The disease has a wide range of symptoms and signs, but rarely do patients go through each stage of rosacea. Variable erythema and telangiectasia is seen on cheeks and forehead. Inflammatory papules and pustules are seen mainly on the nose, the forehead, and the cheeks. Rarely, the neck and the upper part of the chest are involved.
In severe cases, thickened and disfigured noses (rhinophyma) are seen due to prominent sebaceous glands. Patients may complain of drying and peeling of the skin. Ocular lymphedema may be outstanding but is not seen commonly. Usually, rosacea does not cause any scarring.
A rare granulomatous type of rosacea (acne agminata/lupus miliaris disseminatus faciei) can present with inflammatory erythematous or flesh-colored papules spread symmetrically on the upper part of the face, especially around the eyes and nose. This type of rosacea may be associated with scarring and sometimes do not respond to regular treatment.
The diagnosis is made clinically. Sometimes a skin biopsy is done to rule out other cutaneous diseases, like lupus or sarcoidosis. The typical history and visible signs are more than sufficient to diagnose a case of rosacea.
Prior to any therapy, it is better to identify and avoid the triggering factors that flare up the patient's rosacea. These factors can be different for every individual. In some patients, it is seen that regular facial massage helps in reduction of lymphedema. Fairly high doses of prednisolone (30-60 mg/d) followed by oral isotretinoin helps in treatment of rosacea fulminans.
All patients with rosacea should use a broad-spectrum sunscreen that protects against both UV-A and UV-B rays on a daily basis .
Laser treatment can be done to treat enlarged or dilated blood vessels or remove surplus nose tissue in cases of rhinophyma.
Cosmetic change of rhinophyma can be done by various techniques like mechanical dermabrasion, carbon dioxide laser peel, and surgical shave.
The first line of treatment is generally topical metronidazole. Topical azelaic acid, sulfacetamide products, and topical acne medications are frequently used. Antibiotics are also very effective in both ways i.e. orally or topically, and for ocular rosacea, they are generally the first-line therapy. Some people also recommend using retinoids for treating rosacea   .
Medicines that help in reducing the flushing like beta-blockers, clonidine, naloxone, ondansetron, and selective serotonin reuptake inhibitors can also help in treating rosacea.
In some patients who complain of rosacea that worsens with their hormonal cycles, oral contraceptive therapy can be beneficial.
Dapsone is helpful for patients who cannot take isotretinoin  and is used in cases of severe refractory rosacea.
Development of rosacea is different for every individual, depending on various factors like genetics, skin sensitivity, skin complexion, amount of time spent in sunlight without sunscreen, intake of alcohol and spicy foods, and exposure to extreme temperatures. With the help of suitable treatment and avoidance of triggering factors, rosacea can be controlled.
The etiology of rosacea is unknown. Different aggravating factors leading to incidents of flushing and blushing play a role in developing rosacea.
Various factors like vasculature, climatic exposures, pilosebaceous systems abnormalities, dermal matrix degeneration, chemicals and consumed agents, microbial organisms, reactive oxygen species (ROS), increased neoangiogenesis, ferritin expression, and dysfunction of antimicrobial peptides (AMPs), may also lead to its development .
It primarily affects people of northwestern European descent. Although it affects both the sexes, women are three times more prone to it as compared to men. 30-60 years is the most vulnerable age to suffer from rosacea.
As the exact cause of rosacea is unknown, following are the theories that explain the development of this skin condition:
Rosacea cannot be prevented but the symptoms can be controlled by knowing and avoiding the common triggering factors   like hot drinks, exercise, alcohol, spicy foods, emotions, caffeine, sunlight, extreme heat or cold. These factors increase the blood flow and lead to dilation of small blood vessels of the facial skin. It is necessary to identify one’s own trigger factors and pay special attention towards avoiding them.
Rosacea is a common chronic skin condition characterized by symptoms of facial erythema (redness) and a wide range of clinical signs, like telangiectasia, roughness of skin, and an inflammatory papulopustular eruption looking like acne.
Age is no bar for rosacea affection. Rosacea can be divided into four types, of which three affect the skin and the last one affects the eyes.
Rosacea is a chronic inflammatory skin disease manifested as widespread redness and red boils generally over the forehead, cheeks, and nose. It is commonly seen in females of the reproductive age group and is easily diagnosed just by seeing.
As there is no way of preventing rosacea, measures can be taken to reduce the symptoms and their frequency of development. The first and foremost step is avoiding the triggering factors. Then comes, taking care of the skin in general by cleansing and moisturizing your face regularly. Prefer facial products that do not burn, sting, irritate or cause redness when use. One must develop a habit of washing face with lukewarm water and a mild soap.
One must avoid alcohol and acetone based products like toners, scrubs, etc. as they tend to dehydrate the skin. Hydroxy acids and tretinoin like Retinon A have good chances of sensitizing your skin to sun and thereby worsening rosacea. Patients must make it a norm to use broad spectrum sunscreens and sun blockers daily and generously for protecting your face . Use sunscreens that have SPF factor of 30 or more.
During winter patients must take extra care of face by using a scarf or ski mask to protect it. In case one wants to use makeup, one can go for green-tinted foundation creams and powders as they are designed specially to prevent redness of the skin.