RosaceaNet Article
Classification May Help More Recognize Rosacea
and Seek Treatment

According to a Gallup survey, 78 percent of Americans do not know that rosacea exists. This means that they cannot recognize the first signs and symptoms and seek medical attention in the earliest stages before the disease begins to affect everyday life. As the population ages and more Americans enter the years when rosacea is most likely to develop, between the ages of 30 and 60, it becomes increasingly important to recognize these signs and symptoms.

A standard classification system that was recently developed by a group of rosacea experts from around the globe can help identify rosacea. Created to aid dermatologists, primary care physicians, researchers and others in diagnosis and communication of research findings, this classification system clearly defines the signs and symptoms. Since signs and symptoms usually vary from person to person, the system identifies primary and secondary features (signs and symptoms) of rosacea and four subtypes. A subtype exists when primary and secondary features of rosacea commonly occur together.

If you have any of the primary or secondary features or believe that one of the subtypes describes you, be sure to consult a dermatologist. Rosacea rarely clears up without treatment. Left untreated, it usually becomes worse and more difficult to treat. As rosacea progresses, it can bring significant social and emotional effects that some say are worse than the physical ones. With treatment and lifestyle modifications, rosacea can be effectively controlled.

Primary Features
According to the standard classification system, the following signs are the primary features of rosacea and having one or more of these on the central face indicates rosacea:

  • Flushing that comes and goes

  • Persistent flushing

  • Bumps and pimples

  • Visible blood vessels

Secondary Features
Rosacea sufferers with primary features also tend to have one or more of the following signs and symptoms, which are the secondary features. However, some people may experience only one or more of these secondary features:

  • Burning or stinging of facial skin

  • Raised red patches

  • Appearance of dry skin

  • Facial swelling

  • Eye problems, such as burning or itching, sties or chalazia (cyst of the eyelid)

  • One or more primary feature (listed above) on another area of the body

  • Thickening of the skin, such as in rhinophyma

Subtypes
The experts defined four distinct subtypes (when primary and secondary features commonly occur together), and they agree that rosacea patients may have the signs and symptoms of more than one subtype at the same time.

Click on the photo to see an enlarged image and caption
 

Subtype 1: Facial Redness
Signs and symptoms:

  • Flushing and persistent redness of the central face (main characteristic)

  • Telangiectasia often seen

  • Swelling of the central face

  • Stinging and burning

  • Roughness or scaling

  • A history of flushing (This alone is common among patients with this subtype.)

Subtype 1

 


Subtype 2: Bumps and Pimples
Signs and symptoms:

  • Papules or pustules that come and go combined with persistent facial redness, primarily on the central face

  • Burning and stinging may occur

  • Telangiectasia may be present
     

Subtype 2

 


Subtype 3: Skin Thickening
Signs:

  • Thickening skin

  • Irregular nodularities and enlargement, especially of the nose—may also occur on the chin, forehead, cheeks and ears

  • Telangiectasia or large pores may appear in the affected area

  • This subtype frequently observed following or in combination with another subtype

Subtype 3

 


Subtype 4: Eye Irritation
This subtype affects the eyes, which may show one or more of the following signs and symptoms:

  • Watery or bloodshot appearance

  • Sensation of a foreign body

  • Burning or stinging

  • Dryness

  • Itching

  • Light sensitivity

  • Blurred vision

  • Telangiectasia of the eye or eyelid

  • Cyst on the eyelid

  • Decreased visual sharpness

Subtype 4

 

Loss of vision poses a serious risk with this subtype, and an ophthalmologist (physician who specializes in treatment of eye diseases) may need to be consulted when signs and symptoms affect the eye.

Signs and symptoms that occur when rosacea affects the skin are also usually present in Subtype 4, but not always.

Treatment
Treatment is available for all of the signs and symptoms listed above. When diagnosed and treated in the early stages, treatment can control rosacea and sometimes reverse progression of this disease. For information about how dermatologists treat rosacea, see Treatments.



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