Erythematotelangiectatic rosacea (ETR) can cause red or discolored and irritated skin, but many treatment options are available to help ease symptoms.
Rosacea is a chronic skin condition that primarily affects the face. ETR is a type of rosacea characterized by skin redness or discoloration, flushing, and visible blood vessels. It may also cause pain and discomfort.
Although there’s no cure for ETR, the right treatment can help to manage the condition and alleviate its symptoms.
This article lists the symptoms and causes of ETR and provides information on its diagnosis and treatment.
Symptoms of ETR may include:
- redness or discoloration and flushing in the center of the face, especially the cheeks, nose, and forehead
- broken blood vessels, called “spider veins”
- swollen skin that may sting or burn
- skin that’s dry, rough, or scaly
The U.K. National Health Service outlines some of the symptoms a person may experience when they first develop rosacea. These symptoms include:
- repeated episodes of skin redness, discoloration, or blushing, lasting several minutes at a time
- skin that feels hot, warm, or painful
- burning or stinging sensations when in contact with water or applying skin care products
Rosacea is a common skin condition, affecting more than 14 million people in the United States.
Scientists haven’t discovered the exact cause of rosacea, but the following factors likely play a role in its development:
- Genetics: Many people with rosacea have family members who also have the condition, suggesting a role of genetics.
- Skin mites: Demodex is a skin mite that lives on the nose and cheeks of all people. Individuals with rosacea tend to have much greater numbers of demodex on their skin, suggesting a possible link to rosacea, but some individuals without rosacea also have large numbers of demodex on their skin.
- Immune system response: Demodex carries the bacteria called “Bacillus oleronious.” People with acne-like rosacea tend to have an overreactive immune response to these bacteria, but it’s still not clear whether this reaction causes rosacea.
- Gastrointestinal (GI) infection: Helicobacter pylori (H. pylori) are bacteria that infect the GI system. This type of infection is common among people with rosacea, but many people without rosacea also have the infection. Further research is necessary to determine whether H. pylori plays a role in rosacea.
- Cathelicidin production: Cathelicidin is a protein that normally protects the skin from infection. People with rosacea may process this protein in a way that causes skin redness or discoloration and swelling.
There’s no standard medical test for rosacea. Diagnosis involves examining the skin and eyes and carrying out a detailed analysis of a person’s symptoms and medical history.
When diagnosing rosacea, a dermatologist will also want to rule out other conditions that can present with similar symptoms. Similar conditions include:
Although there’s no cure for rosacea, certain strategies can help to manage the condition.
Rosacea treatment typically involves the following three steps:
Rosacea triggers are individual factors that may cause rosacea to flare. Common rosacea triggers include:
- cold wind
- spicy foods
The first step in rosacea treatment is to identify your rosacea triggers so that you can try to avoid them in the future.
The National Rosacea Society provides a form that can help people identify their rosacea triggers. The society recommends completing the form every 2 weeks and checking to see which of the potential triggers coincided with your rosacea flares.
You may want to try symptoms journaling as well.
Using gentle skin care products
A dermatologist can recommend gentle, rosacea-friendly skin care products. They may also outline products to avoid.
Some potential products to avoid include:
- astringents and toners
- waterproof makeup
- heavy foundations that require makeup remover
- skin care, hair care, and toothpaste containing the following common rosacea triggers:
Treating the condition
The earlier a person begins treatment for rosacea, the easier it is to manage. For people with ETR, treatment focuses on treating skin’s discoloration and flushing.
Below are some treatment options a doctor or dermatologist may recommend.
Sunlight is one of the most common triggers of rosacea, so sun protection is critical for people with this condition.
Some tips for protecting the skin from the sun include:
- apply a broad-spectrum sunscreen with an SPF of 30 or higher daily
- use a mineral sunscreen containing titanium dioxide or zinc oxide, ingredients that are less likely to irritate the skin
- wear a wide-brimmed hat when outdoors during the day
- stay in the shade, if possible
- avoid being outdoors during strong, midday sun
Medicated gels, creams, and lotions
A dermatologist may prescribe topical medications to reduce skin redness or discoloration, such as brimonidine gel and oxymetazoline hydrochloride cream. Both medications are FDA approved for the treatment of rosacea and may reduce redness for up to 12 hours at a time.
The following side effects may occur but are usually temporary:
- redness or discoloration and flushing
- a burning sensation
- contact dermatitis
- Metronidazole: Metronidazole is an anti-inflammatory medication that alleviates skin redness or discoloration and acne lesions in moderate to severe rosacea.
- Azelaic acid: Azelaic acid is an anti-inflammatory and antibacterial medication. It kills bacteria on the skin and decreases the production of keratin — a substance that can lead to acne.
- Brimonidine: Brimonidine is a medication that constricts dilated blood vessels to reduce the appearance of spider veins and redness or discoloration.
Green tinted makeup can help to temporarily camouflage skin redness. Some makeup companies create these products specifically for people with rosacea.
Laser therapy and other light-based treatments can reduce the appearance of spider veins and skin redness, and the results can last for years. Those considering laser therapy may want to start by talking with a dermatologist who has experience working with their skin type. Darker skin, for example, may respond better to certain types of laser therapy than others.
ETR is a type of rosacea characterized by skin redness or discoloration, flushing, and visible blood vessels. People who have ETR may also experience skin pain and discomfort, such as stinging, burning, or swelling.
Although there’s no cure for ETR, treatments can help to manage the condition and alleviate its symptoms. Dermatologists typically recommend a three-step approach to treatment, which includes avoiding rosacea triggers, using gentle skin care products, and treating redness or discoloration.
Daily sun protection is crucial for people living with rosacea. Additional treatment options include medicated topical agents and light-based therapies. Talk with a doctor or dermatologist about your individual treatment options.