The 4 Types of Rosacea and How to Treat Flare-Ups with Natural Options

Your Guide to the 4 Types of Rosacea: Holistic Approaches to Controlling Symptoms

Imagine this… among the bustling crowds around the world, an astounding 415 million people are quietly navigating the challenges of rosacea; that is 5.46% of the entire world’s population.^{1 2}

You are not alone! Rosacea’s reach is global, affecting so many.

Our goal today is to offer you some insight into the four types of rosacea and explore some practical solutions.

Whether you seek comfort, clarity, or natural ways to manage rosacea, you’re in the right place.

Let’s embark on this journey of discovery and healing together.

Key Takeaways:

• Patients with rosacea can develop symptoms of multiple subtypes of rosacea simultaneously.
• Proper diagnosis by a physician is necessary, yet traditional treatments can be costly and lifelong.
• Consider a functional medicine or naturopathic doctor to naturally treat the underlying causes of rosacea.
• There are four main types of rosacea: Erythematotelangiectatic, Papulopustular, Phymatous, and Ocular.

What is Rosacea?

Infographic data sourced from The National Library of Medicine ³

Why are my cheeks always red? Before exploring the four types of rosacea, we must have a basic understanding of what rosacea is.

Rosacea is a chronic skin condition primarily affecting the face, head, and neck. This skin condition is much more common than most people would think; millions of people around the world suffer from and live with rosacea every day.⁴

The 4 most common types of rosacea can manifest on different body parts. Each type of rosacea has its own handful of symptoms that allow it to be identified by medical professionals.

What are the Four Types of Rosacea?

Let’s dive into the different types of rosacea. Rosacea is a common skin condition that affects millions of us. It’s important for us to differentiate these types, as it helps us accurately diagnose and find effective treatments.

We will dive into more details within this article, but just in case you are here for a quick study, let’s break down the four types of Rosacea for you:

Type 1: Erythematotelangiectatic Rosacea (ETR)

Type 2: Papulopustular Rosacea

Type 3: Phymatous Rosacea

Type 4: Ocular Rosacea

We’ll dissect each type’s symptoms, causes, and risks, equipping you with the vital information to confront rosacea head-on. You’re not alone; together, we’ll discover the solutions you’re looking for.

What Factors Cause Rosacea?

Understanding rosacea’s causes involves recognizing its many triggers and underlying factors. While not confined to just one type of rosacea, each form has distinct symptoms and triggers leading to flare-ups. Here are some common rosacea triggers that can exacerbate rosacea’s visible symptoms:

• sunlight
• temperature changes
• exercise
• spicy foods
• alcohol
• anxiety
• harsh skincare
• food sensitivities

Some of the visible changes you might notice when you develop rosacea are:

• skin redness
• nose inflammation
• flushing
• skin sensitivity
• facial pain
• papules and pustules
• acne-like breakouts
• itchy red eyes
• visible blood vessels on cheeks

However, these are not the sole causes. Functional medicine doctors look deeper, often helping patients to reverse rosacea by targeting imbalances and chronic inflammation by considering:

• liver
• kidneys
• mental health
• toxic exposures
• dental infection
• heavy metal toxicity
• dormant viruses
• poor gut health

and several other key factors.

The Four Rosacea Subtypes In Depth

1. ETR or Erythematotelangiectatic Rosacea

ETR Rosacea typically shows persistent central facial erythema (redness/flushing), red cheeks, and possibly the nose due to dilated skin blood vessels.⁵

Key Points:

• Common signs: facial redness on cheeks and/or nose
• Triggered by the skin’s blood vessels dilating
• May be chronically red or have episodes of flare-ups

Care Tips:

• Use delicate, non-chemical laundry detergents.
• Opt for gentle skin care products; less is more!
• Practice safe sun exposure to protect your delicate facial skin. Consider a sunhat to protect your face, but allow other areas of your body to enjoy the benefits of the sun!
• Avoid alcohol.
• Consider testing for food sensitivities.

2. Papulopustular Rosacea

Papulopustular Rosacea (acne rosacea) often affects middle-aged women and may mimic acne, though it typically doesn’t involve black heads. Identifying this skin condition involves recognizing additional typical rosacea symptoms like spider veins, skin sensitivity, and dry skin patches.⁶

Key Points:

• Frequently mistaken for acne due to similar skin issues.
• Characterized by tiny whiteheads, dry patches, papules, or pustules as well as “random” breakouts, usually on the cheeks
• Often, the next stage of progression after ETR

3. Phymatous Rosacea

Phymatous Rosacea, more prevalent in men, often stems from untreated rosacea. Its main feature is skin thickening on the nose, leading to a bumpy, protruding nose or rhinophyma. Key signs include persistent erythema (redness) on the central face, a thickened skin texture, enlarged pores, and visible broken blood vessels.

• Severity can range from mild to severe.
• Other parts of the face may be affected by this as well
• Early diagnosis and proper treatment is crucial in preventing rosacea from developing to this level

4. Ocular Rosacea

Ocular Rosacea involves the eyes and is characterized by red, itchy, dry eyes, often in conjunction with other forms of rosacea, and must be properly diagnosed by an eye doctor. Here are some considerations if you think you may be experiencing ocular rosacea:

• Watch for key symptoms: Pay attention to redness, inflammation, and tiny bumps on the eyelids, resembling small styes.
• Be aware of eye discomfort: Notice if your eyes are watery, burning, or overly sensitive.
• Eye symptoms are often most notable upon waking.
• Seek timely diagnosis and treatment: Ocular rosacea can mimic other eye conditions, making early and accurate identification crucial.
• Consult healthcare professionals: We cannot stress more about the importance of professional care to manage ocular rosacea effectively and prevent complications.

Diagnosis:

How Do I Know If I Have Rosacea?

Rosacea can present in various ways, so it’s essential to understand the different types and their symptoms. A person can often suspect they have rosacea if they:

• Observe a change in the appearance of skin and/or eyes 
• Notice their skin has become more sensitive to certain materials, water, skincare, or elements like sun and wind
• Seem to blush or “turn red” more frequently and easily
• Feel a new texture to their skin, such as dry patches or a “sandpaper” feeling.

Seeking medical advice and a proper diagnosis by a dermatologist is crucial, as other conditions, like skin cancer or lupus, can have similar signs and symptoms to rosacea.

By understanding the different types of rosacea and seeking appropriate medical care, we can take control of our symptoms and improve our quality of life!

Treatment:

How Can I Control My Symptoms & Rosacea Flare-Ups?

Understanding the specific type or types of rosacea you have is crucial for effectively managing and treating this complex skin condition. There are a couple of approaches that you can take on the journey to reversing your rosacea flare-ups:

• managing surface-level symptoms with dietary and lifestyle changes
• addressing topical triggers like makeup and skincare, which often make symptoms worse
• preventing symptoms by targeting the underlying causes of rosacea naturally

Managing the Symptoms of Rosacea with your Dermatologist:

Traditional treatments like medicated creams, oral medication, and laser treatments can be somewhat effective for some individuals.

Unfortunately, these options are not meant to heal or reverse rosacea; they are meant to reduce the symptoms and must be used long-term. Traditional treatments may temporarily mask the symptoms you are experiencing but can never assess the root causes.

Therefore, they become a lifelong treatment and often don’t prevent rosacea from progressing to more advanced stages. Some traditionally prescribed treatments include:

• Laser Treatment: Laser therapy is meant to try to reduce redness like rosy cheeks, visible blood vessels, and inflammation associated with rosacea. However, many people report increased rosacea symptoms after laser therapy.
• Azelaic Acid: This topical medication can reduce inflammation and control acne-like breakouts.
• A range of oral and topical medications: Physicians may prescribe medication to manage the redness, specifically using antibiotics and other forms of medication. Initially, bumps and pimples may be treated with oral and topical medication to attempt to bring the condition under control, followed by long-term use of antibiotics or anti-inflammatory medications.

Preventing Rosacea Symptoms Naturally:

A Holistic Doctor’s Perspective

To address rosacea with a root cause approach, rosacea specialist Dr. Tara O’Desky advises educating yourself about gut health, the gut-skin axis, and the connection between liver toxicity and rosacea. Often, consulting with a functional medicine or naturopathic doctor can help you craft a personalized strategy to reverse rosacea by:

• Designing a gut-healing rosacea diet plan is the cornerstone for addressing the internal causes of rosacea.
• Pinpointing and managing your unique food allergens and sensitivities: Essential for keeping flare-ups at bay.
• Adding top-tier supplements: A vital component of addressing chronic internal inflammation

We also recommend these holistic practices:

• Stress Management: Prevent rosacea triggers by incorporating stress-reducing techniques like mindfulness, yoga, and consistent exercise.
• Detoxify Your Life: Choose chemical-free household products to prevent aggravating rosacea.
• Gentle Skincare Routine: While gentle skincare products can help maintain skin health and moisture, they alone aren’t a cure-all for rosacea.

Why the Different Types of Rosacea Article is a Reliable Source of Information and Cited Research 

Exploring the various types of rosacea enriches our understanding of this skin condition, offering patients critical information about symptoms, causes, and potential treatments. Our research explores multiple scientific journals and studies, helping you make informed decisions about your skin health.

The research referenced in this article can be found cited in the Resources section below.

The Bottom Line:
Embrace Natural Solutions for Rosacea & Transform Your Skin’s Health

Armed with knowledge and understanding of rosacea, we have the power to take control of our health and improve our quality of life.

Now that you can recognize your specific type of rosacea, you can tailor your treatment plan and lifestyle choices to minimize and prevent flare-ups.

Again, It’s also important to always consult a dermatologist for a correct diagnosis, although it is never too soon to improve your gut health and rosacea diet.

And for those seeking a holistic approach to managing rosacea, Dr. Tara’s educational program, The Rosacea Method, offers a comprehensive, natural solution for rosacea.

Join the community of clear skin enthusiasts today.

FAQs on the 4 Types of Rosacea

1. Kim HS. Microbiota in Rosacea. Am J Clin Dermatol. 2020 Sep;21(Suppl 1):25-35. doi: 10.1007/s40257-020-00546-8. PMID: 32914214; PMCID: PMC7584533. ↩︎
2. Gether L, Overgaard LK, Egeberg A, Thyssen JP. Incidence and prevalence of rosacea: a systematic review and meta-analysis. Br J Dermatol. 2018 Aug;179(2):282-289. doi: 10.1111/bjd.16481. Epub 2018 May 31. PMID: 29478264. ↩︎
3. Huynh TT. Burden of Disease: The Psychosocial Impact of Rosacea on a Patient’s Quality of Life. Am Health Drug Benefits. 2013 Jul;6(6):348-54. PMID: 24991368; PMCID: PMC4031723. ↩︎
4. Fisher GW, Travers JB, Rohan CA. Rosacea pathogenesis and therapeutics: current treatments and a look at future targets. Front Med (Lausanne). 2023 Dec 13;10:1292722. doi: 10.3389/fmed.2023.1292722. PMID: 38193038; PMCID: PMC10773789. ↩︎
5. Harper J, Del Rosso JQ, Ferrusi IL. Cross-Sectional Survey of the Burden of Illness of Rosacea by Erythema Severity. J Drugs Dermatol. 2018 Feb 1;17(2):150-158. PMID: 29462222. ↩︎
6. Saurat JH, Halioua B, Baissac C, Cullell NP, Ben Hayoun Y, Aroman MS, Taieb C, Skayem C. Epidemiology of acne and rosacea: a worldwide global study. J Am Acad Dermatol. 2024 Jan 4:S0190-9622(24)00002-1. doi: 10.1016/j.jaad.2023.12.038. Epub ahead of print. PMID: 38184278. ↩︎

MEDICAL DISCLAIMER

This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Tara O’Desky nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.