Rosacea subtypes: the importance of knowing yours

Rosacea is a chronic condition that can cause a lot of frustration when first trying to figure it out. If you’re newly diagnosed, it can be a whirlwind trying to learn what’s what. It physically affects skin by causing redness, visible blood vessels, and small bumps. It mainly affects the face, particularly the cheeks and nose and can come and go.

What causes rosoacea?

We’ve come a long way in the discovery of rosacea and there have been a lot of life changing breakthroughs. But we’re still not entirely sure of the cause. It does seem that rosacea tends to run in families. There hasn’t been research done to support this but observations have been made. 

Abnormalities in facial blood vessels could also contribute to whether you will develop rosacea or not. If the blood vessels easily dilate this can cause redness and flushing.

Triggers of rosacea

Although the exact cause of rosacea isn’t clear, there are a number of things that can trigger it leading to flare-ups. These include: 

• Hot drinks 
• Alcohol, particularly red wine and beer
• Exposure to sun or wind
• Stress or anxiety
• Exercise
• Certain foods
• Certain cosmetic, skin or hair products

The 4 rosacea subtypes

Rosacea is well known to vary from person to person. No two people are the same. The symptoms and triggers of someone else with rosacea can be totally different to your own. This doesn’t make things easy when you’re trying to get a diagnosis. Well, try not to worry too much. Thanks to the decades of research undertaken by dermatologists and experts, rosacea has now been broken down into four main subtypes.

Knowing which one you’re dealing with is really important so that you can treat it properly. There is no one size fits all, as with the different subtypes there are different symptoms and different skin types.

1. Erythematotelangiectatic rosacea

Erythematotelangiectatic rosacea is quite a mouthful, we know. For short it’s often just called ETR or subtype one rosacea.  This is the type of rosacea people tend to picture when they think of the condition. Subtype 1 rosacea causes persistent facial redness and can be a tricky one to treat. You might also notice small red veins visible on the surface of the skin. You can find the redness on the nose, cheeks, forehead, and chin. 

Subtype 1/ETR is associated more often with dehydrated, tight feeling skin, whereas subtype 2 is linked more with oily skin. Again, rosacea is tricky and what’s the “norm” mightn’t necessarily ring true for you. Due to the nature of ETR opposed to the other subtypes, it has its own recommended treatments.

2. Papulopustular rosacea

Papulopustular rosacea (commonly referred to as “acne rosacea”) is the second subtype also known as type 2. As you might guess, this is the one that causes acne-like breakouts of red bumps or pimples.

People with this subtype often also notice a burning, stinging sensation. The key difference to acne is that there aren’t generally blackheads or whiteheads when rosacea is the culprit. There is no known connection whatsoever between acne and rosacea. This name “acne rosacea” can lead to confusion and wrong self-diagnosis. If either condition is mistaken for the other and incorrectly treated, symptoms can worsen. Subtype 2 rosacea can happen alongside the symptoms of redness and flushing that are associated with subtype 1 ETR.

3. Rhinophyma/Phymatous rosacea 

Phymatous rosacea is the third subtype. This is the subtype which causes thickening of the skin and the most common presentation of this is rhinophyma (which affects the nose). This is a more rare form of rosacea and is found more commonly in men.

Time and time again studies have shown that women are 3x more likely to develop rosacea. But men shouldn’t be overlooked, especially when it comes to rhinophyma. Subtype 3 is the type of rosacea men are much more prone to which leads to the nose enlarging, and it happens mostly around the age of 50+.

4. Ocular rosacea 

This is the final subtype (type 4) and affects the eyes and/or eyelids. This can make the eyes and eyelids red and sore as well as causing dryness, irritation, and sensitivity to light. Unlike the other subtypes, ocular rosacea doesn’t always come with skin symptoms. This is the type that usually needs systemic treatments like oral antibiotics (eg. doxycycline) to prevent these eye issues. In the case of ocular rosacea, your dermatologist will often work closely with an ophthalmologist to make sure you get the right treatment. 

The best treatment for your rosacea will really depend on the subtype and symptoms that you have, and their severity. This is why it’s really important to know your subtype as well as your phenotypes (a fancy word for symptoms) to make sure you are being treated properly. Some doctors and dermatologists will treat rosacea as simply that - rosacea, all in one bucket. This is why it’s important to know yourself, your subtype and never be afraid to advocate for yourself!

All Finca Skin Organics products have one thing in common. They are all made using a minimal, plant-based ingredients list and formulated by me, a rosacea sufferer. The Finca Skin Organics range has undergone a Harley Street clinical study. After using our products, 87% felt the appearance of their skin significantly improved. 

View the entire range of Finca products here or find out what subtype your skin is.

When in doubt, always refer to your doctor or dermatologist as the condition differs for everyone. It’s always best to talk to your dermatologist first and work out your treatment plan together.

If you have any queries regarding your rosacea or how to use our products get in contact with us, we'd love to hear from you.

With love from Ireland,

Finola

*Clinical evaluation by Harley St. dermatologists on 23 subjects after 8 weeks of use.