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Rosy cheeks in children is often seen as endearing and sweet, this is especially so when they are flushed from running around happily, free of worries. While rosy cheeks in adults often happens when we blush due to certain situations, rosy cheeks accompanied by bumps can be something else entirely.

What is rosacea?

Rosacea is a chronic skin condition that is often mistaken as acne because it leaves your face, particularly your cheeks, nose, chin, or forehead, red, flushed, and bumpy1. 

There are 4 subtypes2 of rosacea, and each subtype is characterised by different signs and symptoms.

Subtype 1, erythematotelangiectatic rosacea (ETR)

• Swollen skin

• Sensitive skin

• Stinging or burning sensation on the skin

• Visible spider veins (broken blood vessels)

• Flushing (blushing) or redness on the cheeks, nose, chin, or forehead (middle of the face)

• Blush or flush easily compared to others

• Dry skin, scaling, or roughness

Subtype 2, papulopustular (or acne) rosacea

• Transient breakouts similar to acne

• Acne-like breakouts causing red skin

• Sensitive skin

• Stinging or burning sensation on the skin

• Oily skin

• Visible spider veins

• Raised areas of the skin known as plaques

Subtype 3, rhinophyma rosacea

• Bumpy skin

• Thickening skin, especially around the nose, but may also happen around the chin, forehead, cheeks, and ears

• Appearance of pores is enlarged

• Oily skin

• Visible spider veins

Subtype 4, ocular rosacea

• Dry eyes

• Itchy eyes

• Watery or bloodshot eyes

• Sensitivity to light

• Burning or stinging sensation in eyes

• Cyst on the eyelid

• Blurry vision

• Deterioration of eyesight

• Feeling of sand or something stuck in the eye

Scientific research has progressed and improved on the classification of different types of rosacea, and while all 4 subtypes have overlapping signs and symptoms, diagnosis and treatment of rosacea is best done using an individual’s presenting features3.

What causes rosacea?

The main cause of rosacea is still yet to be understood, however, there are a few factors that when combined can exacerbate your symptoms. 

These include:

• Exposure to sunlight

• Medications that cause your blood vessels to widen or dilate (vasodilators like blood pressure medications)

• Extreme temperatures

• Consuming spicy foods

• Alcohol

• Exercise 

• Emotions such as stress and anxiety

• Demodex mites (mites that live on everyone’s faces but tend to occur in large numbers on the face of someone with rosacea)

• Presence of the intestinal parasite known as H pylori

Is rosacea painful?

Unfortunately, in some cases, rosacea can be painful for individuals who experience symptoms such as sensitive skin, burning or stinging sensation on the skin, and itching. Rosacea may also have a social and emotional impact on an individual. Studies have shown that rosacea can cause adverse effects on quality of life, and the social and psychological well-being of an individual4.

Who is at risk of rosacea in Singapore?

Rosacea can occur in anyone, and scientist have yet to find the main cause of it, but the following factors could cause someone to be at a higher risk of getting rosacea:

• Between the ages 30 to 50 

• Fair skinned and often blonde with blue eyes

• Family history of rosacea

• Celtic or Scandinavian family history

• Overactive immune system

• Smokers 

How is rosacea diagnosed?

When you present to your dermatologist the signs and symptoms of rosacea, he/she will ask you questions about your medical history and conduct a thorough examination of your face to locate the presence of spider veins. Spider veins will help to distinguish rosacea from other skin conditions such as acne.

What are the treatment options for rosacea?

Although there is currently no cure for rosacea, early diagnosis and treatment can help control it and prevent its progression. Treatment for rosacea aims to control and reduce the signs and symptoms and to prevent flare-ups by identifying and avoiding triggers. Daily use of sunscreen is also a must when managing and treating rosacea.

Treatment often involves a combination of both oral and topical medication and good skin care. Every individual is different; therefore, your treatment is personalised based on your medical history, lifestyle, duration of rosacea, and severity of rosacea. 

Topical medications:

• To constrict the blood vessels and reduce redness, you may be prescribed a cream or gel to apply to the area 

• To control pimples, you may be prescribed creams or gels containing azelaic acid metronidazole 

Oral medications:

• Antibiotics for moderate to severe rosacea with bumps and pimples

• Acne medication that reduces skin bumps


• Laser light therapy to remove enlarged blood vessels

• Dermabrasion which removes the top layer of skin to reveal new skin beneath

• Carbon dioxide laser to reduce the thickness of skin

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