Rosacea – Symptoms and Causes

What is rosacea?

A condition affecting blood vessels in the skin.

What are its symptoms?

Depending on the type of rosacea, the symptoms are:

  • Redness and flushing on the cheeks, nose, forehead and/or chin. This is called “Erythematotelangiectatic” rosacea  -  it’s a mouthful, but all it means is superficial reddening (erythema) and dilated or congested blood vessels (telangiectasia). The redness is aggravated by food triggers, intense physical activity and sun exposure (basically everything that increases blood flow and makes blood vessels dilate). In advanced cases burning and stinging sensations occur.
  • Facial reddening with papules and/or pustules that come and go (called “Papulopustular” rosacea). This type of rosacea looks similar to acne and it is sometimes called acne-rosacea. The difference is that rosacea does not present with whiteheads and blackheads like acne.
  • Thickening of the skin, affecting the nose in most cases, and sometimes also the cheeks, forehead, chin, eyelids and ears. This type is called “Phymatous” rosacea (from the Greek work Phyma = tuber, tubercle or swelling), and it is caused by the swelling of sebaceous glands (tiny glands that produce the oil-like substance which protects and lubricates our skin)
  • Bloodshot, irritated and watery eyes – this is “Ocular” rosacea, which occurs at the same time as, or sometimes before, rosacea symptoms affecting the skin. The eyes feel gritty, dry and/or itchy, and sensitive to light.

What causes rosacea?

Unfortunately the causes of the condition are not well understood. There are several hypotheses being researched, including:

1. Oxidation of fatty acids in blood vessel cellular membranes

Like all cellular membranes in our bodies, the cellular membranes of blood vessels are made of fatty acids, some of then unsaturated. Unsaturated fatty acids are prone to oxidation, which leads to free radical formation. Our bodies have mechanisms to stop oxidative damage (using antioxidants), but in some cases the anti-oxidative response is inadequate. In such cases large amounts of free radicals might damage the blood vessels, which would then become leaky. Research conclusions1  published in 2003 document a link between rosacea and free radicals/oxidative reactions.

2. A fault in the skin’s anti-inflammatory response

Abnormally high levels of anti-inflammatory peptides were found in rosacea skin, pointing to the possibility that rosacea is caused by a fault in the skin’s inflammatory response.2

3. Tiny organisms that live on human skin

A mite (Demodex Folliculorum) and a bacteria (Helicobacter Pylori) have been suspected to cause rosacea. However, both organisms are commonly found on people who do not suffer from rosacea. While  is possible that their presence might aggravate  symptoms, it is unlikely either of the two organisms single-handedly trigger rosacea.


1. Öztas, M. O., Balk, M., Ögüs, E., Bozkurt, M., Ögüs, I. H. and Özer, N. The role of free oxygen radicals in the aetiopathogenesis of rosacea. Clinical and Experimental Dermatology Volume 28, Issue 2, pages 188–192, March 2003

2. University of California – San Diego. “Cause Of Skin Condition Rosacea Discovered.” ScienceDaily, 7 Aug. 2007

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