Definition: Rosacea is an inflammatory skin disorder of unknown aetiology, usually beginning at middle age or later. It begins as flushing and redness on the central face and across the cheeks, nose, or forehead but can also less commonly affect the neck, chest, scalp or ears. The disorder can be confused and co-exist with acne vulgaris and/or seborrheic dermatitis.

The precise pathogenesis of rosacea still remains unknown, but it is thought that rosacea is a disorder where the blood vessels become damaged when repeatedly dilated by stimuli, causing the vessels to readily dilate and remain dilated for longer periods of time or permanently, resulting in flushing and redness. Papulopustular rosacea occurs as immune cells and inflammatory mediators leak from the microvascular bed causing inflammatory pustules and papules. Helicobacter pylori infection is implicated as a causative factor.

Common signs and symptoms of rosacea include:
• Flushing and easy blushing
• Permanent redness
• Red pustules
• Red gritty eyes
• Burning and stinging sensations on the skin
• Small blood vessels visible near the surface of the skin
• Bulbous nose, with thickening of the skin and nodules (Rhinophyma, in phymatous rosacea)
• Increased Demodex mite count                                                                                                                                                         
• Depression stemming from cosmetic disfigurement, painful burning sensations, etc

• Exposure to temperature extremes can cause the face to become flushed as well as strenuous exercise, heat from sunlight, severe sunburn, stress, cold wind, moving to a warm or hot environment from a cold one such as heated shops an d offices during the winter. There are also some foods and drinks that can trigger flushing, these include alcohol, foods high in histamine and spicy food.