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What Are the 4 Types of Rosacea? (Spoiler: You Could Have More Than One)

Read on to learn more about what are the 4 types of rosacea, what makes them different, and what treatments may help with each category.

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Rosacea is a skin condition that is most known for causing redness on the face. But, rosacea can also come along with annoying symptoms such as tiny pus-filled pimples, thickened bumpy skin on the nose, or red and irritated eyes. So what are the 4 types of rosacea?

There are 4 subtypes of rosacea in total, and many rosacea sufferers have a mixture of multiple subtypes, making a personal diagnosis and treatment plan key to getting rosacea under control.

Read on to learn more about the 4 rosacea subtypes, what makes them different, and what treatments may help with each category.

Rosacea Subtype 1: Erythematotelangiectatic Rosacea (ETR)

Erythematotelangiactatic Rosacea is the most basic form of rosacea, and most commonly the type of rosacea that develops first, before potentially progressing on to include the other subtypes.

The first signs of rosacea are normally an increased amount of redness and flushing that is temporary initially but may progress to consistent facial redness over time, and without treatment.

The most common signs and symptoms of ETR are:

  • Redness and flushing centralized on your face
  • Tiny visible broken vessels
  • Sensitivity on the face
  • Swelling on the face
  • Burning or stinging skin
  • Dry, scaly, or rough patches

ETR is generally treated with medications that help try to counteract the excessive vessel dilation which is causing the redness in this rosacea subtype, like Brimonidine or Oxymetazoline. Sometimes Azelaic Acid is also used since it can help reduce the swelling and redness of the skin for those that have the swelling and irritation component. Occasionally, topical or oral antibiotics are used for this subtype.

Rosacea Subtype 2: Papulopustular Rosacea

Papulopustular Rosacea is the rosacea type most associated with numerous tiny, pus-filled pimples across the face.

Papulopustular Rosacea is considered the easiest rosacea subtype to treat.

This subtype is sometimes referred to as “acne rosacea”, however, this is not in itself classified as acne (although it is possible for someone to have both conditions at the same time.)

Signs of papulopustular rosacea include:

  • Small blemishes resembling acne
  • Very red skin
  • Excessive oil
  • Facial sensitivity
  • Visible broken vessels
  • Patches of skin that are raised

The most common treatment for this subtype tends to include a topical or oral antibiotic component to target the tiny blemishes.

This may include an oral tetracycline, topical metronidazole, and/or topical azelaic acid. Ivermectin or Dapsone topical are also sometimes used for this subtype of rosacea.

Azelaic Acid has the ability to kill the bacteria that tends to infect facial pores and well as lending a redness and swelling reduction, making this a good addition for those suffering from subtypes 1 and 2 together.

Rosacea Subtype 3: Phymatous Rosacea

Phymatous Rosacea may be one of the most extreme forms of rosacea, and this subtype tends to affect men more than women.

The most prominent feature of this subtype tends to occur on the nose and leads to a thickening of the skin on the nose causing a “bulbous” or bumpy appearance.

Signs and symptoms of Phymatous Rosacea include:

  • Thickened skin and nodules on the nose, chin, ears, forehead, or eyelids
  • A large, red, or bulbous nose

The most common treatment for Phymatous Rosacea is oral isotretinoin. Some suffering from Phymatous Rosacea may choose to try elective laser or traditional surgery to help debulk the excess tissue from the nose.

Rosacea Subtype 4: Ocular Rosacea

Ocular Rosacea is the rosacea subtype that is can often go undiagnosed. This can be due to there not being any specific test for its diagnosis, plus it can be commonly overlooked or considered to be just transient eye irritation.

But, Ocular Rosacea symptoms can occur in nearly 60% of those with rosacea, so its symptoms should not be ignored.

The signs and symptoms of Ocular Rosacea include:

  • Bloodshot, watery eyes
  • The sensation of a foreign body in your eye
  • Dry eyes
  • Irritated eyes
  • Light sensitivity
  • Inflammation of the lid
  • Blepharitis
  • Conjunctivitis
  • Eyelid irregularities

The most common treatments for Ocular Rosacea are proper eyelid care and cleansing, artificial tears drops to soothe the irritation, and sometimes oral tetracyclines. For moderate to severe cases of Ocular Rosacea, cyclosporin drops may be prescribed by an ophthalmologist.

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Have a free online visit with our doctors today to see if prescription rosacea therapy is a good option for you.

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