4 Subtypes of Rosacea and How to Treat Them

4 Subtypes of Rosacea and How to Treat Them

Rosacea is a common, chronic skin condition that usually starts out as facial flushing or blushing. Over time, the redness from the flushing may last longer and spread to the ears, chest, or back and cause other skin problems like spider veins, acne-like bumps, or thickened skin.

Because rosacea signs and symptoms vary, our board-certified dermatologists at Associated Skin Care Specialists categorize the condition into subtypes based on symptoms. Your rosacea subtype helps direct the care you receive. 

Here, we want to talk about the four subtypes of rosacea and how to treat them.

Subtype 1: Erythematotelangiectatic rosacea

People with subtype 1, also called erythematotelangiectatic rosacea, have facial redness on the nose, cheeks, and forehead, along with visible blood vessels. They may also have skin that stings, burns, or swells more easily. Symptoms of subtype 1 rosacea come and go, but it worsens without treatment.

You may notice your rosacea flares up when you eat spicy food or get overheated; these are your triggers. Identifying and avoiding your triggers is part of the treatment for this rosacea subtype. We also recommend you protect your skin from the sun and use rosacea-friendly skin care products.

If you have moderate to severe rosacea flare-ups, we may prescribe a topical cream or oral medication to reduce inflammation.

Subtype 2: Papulopustular rosacea

With subtype 2, or papulopustular rosacea, you develop pus-filled red bumps on the cheeks, chin, and forehead. These breakouts are often misdiagnosed as acne and take a long time to go away. Acne medication may not help.

Treatment for this type of rosacea may include azelaic acid or metronidazole. These topical medications reduce redness and swelling and clear up the acne-like bumps.

Subtype 3: Phymatous rosacea

Subtype 3, also called phymatous rosacea, is rare. With this subtype, the skin on your face thickens, creating a bumpy texture. The thickening most often occurs on the nose. 

This type of rosacea is treatable, especially during the early stages. We prescribe isotretinoin, an acne medication that prevents the thickening from getting worse. In patients with more severe skin thickening, our surgical dermatologists may need to surgically remove the excess skin before starting isotretinoin. 

Subtype 4: Ocular rosacea

Rosacea may also affect your eyes. Rosacea subtype 4, also called ocular rosacea, may cause symptoms like:

Treatment for subtype 4 includes warm compresses, gentle eye cleaning, and medicated eye drops. We may also need to prescribe an antibiotic.

You can have more than one rosacea subtype. Because each subtype has a different treatment, it’s important to work with skilled dermatologists so you get the right diagnosis and care. 

If you think you have rosacea, or your current regimen isn’t working, schedule an appointment with one of our board-certified dermatologists by calling the dermatology office most convenient to you. 

We provide comprehensive dermatology care at our offices in Blaine, Maple Grove, Coon Rapids, Eden Prairie, New Brighton, and Minneapolis, Minnesota. We also have an office in Fridley, Minnesota, for research and lab testing.

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