What types of rosacea are there?
Erythemato-telangectatic rosacea (ETR)
People with erythemato-telangetatic rosacea are mainly affected by facial redness, visible surface blood vessels and flushing. ‘Erythema’ is the medical term dermatologists use for redness, ‘telangectasias’ are visible surface blood vessels. it is the commonest form of rosacea affecting about 80% of people who are diagnosed with rosacea. People with ETR often find that flushing is a major problem. The flushes are longer lasting than normal blushes, often lasting many minutes and affect the face and sometimes the ears, neck and upper chest. They can be triggered by embarrassment, concentration, emotional stress, physical exertion (such as going to the gym), spicy foods, hot drinks, changes of temperature (such as moving to a hot or cold room or going outside). These flushes can sometimes cause a burning or stinging sensation and can even be painful. People with the ETR form of rosacea usually don’t develop significant numbers of spots, but are commonly affected with dry, gritty or uncomfortable eyes. The other major problem is skin sensitivity and scaly dryness: people with ETR rosacea often find that topical mosturizers and sun creams cause stinging discomfort.
Papulo-pustular rosacea (PPR)
People with papulo-pustular rosacea have a form that was often described as ‘classic rosacea’ in older dermatology textbooks. Actually probably about 15-20% of people with rosacea have this type. As well as redness and visible surface blood vessels, people with this form of rosacea develop spots on the cheeks and nose. These include solid red spots, known by dermatologists as ‘papules’ and spots containing white pus, known as ‘pustules’. People with this form of rosacea often flush, but to a lesser extent than patients with the ETR form. Skin sensitivity, stinging and dryness is also usually less marked.
Phymatous rosacea
‘Phymoma’ is the medical term that dermatologists use to describe swelling of the skin. The commonest type is rhinophyma, which is a swelling of the nose, but swelling of the chin, cheeks, eyelids and ears can also rarely occur. It is very important to note that most forms of rosacea do NOT progress to rhinophyma. In particular rhinophyma is incredibly uncommon in females (it is more than 10 times commoner in men). In its early stages rhinophyma causes thickening of the skin of the nose with increasingly prominent pores.In its late stages it may produce a bulbous swelling and craggy appearance of the nose which can be disfiguring. It is often assumed by the general public and media that this appearance results from drinking alcohol excessively. In fact there is no such link at all. Rhinophyma can occur with very few other signs of rosacea.
Ocular rosacea
Ocular rosacea is rosacea affecting the eyes. Up to 50% of people with rosacea may have involvement of the eyes, a fact which can be overlooked. For some people this is the main symptom. Rosacea typically causes sensations of grittiness, dryness or the feeling that there is something in the eye. It can cause inflammation of the glands on the eyelids, redness of the conjunctiva ( the transparent membrane that covers the eyelids and the front of the eye itself) or rarely redness and complications of the sclera (the white of the eye), iris (the coloured part of the eye) or the cornea (the central window of the eye).
