Rosacea Diagnosis

Patients may be diagnosed with rosacea who have a combination of signs & symptoms which may or may not be specific to this disease. Therefore, when diagnosing rosacea other diseases should also be considered:

As there are also variants of this disease such as ocular rosacea (which affects the eyes), a standard classification system has been developed by the United States National Rosacea Society to aid correct diagnosis.

The classification system uses diagnostic criteria which assesses both primary & secondary features (signs & symptoms) of rosacea.

Primary Features: the presence of one or more of these features is indicative of rosacea.

  • flushing - (transient erythema)
  • persistent redness of the face - (non transient erythema)
  • bumps & pimples - (papules & pustules)
  • visible blood vessels - (telangiectasia)

Secondary Features: a person with rosacea may also experience any of the following features
- in some cases they may occur independently

  • burning or stinging
  • plaques - raised red patches of skin
  • dry appearance to the skin
  • swelling - edema
  • eye irritation - e.g. burning or itching of the eyes, inflammation of the eye lid
  • affected areas beyond the face - features of rosacea can also occur on other areas including the neck chest scalp & ears.
  • skin thickening - phymatous changes such as rhinophyma

Subtypes Of Rosacea

When making a diagnosis, combinations of the signs and symptoms listed above can be compared to those features which characterize a particular subtype of rosacea.

Subtype 1: Erythematotelangiectatic rosacea

Characterized by

  • flushing
  • persistent central facial erythema - reddening of the skin due to capillary action
  • other symptoms may include:
    • telangiectasia - small red lines showing through the skin
    • burning & stinging sensations
    • roughness or scaling
Subtype 2: Papulopustular rosacea

Characterized by:

  • persistent central facial erythema
  • transient papules and/or pustules
  • other symptoms may include:
    • comedones
    • burning & stinging sensations
    • telangiectasia
Subtype 3: Phymatous rosacea

Characterized by:

  • thickening skin
  • irregular surface nodulations& enlargement
  • can affect the nose, chin, forehead, cheeks or ears
  • other symptoms may include:
    • patulous
    • follicles in the phymatous area
    • telangiectasia
Subtype 4: Ocular rosacea

Ocular rosacea affects the eyes. It is characterized by one or more of these features of the eye:

  • watery or bloodshot appearance
  • foreign body sensation - feels like sand or grit is in the eye
  • burning and/or stinging
  • dryness
  • itching
  • photosensitivity - eyes becomes sensitive to light
  • blurred vision
  • telangiectasia
  • other symptoms may include:
    • blepharitis
    • conjunctivitis
    • irregularities of the eyelid margins