Rosacea: Online Diagnosis and Treatment

Rosacea is an inflammatory skin condition that causes skin redness and a rash on the central face and cheeks. It can also cause eye irritation and redness, as well as vision problems. Rosacea symptoms can come and go, with flares triggered by factors such as sun exposure and emotional stress. While there is currently no cure for rosacea, treatment is available to alleviate symptoms and reduce flare-ups.

More than 16 million people in the U.S. are affected by rosacea. This is estimated to be between 1.3% and 2.1% of U.S. adults but may be as high as 5%.¹ Worldwide, the prevalence of rosacea is estimated to reach 5%.² Men and women are equally affected.³

Rhinophyma (thickened and bulbous swelling of the nose) predominantly affects men. Flushing and redness are usually the first signs of disease in younger people, and dilated blood vessels are more common in older adults. Due to the visibility of the rash, comorbid psychological symptoms are common.⁴

Scheduling a consultation with a virtual doctor on the Telegra MD telehealth platform for rosacea diagnosis and treatment is simple and convenient. You will receive a diagnosis, a treatment protocol, and an appropriate online prescription to treat rosacea. Telehealth for rosacea treatment makes it easy to consult with a virtual doctor and receive prescription medication to treat your rosacea quickly and easily, even if you don’t have insurance. Schedule an appointment today to learn whether you might have rosacea and receive a personalized treatment plan to improve your skin appearance.

What Is Rosacea?

Rosacea is a chronic inflammatory skin condition that primarily affects the face. It causes redness, flushing, and visible blood vessels. Many people also experience eye-related symptoms. The exact cause of rosacea is unknown, but a combination of genetic predisposition, exposure to environmental triggers, and immune factors is thought to be involved. According to twin studies, family history and genetic predisposition account for approximately half of your rosacea risk.⁵  

What Are The Common Symptoms Of Rosacea?

Rosacea symptoms may vary by person. Most people don’t experience all these symptoms:

• Facial redness
• Rough skin
• Scaliness
• Red or pus-filled bumps and pimples
• Enlarged, visible blood vessels
• Skin thickening
• Eye irritation
• Eye redness
• Watery eyes
• Dry eyes

According to the American Academy of Dermatology, the National Rosacea Society Expert Committee classifies rosacea signs and symptoms into four main subtypes:^4,6

Type 1 Rosacea

Erythematotelangiectatic or vascular rosacea is characterized by facial redness, flushing, and visible blood vessels.

Skin-related signs and symptoms include:

• Redness
• Easy flushing or blushing
• Skin sensitivity
• Swelling
• Dryness
• Scaliness
• Roughness
• Visible blood vessels

Type 2 Rosacea

Papulopustular rosacea or inflammatory rosacea is characterized by acne-like breakouts

Signs and symptoms include:

• Acne-like breakouts
• Skin sensitivity
• Visible blood vessels
• Raised rough patches

Type 3 Rosacea

Phymatous rosacea is characterized by thickened skin, increased gland size, and a bulbous appearance to the nose.

Signs and symptoms include:

• Skin thickening
• Visible blood vessels
• Bumpy skin texture
• Enlarged pores

Type 4 Rosacea

Ocular rosacea is characterized by having eye and eyelid symptoms.

Signs and symptoms include:

• Dry eyes
• Itchiness
• Watery eyes
• Eye redness
• Eye burning or stinging
• Sensitivity
• Visible blood vessels on eyelids
• Eyelid cysts
• Blurry vision

This classification system can be useful in understanding the full spectrum of rosacea signs and symptoms, but it is important to recognize that the types are not mutually exclusive. Many people have symptoms that fall into multiple categories.

Can Rosacea Be Treated Through Telehealth?

Consulting a medical professional via telehealth is a convenient way to diagnose and treat rosacea. You can schedule an online medical consultation appointment with a virtual doctor using the Telegra MD platform and receive a personalized treatment plan. Your virtual doctor can give you tips on managing your symptoms and call your online prescription to a local pharmacy. Online doctors who prescribe rosacea treatment medications provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Are Some People at Increased Risk for Rosacea?

Anyone can be affected by rosacea, but it is more common in the following groups:

• Women, especially middle age or older
• Fair-skin individuals

Some triggers have been identified that can initiate or aggravate rosacea symptoms.

Common triggers include:^3,5,7,8

• Ultraviolet radiation (sun exposure)
• Wind exposure
• Cigarette smoke
• Spicy foods
• Hot or cold temperatures
• Alcohol consumption
• Emotional stress
• Strenuous exercise
• Certain skin care products and cosmetics
• Warm beverages
• Medications: topical steroids, niacin, beta-blockers
• Microorganisms
• Menstruation
• Dermodex mites
• Marinated meats
• Dairy products

How Do You Diagnose Rosacea?

Rosacea is a clinical diagnosis. Your doctor will review your symptoms and triggers and conduct a physical exam.  

The diagnosis of rosacea is made based on the 2016 global rosacea consensus. The consensus is that one diagnostic or two major phenotypes are required to diagnose rosacea.

Diagnostic rosacea features include:⁶

• Persistent central facial redness that is aggravated by trigger factors
• Phymatous changes (thickened skin, bumpy nose tip)

Major phenotypic features associated with rosacea include:

• Flushing
• Inflammatory papules and pustules
• Dilated blood vessels (telangiectasia)
• Eye symptoms: lid margin telangiectasia, eye redness, eye inflammation

Secondary rosacea features include:

• Burning sensation
• Stinging sensation
• Swelling
• Skin dryness
• Eye crusting
• Eyelid irregularities

How Do You Treat Rosacea?

In all four subtypes of rosacea, avoiding triggers and cleansing skin with mild cleaning and moisturizing agents is essential. Choose fragrance- and abrasive-free cleanser with a mildly acidic to neutral pH. Keep a journal to identify triggers and track your response to treatment. Wearing wide-brimmed hats and using broad-spectrum sunscreens is also important.

Avoid the following types of skin care products:³

• Astringents
• Toners
• Abrasives
• Alcohol-based products
• Acetone-based products
• Menthol or camphor-based products

FDA- Approved Rosacea Treatment:³

• Topical metronidazole, sodium sulfacetamide, or azelaic acid to reduce inflammation and redness
• Topical brimonidine for redness and erythema due to dilated blood vessels
• Topical ivermectin for inflammation in papulopustular rosacea
• Oral antibiotics: doxycycline

Other Rosacea treatment options

• Topical benzoyl peroxide, isotretinoin, or tretinoin to reduce oiliness
• Laser or light-based therapies to treat telangiectasia (dilated blood vessels)
• Oral antibiotics: tetracycline, minocycline, clarithromycin
• Beta-blockers such as carvedilol can reduce flushing
• Tacrolimus reduces itching and inflammation

Ocular rosacea treatment options:

• Lid hygiene: artificial tears, warm compresses, cleanse the eyelashes with baby shampoo
• Topical cyclosporine to reduce redness
• Topical or systemic antibiotics

When Should You See a Doctor for Rosacea?

If you have symptoms consistent with rosacea, see a doctor as soon as possible. Early diagnosis and treatment can prevent the condition from getting worse.

The first sign of a rosacea flare is typically redness, but your symptoms may vary, and several other skin conditions have symptoms that overlap with rosacea. Talk to a doctor to learn more about rosacea and determine whether you might have it. Early treatment can improve skin appearance and prevent complications.

Telehealth for rosacea is the perfect option. You can schedule an online appointment with a virtual doctor using the Telegra MD platform and receive a diagnosis based on rosacea symptoms. Your virtual doctor can give you tips on preventing further skin damage and call in a prescription to a local pharmacy. Online doctors who treat rosacea provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Obtaining a rosacea treatment plan after seeing a doctor online through telemedicine is similar to seeing your local doctor. In both cases, you would:

• Make an appointment: Typically, appointments to see virtual doctors through telehealth are much easier to make and are more convenient than in-person appointments, as many telemedicine companies provide online telehealth services for rosacea treatment at any time, day or night.
• Provide a medical history: Whether completing forms in your local doctor’s office or online before consulting with your virtual doctor, you will need to provide a medical history.
• Consult with your doctor: After reviewing your medical history forms, your virtual doctor will discuss your rosacea treatment options.
• Treatment: After deciding on an optimal and personalized treatment plan for rosacea, your virtual doctor will transmit your prescriptions to your local pharmacy.

Frequently Asked Questions

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Elewski BE, Draelos Z, Dréno B, Jansen T, Layton A, Picardo M. Rosacea—global diversity and optimized outcome: proposed international consensus from the Rosacea International Expert Group. J Eur Acad Dermatol Venereol. 2011;25(2):188-200.

2. Tan J, Berg M: Rosacea: current state of epidemiology. J Am Acad Dermatol. 2013; 69(6 Suppl 1): S27–35.  https://doi.org/10.1016/j.jaad.2013.04.043

3. Oge’ LK, Muncie HL, Phillips-Savoy AR. Rosacea: Diagnosis and Treatment. Am Fam Physician. 2015 Aug 1;92(3):187-96. PMID: 26280139.

4. Buddenkotte J and Steinhoff M. Recent advances in understanding and managing rosacea [version 1; peer review: 3 approved]. F1000Research 2018, 7(F1000 Faculty Rev):1885 (https://doi.org/10.12688/f1000research.16537.1)

5. Anzengruber F, Czernielewski J, Conrad C, et al. Swiss S1 guideline for the treatment of rosacea. J Eur Acad Dermatol Venereol. 2017;31(11):1775-1791.doi:10.1111/jdv.14349

6. Gallo RL, Granstein RD, Kang S, et al.: Rosacea comorbidities and future research: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2018; 78(1): 167–70. https://doi.org/10.1016/j.jaad.2017.06.150

7. Ahn CS, Huang WW. Rosacea Pathogenesis. Dermatol Clin. 2018 Apr;36(2):81-86. doi: 10.1016/j.det.2017.11.001. Epub 2017 Dec 15. PMID: 29499802.

8. Thiboutot D, Anderson R, Cook-Bolden F, et al. Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2020;82(6):1501–1510. doi:10.1016/j.jaad.2020.01.077