Rosacea ICD-10: L71.9

Chronic inflammatory skin condition

Often searched as: red face that won't go away, flushing cheeks and nose, pimples on cheeks no blackheads, visible blood vessels on face, red bumpy nose, face turns red from heat or wine, rosacea photos, rosacea treatment…

Clinical urgency level

lowmediumhigh

Systems Affected

skin (central face)eyes (ocular rosacea — in ~50% of patients)

Severity Levels

mild

Episodic flushing and mild persistent redness on the central face, no papules or pustules — manageable with trigger avoidance and topical treatments (metronidazole, azelaic acid).

moderate

Persistent erythema with papules and pustules, telangiectasia, and moderate eye involvement — requires combination topical and oral treatment (doxycycline).

severe

Phymatous rosacea (tissue overgrowth, especially rhinophyma — enlarged red bumpy nose), severe ocular rosacea with corneal involvement, or extensive inflammatory rosacea resistant to standard treatment — requires specialist care and possible laser or surgical intervention.

Red Flags

Eye redness, irritation, blurred vision, or light sensitivity (ocular rosacea — risk of corneal damage if untreated)
Rapidly enlarging nose with thickened skin (rhinophyma — mostly in men, requires early treatment to prevent disfigurement)
Pustular rosacea not responding to antibiotics after 8 weeks
Facial redness in a patient on corticosteroids — steroid-induced rosacea or perioral dermatitis
New-onset severe facial flushing with systemic symptoms (sweating, diarrhea, palpitations) — rule out carcinoid syndrome

Clinical Presentation

Rosacea — erythema, telangiectasia, and papulopustular lesions on the central face

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Rosacea image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

See a dermatologist if you have persistent facial redness, visible blood vessels, or recurring pimple-like bumps on the central face — especially if they come and go with triggers like sun, heat, or alcohol. Ocular rosacea (eye irritation, dryness, redness) should be evaluated by both a dermatologist and ophthalmologist. Early treatment prevents progression to permanent skin changes.

Differential Diagnosis

Acne vulgaris (has comedones — rosacea does not; different distribution)
Seborrheic dermatitis (greasy, scaly — affects nasolabial folds and scalp)
Perioral dermatitis (small pustules around mouth — often from topical steroids)
Lupus erythematosus (butterfly rash — photosensitive, systemic symptoms)
Carcinoid syndrome (flushing with systemic symptoms — measure urinary 5-HIAA)
Demodicosis (Demodex mite overgrowth — may coexist or mimic rosacea)

Comorbidities

Ocular rosacea (blepharitis, conjunctivitis, keratitis — ~50% of rosacea patients)
Demodex folliculorum overgrowth (contributes to rosacea pathogenesis)
Helicobacter pylori infection (debated association)
Cardiovascular disease (some association with chronic systemic inflammation)
Depression and anxiety (chronic visible facial condition has significant QoL impact)

Prognosis

Rosacea is a chronic condition with no definitive cure, but it is highly manageable with appropriate treatment and trigger avoidance. Most patients achieve good control with topical treatments (metronidazole, azelaic acid, ivermectin) and/or low-dose oral doxycycline. Vascular laser and IPL treatments are very effective for persistent redness and telangiectasia. Rhinophyma, if left untreated, requires surgical debulking. Ocular rosacea requires long-term ophthalmologic management to protect corneal health. With good management, most patients maintain clear or nearly clear skin.

Detailed Overview

Causes, Symptoms, and When to Take Action Rosacea is a chronic inflammatory skin condition that most commonly affects the face. It can cause persistent redness, visible blood vessels, and sometimes small, red, pus-filled bumps. While not dangerous, rosacea can significantly impact a person's self-esteem and quality of life if left unmanaged. How It Looks Texture: May include dry, rough patches or swelling Color: Redness across cheeks, nose, forehead, or chin Shape: Diffuse or localized redness, with or without bumps Location: Primarily the central face, but can also affect eyes and scalp Why Does It Appear? Genetics, immune response dysregulation, Demodex mite overgrowth, environmental triggers (sun, heat, cold, wind), lifestyle factors (alcohol, spicy foods, stress), and microbiome imbalance all contribute. Should You Be Concerned? Rosacea is chronic and can worsen over time if not managed. Seek medical attention if flushing becomes persistent, bumps or pustules appear, eye irritation occurs, or redness spreads. Can You Prevent It? Use gentle skincare, daily SPF 30+ sunscreen, avoid hot beverages and spicy foods, manage stress, and track your symptoms to identify patterns. 👉 How Piel AI Can Help Piel AI helps users monitor visible skin changes over time, track redness patterns, and compare images to spot changes worth discussing with a dermatologist. Summary Rosacea is a chronic but manageable inflammatory skin condition. Common signs include redness, bumps, and eye irritation. Flare-ups are often triggered by sun, heat, diet, or stress. Early detection and lifestyle adjustments can greatly improve outcomes.

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