Rosacea Explained: What It Is, Who Gets It, and When to Seek Help

April is Rosacea Awareness Month. Throughout this month, the consultant dermatologists at the Institute of Dermatologists are sharing a series of guides to help you understand rosacea, manage it day to day, and explore the treatment options available.

This is the first in the series, starting with the basics: what rosacea actually is, how it presents, who is most commonly affected, and when it is worth seeking specialist advice.

What Is Rosacea?

Rosacea is a chronic inflammatory skin condition that primarily affects the face. It is characterised by persistent redness, visible blood vessels, and in some cases, papules and pustules that are often confused with acne.

It is a long-term condition. It does not resolve on its own, and without appropriate management it tends to worsen over time. It goes through cycles of flare-ups and periods of relative calm, and triggers vary considerably from person to person.

One of the most important distinctions: rosacea does not involve blackheads. This is one of the key differences between rosacea and acne, and it matters when it comes to getting the right diagnosis and the right treatment.

Who Does Rosacea Affect?

Rosacea is more common than many people realise. It tends to affect:

• Adults between the ages of 30 and 60
• Fair-skinned individuals, particularly those with Irish, Scottish, or Northern European heritage
• Women, who are more frequently diagnosed, although men often develop more severe forms
• People with a family history of the condition

In Ireland, rosacea is particularly prevalent. Fair skin, a changeable climate, and a tendency to underestimate UV exposure year-round all contribute. At the Institute of Dermatologists, it is one of the most common reasons patients come to us for a skin consultation.

It is also frequently missed or misdiagnosed. Many patients spend years managing what they assume is sensitive skin, adult acne, or general redness, without realising they have rosacea. Getting a proper diagnosis is the first step toward managing it effectively.

The Four Subtypes of Rosacea

Rosacea is not a single, uniform condition. It presents differently depending on the subtype, and many patients have more than one at the same time.

1. Erythematotelangiectatic Rosacea

The most common presentation, particularly in Irish patients. This subtype involves persistent facial redness, visible broken blood vessels, and a tendency to flush easily. The skin can feel warm, sensitive, and reactive. Redness is typically concentrated across the cheeks, nose, chin and forehead.

2. Papulopustular Rosacea

Red papules and pustules on the face that closely resemble acne. Unlike acne, there are no blackheads or comedones. This subtype is particularly common in women in their 30s and 40s and is frequently confused with adult hormonal acne, which can lead to the wrong treatment approach.

3. Phymatous Rosacea

This subtype involves skin thickening and changes in texture, most commonly affecting the nose. It is known as rhinophyma and is more commonly seen in men. It is sometimes incorrectly associated with alcohol use, which is not supported by clinical evidence.

4. Ocular Rosacea

Rosacea can also affect the eyes, causing redness, irritation, sensitivity to light, and a persistent gritty or burning sensation. Ocular rosacea is often overlooked because it can occur independently of visible skin symptoms, and patients may not connect their eye discomfort to a skin condition.

Recognising the Symptoms

The symptoms of rosacea vary depending on the subtype, but common signs include:

• Persistent redness across the central face
• Visible broken blood vessels (telangiectasia)
• Flushing and blushing that occurs easily and lasts longer than expected
• A sensation of heat, burning or stinging in the skin
• Papules and pustules without blackheads
• Skin that feels rough, dry, or thickened
• Swelling in the central face
• Eye irritation, redness or sensitivity

Many people assume persistent facial redness is simply sensitive skin. Rosacea is a recognised chronic condition that responds well to treatment when correctly diagnosed.

When Should You See a Dermatologist?

We recommend booking a consultation if:

• You have persistent facial redness that does not settle
• You flush frequently and it is affecting your confidence or quality of life
• You have papules or pustules on your face that are not responding to over-the-counter products
• You notice visible broken blood vessels, particularly across the cheeks and nose
• Your eyes feel irritated, red, or gritty on a regular basis
• Your symptoms are becoming more frequent or more severe over time

A consultant dermatologist can confirm the diagnosis, identify the subtype of rosacea present, and recommend a personalised treatment plan. Early diagnosis leads to better long-term outcomes and reduces the risk of progression.

You can learn more about rosacea and book a consultation on our rosacea condition page.