best skin care routine for rosacea treatment and control. You may also find that you have more than one rosacea type, which is very common.

Let’s look at the different forms of rosacea:

1. Erythematotelangiectatic Rosacea (Type 1)

Redness, flushing, visible capillaries, sensitive skin.

• Most apparent on the apples of the cheeks, mid-forehead, nose and chin.
• Inflammation is diffused in the ares of facial skin and may be dramatic or quite subtle.
• Associated with redness and flushing that often burns or stings.
• History of flushing episodes lasting over 10 minutes and occurring from various stimuli (see the triggers section).
• Very sensitive skin and facial redness is easily made worse by most skin care products, temperature extremes, exfoliation, sun exposure, volatile chemical fumes, etc. leading to flare ups.
• 'Broken' capillaries, often visible as a fine network and skin flushing, may sting.
• Finely textured skin with scaling and roughness of the central face. The skin may feel 'filmy'.
• The red pimples are often small.
• Frequently accompanied by facial seborrheic dermatitis (aka dandruff).

2. Papulopustular Rosacea (Type 2)

Pimple-like bumps, redness, potential pustules, oily skin.

• Papulopustular rosacea is the classic rosacea subtype.
• Skin inflammation is heavily centered around the pore.
• Pimple-like redness and swelling, sometimes with pustules and nodules.
• Skin is often sebaceous, oily with large pores, a 'filmy' feel, red thick, and swollen.
• Pimples are often large and very red.
• Broken capillaries are often large.
• There is often a history of flushing that may or may not sting.
• Skin is often less sensitive and may be very tolerant when not inflamed.

3. Glandular / Phymatous Rosacea (Type 3)

Thickened skin, enlarged oil glands, often on the nose (rhinophyma).

• With or without rhinophyma.
• Most common in men with a history of teenage acne.
• Flushing and telangiectasias ('broken capillaries') are less prominent.
• Thick and sebaceous skin, especially on the nose, chin, forehead, cheeks and ears.
• Not sensitive or easily irritated.
• Large pores filled with plugs of dead skin cells and sebum.
• Swollen and enlarged oil glands, classically evidenced by a larger rounded nose.

4. Ocular Rosacea (Type 4)

Affects the eyes, causing irritation and redness.

• Inflammation of the oil glands along the eyelash line.
• It can be seen with all the types of rosacea. Some studies have linked it to demodex mites.
• Redness, irritation, and grittiness of the eyes, stinging, burning, and light sensitivity.
• Blurred vision and swelling may be present.
• May precede facial skin involvement.
• Inflammation of the lash-line (called blepharitis) with itching, crust, swelling and/or irritation.

Explore Further:

• How to Get Rid of Redness on the Face - Treatment, Products, Routine, Causes
• Effective Facial Redness Treatments from Rosacea

What Are Rosacea Triggers?

There are many rosacea triggers and you want to specifically identify yours to control your rosacea and prevent a flare-up.

Rosacea gets worse when your complexion is exposed to:

1. things that increase the capillary blood flow in your skin, or
2. things that irritate the fragile skin-barrier that characterizes rosacea-prone complexions.

This is because two of the key characteristics of rosacea are an abnormal skin vascular response and skin-barrier fragility.

A number of triggers increase during the fall and winter which are high risk times for a rosacea flare-up. Others happen year-round.

Classic Rosacea Trigger-Factors

• alcoholic beverages
• hot drinks
• spicy foods
• temperature extremes, like being in hot environments (such as running indoor heat or sitting in a sauna)
• certain foods, like histamine-rich foods such as aged cheese, wine and processed meats
• emotional stress

Interestingly, a scientific study showed that drinking caffeinated coffee is somewhat helpful for rosacea, while other hot and/or caffeinated beverages are not.

Triggers That Cause Facial Capillaries to Flush Can Be Rosacea Triggers

Many people suffering from rosacea find that anything that causes their skin to flush will also trigger rosacea. The term for this is vasodilation [4]; when the skin’s capillary network vasodilates and more blood flows to the facial skin, rosacea gets triggered.

Examples of vasodilating rosacea triggers include:

• Alcohol, spicy foods, exposure to hot environments, and strenuous exercise
• Menopause is associated with worse rosacea, and anyone who has gone through it knows that the "hot flashes" are associated with flushing and vasodilation

Weather

• Extremes in weather, such as strong wind and cold, will trigger rosacea.
• Sun and humidity can aggravate rosacea.
• Heat causes vasodilation.
• Wind and cold may also, but these cause additional skin-irritation by damaging the fragile, rosacea skin-barrier.

Some Skin Care Products and Procedures

Harsh skin-care products will trigger rosacea through irritation of the fragile rosacea skin-barrier. Products such as

• alpha hydroxy acids
• retinoids
• rubbing alcohol
• acid face peels
• other skin irritants such as some essential oils, strong soaps etc.

These all seep readily into a rosacea-prone barrier compromised complexion and cause irritation. The irritation triggers rosacea.

In addition to trying to avoid rosacea trigger factors, you can help heal your rosacea with a skin care routine designed for rosacea. - Dermatologist Dr. Cynthia Bailey

Take Action:

• What skin care routine will help to treat rosacea?

When your rosacea-prone complexion is stable, it is better able to endure all the rosacea triggers with less sensitivity.

Rosacea Treatment & Special Considerations

As a dermatologist, my goal is to give you practical medical information about rosacea. That's because you can do a lot on your own to help heal and control your rosacea. When you understand the unique skin issues that make it worse than you can avoid them. You will be surprised how much this helps.

Designing a Skin Care Program to Help Control Your Rosacea

Which Type of Rosacea Do You Have?

The first and most important step in controlling rosacea is to decide if you have the exquisitely sensitive skin of the erythematotelangiectatic type, the tougher skin of papulopustular rosacea, or if you are somewhere in between. In general, the facial skin barrier strength in rosacea is abnormal, making any irritating products or treatments (such as anti-aging or acne treatments) much more irritating to rosacea-prone skin.

From the standpoint of avoiding triggers and improving your rosacea with your skin care routine, the four types or rosacea (see more above) distill down to two basic complexion types:

1. Rosacea with highly sensitive skin
2. Rosacea with fairly tolerant skin

There can be overlap, but try to decide which of these your complexion most closely resembles to find the right skin care products to fix the redness, pustules, and flushing of rosacea without triggering it!

Because skin sensitivity differs in these two rosacea skin types, it’s important to decide if you have mostly type 1 or 2 rosacea before you try any new products. - Dermatologist Dr. Cynthia Bailey

Before You Start a Skincare Regimen

The best way to begin a new skincare routine is to think about what products and procedures you have tried before. What have you tolerated or not tolerated? Use this history as a guide.

When in doubt, start cautiously with non-irritating products and treat only a small area of your rosacea-prone skin to see how it responds!

All products need to be rosacea-friendly from your cleanser to your sunscreen. Include products that help heal rosacea and repair your fragile skin barrier. I call this a Complete Skin Care Routine™ for rosacea.

4 Step Skincare Routine to Heal Rosacea

The 4 skincare steps I use to create a Complete Skin Care Routine for my rosacea patients: Cleanse, Correct, Hydrate, Protect ™.

Compatible Products are Key

The key to controlling rosacea is to use compatible and healing products for each step to quiet the inflammation and heal the weakened skin barrier of rosacea.

I’ve taken out the guesswork with my Rosacea Therapy Skin Care Kit by providing the right cleansers, correcting products, barrier repairing moisturizer, and pure mineral SPF. Alternatively, create your own routine for rosacea by understanding what type of products to use for each of these steps.

My patients integrate their prescription rosacea-treatment medicines with these products for personalized results that fit their specific needs.

Knowledge is Power

• Best Acne Rosacea Treatment and Routine Guide

Diet and Lifestyle Modifications

Beyond Skin Care

Rosacea is a lifelong skin condition that requires constant management - there is no cure! For this reason, I use oral antibiotics to treat rosacea only as a last resort.

My approach to rosacea treatment is to have my patients on a good foundation of holistic and healthy control measures to control total body inflammation including rosacea. We use:

• Diet
• Lifestyle

Dietary Recommendations

• Anti-inflammatory diet (e.g., Mediterranean diet).
• Foods rich in omega-3 fatty acids (e.g., flax seeds).
• Probiotic-rich foods (e.g., yogurt, kefir, fermented foods).
  

Foods to Avoid

• Alcohol and spicy foods.
• Potential triggers: Avocados, cinnamaldehyde-containing foods, dairy, histamine-rich foods.
• Learn more: Does Alcohol and Wine Make Rosacea Worse?

Lifestyle Adjustments

• Stress management (yoga, meditation).
• Avoidance of temperature extremes.
• Limit exposure to sun and wind.

Learn How to Use Foods for a Healthy Skin

• 30 Day Dietary Challenge for Your Health and Complexion
• The Alkaline Mediterranean Diet for Overall Health and Beauty
• Understanding the Alkaline Diet 
• Benefits of Using Kefir to Support Healthy Skin
• Diet to Heal Acne; Dermatologist’s Advice

Rosacea and Related Conditions

Are Your Complexion Problems Due to Rosacea?

Not all facial redness is due to rosacea.

Conditions that Mimic Rosacea

1. Non-rosacea forms of acne
2. Facial dandruff (seborrheic dermatitis)
3. Skin rashes of allergic and irritant dermatitis

Tips to Tell Acne from Rosacea

• Look for blackheads - not just engorged and clogged pores. Blackheads are more common in acne.
• How old are you? Acne is more common in adolescents and young adults. Rosacea is more common in young and older adults, and the risk of rosacea increases with age.
• Female hormonal acne, another form of acne that can develop in adult women, usually manifests as big, painful cysts along the jaw. This is not a common site for the pimple-like lesions or rash of rosacea.

Rosacea vs. Facial Dandruff (Seborrheic Dermatitis)

Is Seborrheic Dermatitis a Symptom of Rosacea? 

Dandruff can be harder to distinguish from rosacea. Many people with rosacea, especially the erythematotelangiectatic / type 1 of rosacea also have facial seborrheic dermatitis (aka dandruff).

The facial distribution of seborrheic dermatitis is different from that of rosacea. Dandruff usually involves more than the convex surfaces of the face:

• Eyebrows, hairline, ears, and along the sides of the nose, areas that are not typically involved with rosacea. Rosacea often involves the “apples” of the cheeks, mid forehead, chin and nose.
• Seborrhea causes a pinkish-salmon rash that is dry and flaky, which people often mistake for 'dry skin'. Involved areas are often sensitive.
• Facial seborrhea may be accompanied by scalp dandruff.
• It often occurs with rosacea, and the good news is the treatments for these 2 common conditions overlap.

Rosacea

Seborrheic Dermatitis

Pro-Tip: People who have rosacea often have facial seborrheic dermatitis (aka dandruff)

Treatment

If you think you may also have seborrheic dermatitis on your face, then it's important to use products that treat both conditions. Both rosacea and seborrhea cause sensitive red facial skin, and both respond to some of the same treatments. The skin care routine in my Rosacea Therapy Kit addresses both conditions. Stubborn flare-ups of either of these two conditions may call for different approaches.

Explore Further:

• Effective Rosacea Treatments & Skincare Routine
• Seborrheic Dermatitis (Facial Dandruff) Causes and Treatments
• Rosacea, Seborrhea and Clogged Pores
• Best Treatment for Flaky Facial Skin from Dandruff and Rosacea

Rosacea vs. Contact Dermatitis

Contact dermatitis is a skin reaction caused by direct contact with an irritant or allergen, while rosacea is a chronic inflammatory condition primarily affecting the central face with various triggers. Here are key differences from rosacea:

Initial Rash Location:

• Contact Dermatitis: Starts only where the substance touched the skin. May spread later.
• Rosacea: Typically affects the central face (cheeks, nose, chin, forehead).

Common Symptoms:

• Allergic Contact Dermatitis: Itching, redness, and potentially blisters (like poison ivy/oak).
• Irritant Contact Dermatitis: Stinging, redness, dryness, chapping, and even a burned appearance.
• Rosacea: Characterized by redness, flushing, visible blood vessels, and sometimes bumps and pus-filled spots.

Common Causes:

• Allergic Contact Dermatitis: Specific allergens found in skincare, hair care (especially fragrances, essential oils), and other products.
• Irritant Contact Dermatitis: Harsh weather, chemicals, solvents, strong soaps, and overly strong skincare ingredients (AHAs, benzoyl peroxide).
• Rosacea: Triggers often include spicy food, alcohol, heat, stress, and genetics.

When to See a Dermatologist

Remember, if your skin is not getting better or not responding to your rosacea friendly skin care routine then it's time to see a dermatologist. Sometimes medical prescription treatments are necessary to control the skin inflammation and prevent scarring or hyperpigmentation. Doctors can add a prescription oral antibiotic or powerful topical medicine. These often work quickly to jump start control so that your good rosacea friendly skin care routine can finally take over.

Signs That Warrant Professional Consultation

• Severe inflammation or worsening condition.
• Lack of response to rosacea-friendly skincare routine.
• Need for prescription treatments.

Final Considerations

Rosacea is an inflammatory facial rash that's technically a skin disease. It's actually so common that I almost think of it as a 'skin type'. I treat a lot of rosacea patients in my dermatology practice and I have rosacea myself. I see it every day in subtle and not so subtle forms and I counsel rosacea patients constantly; I treat it, I manage it and I work around it to accomplish a variety of goals for my patients.

Know Your Treatment Options

Rosacea is a chronic condition that continues to confound scientists. We don't know what causes it but doctors have treatments and advice that help our patients control the condition. In my guide to treatment options for rosacea, I share my successful treatment tips that I've developed over my 30+ years or so treating patients with this common rash.

Look at Your Skin Care Products

If you are doing everything and your skin is not getting better, then have a good look at your products. Check carefully for problem ingredients such as cortisone (more common in products from outside the U.S.), or irritating ingredients like vitamin C, AHAs, BHAs, benzoyl peroxide, retinol, etc. In my experience, even niacinamide can sometimes irritate a sensitive rosacea-prone complexion.

Simplify Your Rosacea Skincare with Expert Guidance

Managing rosacea effectively requires a consistent and gentle skincare routine. Drawing upon my 35+ years of experience as a dermatologist successfully treating this common condition, I've streamlined the process for you.

The Rosacea Therapy Skincare Kit offers a complete and thoughtfully formulated regimen designed to address the key needs of rosacea-prone skin. It takes the guesswork out of product selection, providing you with a reliable system built on proven dermatological principles. If you're seeking a comprehensive and expert-backed approach to managing your rosacea, this kit is a valuable resource.

There is no cure for rosacea, but it is possible to have rosacea and still keep your skin looking healthy and attractive. - Dr. Cynthia Bailey Rosacea Expert and Dermatologist

About the Author

Dr. Cynthia Bailey is a Board Certified Dermatologist practicing general, surgical and cosmetic dermatology in California since 1987. She has done well over 200,000 skin exams during her career. Dr. Bailey is the Founder of DrBaileySkinCare.com, the longest running dermatologist written skin health resource in the world. Dr Bailey is first and foremost a clinician with a pragmatic holistic approach to medical care and a heavy emphasis on skin health education. Her practical skin care information and advice can be found at DrBaileySkinCare.com, across the web and in numerous international print publications.

References

1. Mikkelsen, Carsten Sauer et al. “Rosacea: a Clinical Review.” Dermatology reports vol. 8,1 6387. 23 Jun. 2016, doi:10.4081/dr.2016.6387
2. Rainer, Barbara M et al. “Rosacea: Epidemiology, pathogenesis, and treatment.” Dermato-endocrinology vol. 9,1 e1361574. 4 Oct. 2017, doi:10.1080/19381980.2017.1361574
3. Andrew F. Alexis, MD, MPH, Valerie D. Callender, MD, Hilary E. Baldwin, MD, Seemal R. Desai, MD, Marta I. Rendon, MD, Susan C. Taylor, MD.
   "Global epidemiology and clinical spectrum of rosacea, highlighting skin of color: Review and clinical practice experience", JAAD Sep. 2-18
4. Del Rosso JQ. Advances in understanding and managing rosacea: part 1: connecting the dots between pathophysiological mechanisms and common clinical features of rosacea with emphasis on vascular changes and facial erythema. J Clin Aesthet Dermatol. 2012 Mar;5(3):16-25. PMID: 22468176; PMCID: PMC3315879.
5. Baldwin HE. Diagnosis and treatment of Rosacea; State of the Art. J Drugs Dermatol. 2012; 11: 725-730.
6. Borkowski AW, Gallo RL. The coordinated response of the physical and antimicrobial peptide barriers of the skin. J Invest Dermatol. 2011; 131: 285-7.
7. De. Rosso JZ, et. al. Why is Rosacea Considered to Be an Inflammatory Disorder? J Drugs Dermatol. 2012; 11: 694-700.
8. Elston DM. Demodex mites: facts and controversies. Clin Dermatol. 2010; 28: 502-4.
9. Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using stan-dardized skin-surface biopsy. British Journal of Dermatology. 1993; 128: 650-659.
10. Gao YY, Di Pascuale MA. In vitro and in vivo killing of ocular Demodex by tea tree oil. Br J Oph-thalmol. 2005; 89: 1468-73.
11. James WD, BergerT, Elston GV, Dirk M. Andrews' Diseases of the Skin: Clinical Dermatology. 11th ed., Elsevier Inc.; 2011: 241-244.
12. Jarmuda S, O'Reilly N, Zaba R, Jakubowicz 0, Szkaradkiewicz A, Kavanagh K. The potential role of Demodex folliculorum mites and bacteria in the induction of rosacea. J of Medical Mi- crobiology. 2012; 61: 1504-10.
13. ILi J, O'Reilly N, et. al. Correlation between ocular Demodex infestation and serum immunore-activity to Bacillus proteins in patients with facial rosacea. Ophthalmology. 2010; 117: 870-877.
14. Uta S, Bzbakir 0, Turasan A, Uta C. Helicobacter pylori eradication treatment reduces the severity of rosacea. Journal of the American Academy of Dermatology. 1999; 40: 433-435. Vollmer RT Demodex-Associated Folliculitis., American Journal of Dermatopathology. 1996; 18: 589-591.
15. Zhao YE, Wu LP et. al. Retrospective analysis of the association between Demodex infestation and rosacea, Arch Dermatol. 2010; 146: 896-902
16. Sharma, A, Kroumpouzos, G, Kassir, M, et al. Rosacea management: A comprehensive review. J Cosmet Dermatol. 2022; 21: 1895– 1904.
17. Daou H, Paradiso M, Hennessy K, Seminario-Vidal L. Rosacea and the Microbiome: A Systematic Review. Dermatol Ther (Heidelb). 2021 Feb;11(1):1-12. Epub 2020 Nov 10. PMID: 33170492; PMCID: PMC7859152.
18. Vijay, A., Valdes, A.M. Role of the gut microbiome in chronic diseases: a narrative review. Eur J Clin Nutr 76, 489–501 (2022).
19. Dawson-Hughes, B. Acid–base balance of the diet—implications for bone and muscle. Eur J Clin Nutr 74 (Suppl 1), 7–13 (2020).
20. Searle T, Ali FR, Carolides S, Al-Niaimi F. Rosacea and Diet: What is New in 2021? J Clin Aesthet Dermatol. 2021 Dec;14(12):49-54. PMID: 35096255; PMCID: PMC8794493.