Are there different types of rosacea?

I'm 52 and, in the past year, I've been getting what appear to be rashes on my cheeks. I have a close friend who's had rosacea since we were in high school so I'm familiar with how it looks and my rashes don't exactly resemble hers. Sometimes there will be blisters too. Are there different types of rosacea? Before seeking professional treatment, can you suggest a way for me to find out if it's rosacea or something completely unrelated? Its onset coincided with the beginning of my menopause. Is there a form of rosacea that's specific to menopause? Please let me know if you require further details.


F, 55, Tennessee

Tags:woman age 45-54 cheeks rosacea blister rash

Hi ElizabethK,

In general, there are several types of Rosacea: erythematotelangiectatic (associated with an overall red-appearing face and visible blood vessels), papulopustular (associated with red bumps and pustules), phymatous (red thickened skin, commonly of the nose), and ocular (mimics a stye and more often treated and/or diagnosed by an ophthalmologist).

Most often patients present with a combination of erythematotelangiectatic and papulopustular rosacea types - one usually more predominant than another. There have been great advancements to treatments of all types including laser treatments for resurfacing the skin and ablating (or destroying) the vessels that are visible, topical prescription therapies aimed at treating the overall redness and papules/pustules, and oral medications that help to lower inflammation and bacterial/demodex populations on the skin. Common topical brands used to treat rosacea are Finacea (azelaic acid foam or gel), Rosadan (metronidazole cream or gel), Soolantra (ivermectin cream), and most recently Rhofade (oxymetazoline HCL cream). 

There's no specific timeframe in which individuals would begin to suffer from rosacea, rather a general age group is expected to present with the condition: ages 30-50. Patients who are fair skinned with light colored eyes are also at a higher risk of rosacea. 

Information online can be helpful for honing in on what you're suffering from, but even specifically defining it one way or another can be a challenge. One of the most reliable resources with the best fact checking is with the American Academy of Dermatology (AAD). The photos you may find online can be a bit to the extreme, and sometimes doesn't always have the proper definition beneath it (I've seen plenty of "photos of psoriasis" that show psoriasis and other unrelated conditions like Mycosis Fungoides and Tinea Corporis - so don't believe all you read/see). 

I would advise you find a Board Certified Dermatologist and discuss your symptoms, onset, tried/failed therapies, etc. and work from there to find the best solution. And don't forget the sunscreen!

Good luck!

Jeanine Downie, MD