Rosacea (commonly referred to as adult acne) is a chronic inflammatory condition affecting the central face of adults (it is rare in children) and manifested by redness of the forehead, eyelids, cheeks, nose, and chin. Rosacea is often accompanied by inflammatory papules (raised bumps) and pustules (bumps containing pus), or rarely with enlargement of the connective tissues beneath the skin (termed phymatous rosacea), including the nasal tissues (known as rhinophyma).
The cause of rosacea is unknown, but it is generally agreed that affected people have an unusual degree of vascular hyper-reactivity in that they tend to manifest vigorous and prolonged facial flushing in response to a number of stimuli including the ingestion of hot liquids. After a time, the flushing becomes permanent due to persistent enlargement of small facial blood vessels (telangiectasia).
It seems likely that genetic factors also play some role in this condition. The frequency of rosacea has been estimated to be as high as 10% of an adult Swedish population. It is most common among in those of Celtic ancestry and is less common in darkly pigmented races. In a recently published study, a family history of rosacea, smoking, and sensitivity to sunlight were the significant predictive factors for rosacea.
Many people with rosacea seem to have a lowered threshold for facial irritation. This predisposition seems to be correlated with elevated levels of certain inflammatory chemicals and a defective barrier function of the skin. When the skin's normal barrier function is restored, levels of these inflammatory substances decrease to normal.
Excessive use of potent topical steroids on facial skin can induce a rosacea-like condition. Although the relationship to rosacea is controversial, some people have facial follicles that are infested by a mite, Demodex folliculorum, which may cause signs and symptoms that are easily confused with rosacea. This diagnosis can be made by a physician and then treated successfully with appropriate topical medications (permethrin cream).
Medically Reviewed by a Doctor on 4/24/2015
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