It typically begins as redness on the cheeks, nose, chin or forehead that may come and go. Over time, the redness tends to become more persistent, skin swelling and visible tiny blood vessels appear and small bumps often develop. In some patients the eyes are also affected and may be watery or bloodshot, and even cause gritty discomfort.
Rosacea is characterized by flare-ups and remissions. In long standing and severe cases the nose may grow swollen and lumpy from excessive tissue (rhinophyma).
There are 4 types of rosacea, and patients may experience characteristics of more than one type at the same time.
Erythemato-telangiectatic rosacea - characterized by flushing and persistent redness, with multiple visible tiny blood vessels.
Papulopustular rosacea- characterized by persistent redness with transient bumps and pimples.
Phymatous rosacea- characterized by skin thickening, often resulting in an enlargement of the nose from excessive tissue buildup.
Ocular rosacea- characterized by dry eyes, tearing and burning, swollen eyelids, and potential vision loss from corneal damage. Referral to the ophthalmologist may be required for severe cases.