Summary
Definition
History and exam
Key diagnostic factors
- flushing
- erythema
- papules and pustules
- telangiectases
- ocular manifestations
- plaque formation
- facial distribution
- phymatous changes
Other diagnostic factors
- acne vulgaris
- burning or stinging
- dry appearance
- edema
- peripheral location
Risk factors
- Fitzpatrick skin type I or II
- hot baths/showers
- temperature extremes
- sunlight
- emotional stress
- hot drinks
- family history
- female sex
- spicy foods
- alcohol
- medications
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- skin biopsy
- antinuclear antibody titer
Treatment algorithm
all patients
Contributors
Authors
Abel D. Jarell, MD

Dermatologist and Dermatopathologist
Northeast Dermatology Associates
Principal Investigator
ActivMed Research
Portsmouth
NH
Disclosures
ADJ declares that he has no competing interests.
Acknowledgements
Dr Abel D. Jarell would like to gratefully acknowledge Dr Alexa Boer Kimball, a previous contributor to this topic.
Disclosures
ABK has received honoraria for consulting from Intendis and has been an investigator for Intendis and Bayer.
Peer reviewers
Jashin J. Wu, MD
Chief Dermatology Resident
University of California
Irvine
CA
Disclosures
JJW declares that he has no competing interests.
Paradi Mirmirani, MD
Physician
Department of Dermatology
Kaiser Permanente Vallejo Medical Center
Vallejo
CA
Disclosures
PM declares that she has no competing interests.
Brian L. Swick, MD
Assistant Clinical Professor of Dermatology and Pathology
University of Iowa
Iowa City
IA
Disclosures
BLS declares that he has no competing interests.
Thierry Simonart, MD, PhD
Physician
Department of Dermatology
Erasme University Hospital
Brussels
Belgium
Disclosures
TS declares that he has no competing interests.
References
Key articles
Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2018 Jan;78(1):148-55. Abstract
Hampton PJ, Berth-Jones J, Duarte Williamson CE, et al. British Association of Dermatologists guidelines for the management of people with rosacea 2021. Br J Dermatol. 2021 Oct;185(4):725-35.Full text Abstract
Del Rosso JQ, Tanghetti E, Webster G, et al. Update on the management of rosacea from the American Acne & Rosacea Society (AARS). J Clin Aesthet Dermatol. 2020 Jun;13(6 suppl):S17-S24.Full text Abstract
Thiboutot D, Anderson R, Cook-Bolden F, et al. Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2020 Jun;82(6):1501-10. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Seborrheic dermatitis
- Contact dermatitis
- Systemic lupus erythematosus
More DifferentialsGuidelines
- Guidelines for the management of people with rosacea
- Management of rosacea
More GuidelinesPatient information
Rosacea: what is it?
Rosacea: what are the treatment options?
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