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Rosacea

Last reviewed: 9 Apr 2025
Last updated: 21 Mar 2025

Summary

Definition

History and exam

Key diagnostic factors

  • flushing
  • erythema
  • papules and pustules
  • telangiectases
  • ocular manifestations
  • plaque formation
  • facial distribution
  • phymatous changes
Full details

Other diagnostic factors

  • acne vulgaris
  • burning or stinging
  • dry appearance
  • edema
  • peripheral location
Full details

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
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
Full details

Tests to consider

  • skin biopsy
  • antinuclear antibody titer
Full details

Treatment algorithm

ONGOING

all patients

Contributors

Authors

Abel D. Jarell, MD
Abel D. Jarell

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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  • Patient information

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    Rosacea: what are the treatment options?

    More Patient information
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