Rosacea is a chronic skin condition that’s more common than many think, affecting more than 14 million people in the United States.¹ It usually appears as persistent facial redness, occurring on the center of the face across the nose, cheeks, forehead, and chin. And although less common, it can also appear on other areas including the ears, neck, scalp, and chest. Scientists have yet to determine what the main cause of rosacea is, and currently, there’s no known cure. The good news is that the symptoms can be managed through lifestyle and skincare changes. 

If you’re experiencing rosacea, you don’t need to feel ashamed—you’re not alone! And if you’re looking for information about potential contributing factors to rosacea on the body or the face, we’re here to help. We’ll also give you insight into who is more prone to getting rosacea, possible risk factors, and rosacea triggers. 

Who is most likely to get rosacea?

Rosacea can affect people of all ages and ethnicities, but most people who experience rosacea are over the age of 30 with fair skin. Women are more likely to be diagnosed than men.² 

Rosacea is a well-studied condition, and with each discovery, experts are getting closer to finding a cure—or, at least, more effective treatments. For example, rosacea used to be classified into four types of rosacea. We now classify rosacea differently, based on its specific characteristics and different combinations of those characteristics. Nonetheless, scientists have found some common associations among rosacea patients, including: 

• Family history. A survey conducted by the National Rosacea Society showed that 52% of respondents experiencing rosacea had a family member with rosacea.³ Research by Stanford scientists has also shown a genetic connection.⁴

• Reactive immune system. People with rosacea with papules and pustules may have a reactive immune response to bacteria known as Bacillus oleronius. Skin mites can carry this bacteria, making the reaction to it another possible characteristic of rosacea.⁵

• Intestinal infections. Helicobacter pylori is a bug that causes intestinal infections, and it’s also commonly found in people with rosacea. But people without rosacea can also have H. pylori infections.⁶

• Cathelicidin. This peptide normally protects the skin from infection. People with rosacea can process this peptide differently, which may cause redness and swelling.⁷ 

Signs and symptoms of rosacea

Several lifestyles and environmental factors or triggers can trigger rosacea flare-ups. It’s important for people with rosacea to recognize what triggers rosacea flare-ups and how to manage them (we’ll get to that in just a bit). A rosacea flare-up can go away on its own, but flare-ups can bring it back.

Let’s take a look at common symptoms. Redness is the most commonly reported symptom (specifically in those with lighter skin), but other symptoms can also be present.⁸ 

• Frequent blushing or flushing. Blushing or flushing results in redness. Flushing can occur almost instantaneously when exposed to a trigger, like a sun, spicy food, or hot beverages. 

• Redness. People with rosacea often have persistent erythema (redness) of the face. A burning or stinging feeling can be present, and their skin might also be dry.

• Acne-like lesions. Papules and pustules are acne-like lesions present in the area of redness. These are not acne-related pimples. Their etiology stems from inflamed, irritated skin. Acne and rosacea are different conditions, but a person with rosacea can also experience acne that’s not related to rosacea, including whiteheads and blackheads.  

• Visible blood vessels. Telangiectasias is the technical name for dilated or broken blood vessels, which are often more visible in people with lighter skin tones. Even though they’re generally less visible in those with darker skin tones, telangiectasias can be present. 

• Eye irritation. Eye irritation caused by rosacea can range from mild to severe. Symptoms can include:

  • Dilated blood vessels along or inside the eyelids with a “honey crust”

  • Inflammatory deposits in the cornea (the transparent covering of the eye)

  • Scleritis and sclerokeratitis (the white part of the eye becomes red and inflamed)  

• Phymatous changes (aka skin thickening). This most commonly occurs on the nose (aka rhinophyma) but it can occur in other areas as well.

Typical triggers that cause rosacea flare-ups

What triggers rosacea can vary from person to person, but research has found some common factors that can lead to flare-ups. Flare-ups can happen almost instantaneously after exposure to a trigger, but not always.  

• Food and drink. Spicy or temperature-hot foods and beverages, certain types of dairy, chocolate, and citrus can cause rosacea to flare up. 

• Emotional stress. Stress and anxiety can trigger a nerve pathway associated with rosacea symptoms.⁹ Mindfulness, yoga, and walking meditation can help alleviate day-to-day stress and may help prevent flare-ups.

• Alcohol consumption. Red wine, beer, bourbon, gin, vodka, and champagne have been associated with flare-ups. That doesn’t mean you need to skip happy hour! Opt for a mocktail instead.

• Weather. Extremes on both sides of the thermometer—heat, humidity, and windy, cold weather—can also trigger rosacea. In summer, try to stay cool, and in winter, use a humidifier if you live in a dry climate. 

• Sun exposure. Ultraviolet radiation can increase inflammation and telangiectasias,¹⁰ so try to limit your time in the sun and wear UV-rated sun-protective clothing, a large brimmed hat, and sunglasses. And don’t forget the sunscreen! 

• Skincare products. Certain ingredients in skincare products are well-documented irritants, including denatured alcohol, witch hazel, and added fragrance, and irritated skin may be more susceptible to a rosacea flare-up. Some acne-specific treatments, like salicylic acid, can also aggravate rosacea. Check the ingredients list before you buy or do a patch test to see if the product is a trigger for you.

Rosacea in everyday life

Curology is here for you!

If you have rosacea, Curology can help! We’re a dermatology service with more than 100 years of combined experience. Curology was founded by dermatologists dedicated to finding affordable and convenient solutions to everyday skincare concerns like rosacea, acne, hyperpigmentation, and signs of aging. 

Your skin is unique. So, it’s essential to use products that work for you. As a Curology member, you’re paired with a licensed dermatology provider who’s with you every step of the way. Your medical provider will advise you on recommended skincare routines and products for rosacea. We use ingredients like ivermectin, metronidazole, and azelaic acid to create a personalized prescription formula for the treatment of rosacea in addition to other skin concerns like acne and signs of aging.

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Get your personalized skincare routine with Curology

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Your first month is on us! You’ll get your personalized formula and other recommended skincare products for just $4.95 (plus tax) to cover shipping and handling.*

P.S. We did the homework so you don’t have to:

1. American Academy of Dermatology. Rosacea: Who gets and causes. (n.d.).

2. Gallo, R.L., et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee.Journal of the American Academy of Dermatology. (2017, October 28).

3. Huynh, T.T. Burden of disease: The psychosocial impact of rosacea on a patient’s quality of life. American Health and Drug Benefits. (July-August 2013).

4. Stanford Medicine. Genetic basis of rosacea identified by researchers. (2015, March 12).

5. Stanisław Jarmuda, Niamh O’Reilly, Ryszard Żaba, Oliwia Jakubowicz, Andrzej Szkaradkiewicz, Kevin Kavanagh. Potential role of Demodex mites and bacteria in the induction of rosacea. Journal of Medical Microbiology Volume 61, Issue 11. (2012, November 1).

6. American Academy of Dermatology. Rosacea: Who gets and causes. Ibid.

7. Yamasaki K, et al. Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nature Medicine. (August 2007).

8. Gallo, R.L., et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee.Journal of the American Academy of Dermatology. (2017, October 28).

9. Buddenkotte, J., et al. Recent advances in understanding and managing rosacea. F1000 Research. (2018, December 3).

10. Morgado-Carrasco, D., et al. Impact of ultraviolet radiation and exposure on rosacea: Key role of photoprotection in optimizing treatment.Journal of Cosmetic Dermatology. (November 2021).

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Written by

Curology Team

Medically reviewed by

Kristen Jokela, NP-C