What are the different types of rosacea?

The first type of rosacea causes facial redness. It can be referred to as vascular rosacea, or erythematotelangiectatic rosacea (ETC).

Type 1 is the most common kind of rosacea. As well as redness, it can cause:

• flushing (when the skin gets red and hot to touch)
• visible blood vessels (these might look like small red lines that are showing through the skin)

Redness is normally seen on the centre of the cheeks, the nose, and the forehead. Sometimes, those with ETC will experience redness on the chin, scalp, or neck.

This type of rosacea often flares up and then disappears. Having more flare-ups is likely to worsen your condition over time.

Finding out what triggers your flare-ups is one of the best ways to manage them. By avoiding triggers you can keep your skin in a calmer state.

Type 2 rosacea causes bumps and spots on the skin’s surface. This is known as papulopustular rosacea or acne rosacea.

Due to the appearance of pimples, it is often confused with acne. However, using acne creams on type 2 rosacea can aggravate the skin and should be avoided.

If you’re not sure if your breakout is acne or rosacea, consider the following:

Other symptoms of type 2 rosacea include:

• redness covering large sections of the face
• sensitive skin
• oily skin
• raised patches
• broken and visible blood vessels

Speak to a dermatologist or a healthcare professional if you aren’t sure if you have rosacea or acne. With their guidance, you can begin the correct treatment.

Type 3 rosacea is rarer, and involves parts of the skin (usually on the nose) thickening. This is known as phymatous rosacea or rhinophyma.

It is most commonly seen in men. Unlike types 1 and 2, which mostly affect 30-50 year olds, type 3 rosacea is most common in older men, between ages 60 and 70.

As well as causing the skin on the nose to thicken, type 3 rosacea might cause:

• reddened skin (on the nose)
• bumpy skin texture
• enlarged pores
• a visibly bigger nose (due to thickening of the skin)
• a bulbous or ‘ruddy’ nose
• visible, broken blood vessels

It is also possible for skin to thicken on the ears, cheeks, chin, and forehead. However, this is much rarer than occurring on the nose.

If your condition begins to affect your self-esteem, you could consider having surgery. This treats the rhinophyma by changing the shape of the nose back to what it once was.

However, because this surgery is deemed cosmetic you will have to pay for it privately. It is very unlikely to be provided for by the NHS.

The last type of rosacea affects the eyes. It is referred to as ocular rosacea.

If you have type 4 rosacea, you may notice inflammation and redness around your eyes and on your eyelids. You may also experience:

• bloodshot, watery eyes
• dry eyes
• itchy eyes
• a feeling of something gritty in the eye(s)
• a stinging sensation in the eye(s)
• sensitivity to light
• cysts on the eyelids, or areas surrounding the eyes
• visible blood vessels on the eyelids

It may be useful to use eye drops to help relieve any symptoms of discomfort.

Eating fatty fish which contains omega-3s might also help to ease ocular rosacea. It is considered one of the best foods for rosacea and for promoting healthy skin, too.

As well as having different types, rosacea can be categorised into different grades. This helps you distinguish if your condition is mild, moderate, or severe.

Your rosacea might vary from being almost clear on some days, to moderate or severe on days that you have flare-ups.

If you are tracking the condition of your skin, this grading scale can be useful.

The following table shows more concisely how the 4 main types of rosacea compare with one another:

Luckily, all types of rosacea can be managed with the correct treatment. However, treatment options will vary depending on your type. Some options include:

• managing your diet
• avoiding triggers
• laser therapy
• taking prescription medication
• surgery

Speaking with a dermatologist will provide you with the best advice, especially if you need to treat a combination of rosacea types.

To summarise, the different types of rosacea are:

Type 1: The most common form of rosacea which causes facial redness and flushing.

Type 2: ‘Acne’ or papulopustular rosacea which causes bumps and spots on the skin, as well as facial redness.

Type 3: Rhinophyma, which involves thickening of the skin usually on the nose. It can create large pores and a waxy appearance.

Type 4: Ocular rosacea which affects the eyes, causing itching, dryness, and discomfort.