Disease of the Month – Rosacea

Shots:

Rosacea is a chronic skin condition characterized by facial redness, acne-like breakouts, and flushing. It may cause enlarged blood vessels and small pus pus-filled bumps

PharmaShots’ Disease of the Month report aims to educate a broad audience about health conditions that affect communities worldwide. These reports provide a comprehensive overview of disease, including their characteristics, types, symptoms, diagnostic approaches, available treatment options, epidemiology, market size, ongoing clinical trials, active patient advocacy groups (PAGs), and inspiring patient stories

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Rosacea affects around 14M people in the US alone. It is a common inflammatory condition that mostly begins after 30 and flares throughout life. It is often mistaken for acne, dermatitis, or other skin conditions [1]

Rosacea can be classified into four distinct categories: [1]

Erythematotelangiectatic: Causes persistent facial redness with visible blood vessels and flares

Papulopustular: Pus- or fluid-filled bumps develop on the skin. It is characterized by swelling on the skin, with symptoms like acne

Phymatous: Symptoms cause skin thickening and swelling, often making the nose bumpy or bulbous (rhinophyma)

Ocular: Rosacea can affect the eyes, causing irritation, light sensitivity, redness, and eyelid bumps (styes)

The exact cause of rosacea is unknown, but genetics, immune response, and lifestyle factors may play a role in triggering it. It is not caused by poor hygiene and isn’t contagious. [2]

Triggers for flare-ups may include:

Sun or wind

Hot drinks

Spicy foods

Alcohol

Very hot and cold temperatures

Emotional stress

Exercise

Drugs that dilate blood vessels, including some BP medicines

Some cosmetic, skin, and hair care products

Rosacea symptoms vary depending on the subtype: [3]

Signs of Erythematotelangiectatic:

Flushing and redness in the center of your face

Visible broken blood vessels

Swollen skin

Sensitive skin

Stinging and burning skin

Dry, rough, and scaly skin

Signs of Papulopustular:

Acne-like breakouts and very red skin

Oily skin

Sensitive skin

Broken blood vessels that are visible

Raised patches of skin

Signs of Phymatous:

Bumpy skin texture

Thick skin on the nose

Thick skin on the chin, forehead, cheeks, and ears

Large pores

Visible broken blood vessels

Signs of ocular:

Bloodshot and watery eyes

Eyes that feel gritty

Burning or stinging sensation in the eyes

Dry, itchy eyes

Eyes that are sensitive to light

Cysts on the eyes

Diminished vision

Broken blood vessels on the eyelids

To diagnose rosacea, a healthcare provider examines your skin and reviews your symptoms, possibly ruling out conditions like psoriasis or lupus. On people with colors, signs like flushing or spider veins may be less visible, so other symptoms like swelling, bumps, and stinging are key. Eye symptoms may require evaluation by an ophthalmologist. [2]

There is no cure for Rosacea. Though there are medications that relieve symptoms and prevent worsening. Options may include: [1]

Medicines: Oral and topical medications can reduce bumps, pimples, and redness, helping manage symptoms and limit flare-ups. Medications to treat rosacea symptoms may include:

Antibiotics like doxycycline (pills, gel or creams) to reduce bumps and pimples

Brimonidine gel to reduce redness

Creams or gels containing azelaic acid, ivermectin or metronidazole to minimize bumps and pimples

Laser treatment: Laser therapy can reduce redness and remove visible blood vessels

Surgical procedures: In severe cases, surgery may be recommended to correct nose disfigurement from rhinophyma

Global Incidence: Estimated to affect more than 5% of the worldwide population [4]

Age Group Most Affected: Commonly occurs in adults aged 30 to 50 years [4]

Gender Distribution: More prevalent in females than in males [4]

Skin Type Susceptibility: More frequently diagnosed in individuals with fair skin (Fitzpatrick phototypes I and II). Affects over 10% of the White population [4]

In 2025, the global rosacea treatment market was valued at $2.22B and is projected to reach $3.12B by 2030, growing at a CAGR of 7.1% [5]

MIRVASO (brimonidine) topical gel is an alpha-adrenergic agonist indicated for the topical treatment of persistent (nontransient) facial erythema of rosacea in adults 18 years of age or older [6]

Other approved therapies:

Rhofade (Mayne Pharma)

Mirvaso (Galderma)

Noritate (BAUSCH)

FINACEA (Leo Pharma)

METROGEL (Galderma)

SOOLANTRA (Galderma)

As of August 20, 2025, a significant number of active and inactive trials (Phase II and III) are concentrated in the US [7]

Numerous patient advocacy groups are dedicated to supporting individuals with rosacea and other allergic conditions, aiming to improve patient care, raise awareness, and promote research

Jenn Adele K [8]

Like most people with chronic illnesses, mine wasn’t easily diagnosable at first. In fact, I lived unknowingly with mine for about 20 years. It would’ve been impossible to diagnose my condition back then; my only outward signs were sensitive skin and a tendency to easily blush. In my twenties, I began seeking help. Since then, I’ve been diagnosed with allergies (environmental and dietary), dermatitis (acute and chronic), eczema, psoriasis, acne, etc. I’ve seen my fair share of doctors and endured a ton of screenings and prescriptions. But no matter what treatments I was given for whatever malady the professionals guessed I had, or how complete my remission seemed, my sensitive skin always came roaring back with a vengeance.

In 2017, and I’m still seeking answers. Months ago, I finally found the answer to the riddle: rosacea. The pattern fits. It fits so perfectly with what others tend to experience that I am awash with a mixture of feelings – relief, sadness, uncertainty, fear, a glimmer of understanding and the early stages of acceptance. Rosacea is not my fault. Nothing I could’ve done would’ve changed this outcome. And though I now have effective medication, it’s no one’s fault that all the previous treatments for the other conditions failed. Of course they failed. They weren’t suited to rosacea.

In the grand scheme of things, nothing much has changed since my most current diagnosis. “Rosie” (as I like to call her) has been with me for decades. The only difference now is that I have a basis for understanding her better and more knowledge about what needs to be done to keep us both healthy, and by extension happy.

Living with Rosie isn’t always easy. She’s a bit nervous and reactive (and she can make me feel this way too!) Her moods and needs can change from day to day depending on environments, weather patterns, sun exposure, stress, dietary balance, and many more lifestyle factors. My skin can go from being completely serene in the morning, to itchy, red and bumpy in the afternoon (delivering a blow to my self-confidence), to near perfect again by bedtime. But what I’m discovering along my journey with her is that she has her reasons for her mood swings.

Deep down, I suspect Rosie is trying her best to protect me, warning me away from aspects of life that would otherwise do me a great deal of harm: UV damage (my own mother suffered with skin cancer), harsh chemicals, synthetics, poor dietary choices for my body chemistry, toxic relationships, and ill-suited work environments, as well as choices that aren’t authentic to who I truly am and what I really want for myself. Rosie keeps me real. If I’m on track, so is she… generally.

Rosie has also opened up a wealth of compassion within me, for others and myself. I’m not as brash or judgmental as I used to be. I see and sense suffering in others where I would’ve missed it before. And I understand in a very visceral way what it is to hurt, to tolerate, to endure, to be frustrated, to feel less than, to be afraid, to be tired, and to be the one not in control of what I experience moment to moment. I also know what it means to release and to let go. To mourn and to move on. To make lemonade out of those proverbial lemons. Because, in the end, Rosie is mine for life. She’s not my enemy unless I make her so. She’s a long misunderstood friend, a sister, a guiding beacon with a uniquely rosy glow.

Lex [9]

I’m Lex, and I have rosacea. Rosacea is a chronic skin condition that mainly affects the face. It can present as facial redness, flushing, swelling, pustules, ocular issues, and – in severe instances – thickening of the skin.

I was 21 when I was diagnosed with rosacea. It was hard to hear that I had an incurable skin condition and I was given no real support or plan to help me, which felt devastating. I found it difficult to accept my diagnosis and I felt isolated.

In those early days, my skin made me incredibly self-conscious and upset. It would be hard to forget about even if I wore makeup, as my skin would be hot, itchy and would swell up.

Because rosacea is exacerbated by stress, I would get into a painful cycle of having a flare up, panicking about the flare up, which made it worse, which would make me panic more. It was really hard to break that cycle once it got going, especially as I still didn’t really understand what rosacea was.

The anxiety I had about my rosacea would manifest in compulsive checking of my skin. I would touch my face to see if it felt warm, I would check my reflection in every mirror I could to see if my make up was still covering my skin, and I would obsessively ask friends and family if I looked okay. I could never enjoy myself fully as I was petrified that my skin was going to flare up or that someone would notice it.

I would get very upset if someone mentioned my skin or made a joke about it. As I got to know more about my skin and gained a little confidence, I would deflect these situations with humour or by pointing out the rudeness of people’s comments.

Because of all this, my self-esteem and confidence has been severely impacted over the years, something I’m still repairing now. I would cancel dates, wouldn’t see friends and would refuse to be seen without extremely high coverage make up. I would also feel guilty for indulging in things that I knew would trigger my skin.

It also affected my career at one point. I’ve cancelled job interviews and called in sick when I just couldn’t face people seeing me. I wouldn’t put myself forward at work if it meant speaking publicly or being involved in large meetings with people who didn’t know me.

One of my lowest points was when I stood in front of a large team of colleagues to present some work. A member of the team interrupted my opening speech to say that I looked flustered and if I wasn’t ready for the meeting, we could postpone it. I have never been so embarrassed, deflated, and upset. I cried in the bathrooms for close to an hour – which did not help my flare up!

Looking back, my rosacea developed at a formative time in my life, when I was away from home for the first time and trying to make friends and become my own person. It impacted how I saw myself and related to others. I’ve had therapy in recent years to try to unpick some of this trauma.

It’s taken a lot of work to feel comfortable in my skin. Not only to feel confident to show my skin to others, and to be ok with rosacea showing day to day, but also to know that no matter how my skin looks, I am still worthy of love, respect and care.

This has been a good breakthrough, considering the media we are exposed to in every part of our lives is obsessed with perfection and portrays an unrealistic idea of what ‘beauty’ should look like. It has been freeing to realise that comparing myself to that beauty standard was not only pointless but also hurting my recovery. The only person I can compare myself to is myself: is my skin happier than it was this time last year? Is it more resilient? Do I think about my skin less than I used to? Am I able to look in the mirror and be kinder to the person looking back at me? These are the things that matter.

Advances in dermatologic care are paving the way for managing common conditions like Rosacea and helping patients like Jenn and Lex tackle the symptoms with confidence.

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