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What is rosacea?

Do you suffer from rosacea or from pyoderma faciale?

In rosacea and in PF we have no comedones.

Actually, here is my laywoman's speed-diagnosis:

If you have a red face with some monkey business going on, it's rosacea.

If you think your face is wearing a prosthetic from a horror movie resembling the lone survivor of an explosion in a leprosy colony, it's PF.

Still not sure?

Wait 24 hours. If it is PF, it won't disappoint.


This is from Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology 2013:

Rosacea is a common chronic inflammatory acneiform disorder of the facial pilosebaceous units. It is coupled with an increased reactivity of capillaries leading to flushing and telangiectasia.

May result in rubbery thickening of nose, cheeks, forehead, or chin due to sebaceous hyperplasia, edema, and fibrosis.

Occurence: Common, affecting approximately 10% of fair-skinned people. [fair as in light. not fair as in beautiful.]

Age of Onset: 30-50 years; peak incidence between 40 and 50 years.

Sex: Females predominantly, but rhinophyma occurs mostly in males.

Ethnicity: Celtic persons (skin phototypes I and II) but also southern Mediterraneans: less frequent in pigmented persons (skin phototypes V and VI, i.e. brown and black).

Duration of Lesions: Days, weeks, months.

No comedones. The early stages of rosacea often present by episodic erythema, "flushing and blushing," which is followed by persistent erythema, which is due to multiple tiny telangiectasias, resulting in a red face.

Recurrences are common. After a few years, the disease may disappear spontaneously; usually it is for lifetime.


Acneiform Eruptions in Dermatology - A Differential Diagnosis. Joshua A. Zeichner, M.D. (Editor). Springer, New York, 2014
Joseph Bikowski, M.D., Director, Bikowski Skin Care Center, 500 Chadwick Street, Sewickley, PA

[I've trimmed this article quite a bit. Here you can buy the book from Springer.]

Rosacea, a chronic, inflammatory skin condition, is estimated to affect ten million Americans.

Characterized by a centrofacial distribution of acneiform papules and pustules, diffuse erythema, and frequently but not always telangiectases

Although the disease is generally thought to be of primarily cosmetic consequence, patients have reported stinging and pain associated with rosacea, and functional impairments may result from severe rhinophyma. Control of rosacea is possible.

Rosacea is generally considered a disease that affects individuals in middle age; the incidence is shown to increase with age and peak in those over age 65. While the majority of individuals with rosacea are women (69 %), men may be prone to more severe presentations. The vast majority of rosacea patients (96 %) are Caucasian.

Environmental trigger factors may be associated with exacerbation of rosacea and may initiate the flushing and blushing response in susceptible individuals. The degree to which any individual is affected, if at all, by a given trigger is variable. Commonly cited triggers include thermally hot beverages or foods, alcoholic drinks, and/or spicy foods.

Rosacea may be mistaken for acne vulgaris, though the two are distinguished by the presence (acne) or absence (rosacea) of comedones. Furthermore, while rosacea’s centrofacial distribution includes the forehead, lesions are not typically present at the hairline. By contrast, lesions may be concentrated at the hairline in some acne presentations.

There are no diagnostic tests for rosacea.

Despite historic associations of rosacea with acne vulgaris, the two are of distinctly different etiologies, and there is no microorganism widely accepted as causative in rosacea.

Rosacea is a chronic, inflammatory facial dermatosis frequently confused with acne vulgaris.

While the papulopustular subtype of rosacea presents with pustules, other clinical features (such as centrofacial erythema and a lack of comedones) distinguish rosacea from acne.

This is the rosacea link to the

American Academy of Dermatology





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