Rosacea (sometimes referred to as acne rosacea) is a chronic skin disease of unknown aetiology.

• sunlight and alcohol may exacerbate symptoms

Features

• typically affects nose, cheeks and forehead
• flushing is often first symptom
• telangiectasia are common
• later develops into persistent erythema with papules and pustules
• rhinophyma
• ocular involvement: blepharitis

Management

Conservative management

• recommend daily application of a high-factor sunscreen
• camouflage creams may help conceal redness

Medical management

• For papulopustular variants: Topical azelaic acid, topical metronidazole, topical ivermectin, oral antibiotics (such as tetracyclines)
• topical brimonidine gel or oral propanolol may be considered for patients with predominant flushing but limited telangiectasia
• For ocular rosacea: Warm compress, massage, and lubricants. Referral to ophthalmology may be necessary.