Types of rosacea and treatments

Rosacea Types and Treatments

It is debatable whether rosacea is a disease that progresses from one type to another. However, the classification of rosacea is necessary as treatment for rosacea can depend on the type of rosacea and its unique symptoms.

Erythematotelangiectatic rosacea (ETR) – most common type of rosacea featuring persistent skin redness of the nose, cheeks, or chin. Easily irritated skin that often stings or burns. ETR often features small, visible blood vessels (telangiectasias). Treatment is often limited to avoidance of any trigger factors. Any topical treatments will probably worsen skin because of skin sensitivity and is not recommended.

Papulopustular rosacea (PPR) – persistent skin redness of the nose, cheeks, or chin. Skin is inflamed with small papules (bumps) or pustules (pus-filled). Topical or oral antibiotics are effective treatments to reduce redness and clear inflamed papules and pustules. Topical metronidazole and azelaic acid cream are usually applied twice daily. Recurrence of rosacea typically occurs in 25% of treated patients and maintenance therapy may be required.

Phymatous rosacea – rare type of rosacea that features irregular, thickened skin with large, bumpy pores found on the nose (rhinophyma), chin, forehead, ears, or eyelids. Skin symptoms may include redness and inflammatory papules or pustules. Treatments include surgical options including partial or complete excision, electrocautery, cryosurgery, or laser surgery. Isotretinoin is limited to severe rosacea and can reduce inflammatory pustule or papules.

Ocular rosacea (eye rosacea)– common type of rosacea that involves mild itching or dryness of the eyes. Eyelid blood vessels are inflamed and visible. Some crusting that forms near the eyelids. Skin symptoms may include redness of the cheeks, chin, or nose. Treatment options for ocular rosacea include topical and systemic therapy. Topical eye treatments include artificial tear eye drops, proper eyelid hygiene, fucidic acid, and antibiotic eye drops. Oral antibiotics are sometimes used with mixed results.