This rare form of rosacea can cause thicker skin and larger pores, especially on the face.

Rosacea is a chronic inflammatory condition of the skin. It causes redness, flushing, and visible blood vessels across different areas of the face. According to the American Academy of Dermatology Association, more than 14 million people in the United States live with rosacea.

Rosacea most commonly appears across the cheeks, nose, chin, and forehead. In addition to red, flushed skin, some subtypes of rosacea can cause small, pus-filled bumps called papules and pustules. A rare type of rosacea called phymatous rosacea can also cause thickening and scarring of the skin.

Ahead, we’ll share everything you need to know about the phymatous subtype of rosacea, including signs and symptoms, causes, treatment, and more.

Signs and symptoms of rosacea can vary across the different subtypes. But the most common symptoms of rosacea include:

In addition to the symptoms mentioned above, phymatous rosacea can also cause the following symptoms:

If phymatous rosacea is left untreated, it can lead to rhinophyma. Rhinophyma is a skin condition in which thickened skin builds up on the nose, causing it to become large, bumpy, and bulbous.

Researchers are still exploring the causes and triggers of rosacea, including phymatous rosacea. However, some of the possible causes of this inflammatory condition may include:

  • heat exposure
  • sun exposure
  • humidity or steam
  • skin products
  • certain medications
  • spicy foods
  • foods that have strong, intense, or sharp flavors (pungent foods)
  • alcohol consumption (if applicable)
  • vigorous exercise
  • emotional stress
  • microorganisms, like Demodex mites

Physical factors like heat, sun, or steam can trigger a flare-up. One reason for this is that they can cause the lymphatic and blood vessels to dilate. Also, factors like emotional stress or infection can trigger a flare-up by activating the immune system.

Triggers for phymatous rosacea differ from person to person. So an important part of treatment for this condition is identifying and avoiding the triggers.

Is phymatous rosacea painful?

Even without complications, rosacea can cause symptoms like burning, stinging, or painful sensations in the skin. For people living with phymatous rosacea, rough and bumpy skin can become itchy, painful, or otherwise uncomfortable.

Other complications of rosacea, like swelling of the eyes or pus-filled bumps and spots, can also cause discomfort and pain.

While there’s no cure for phymatous rosacea, your doctor can recommend a combination of medication and lifestyle changes to help manage your symptoms. Certain procedures may also help lower the symptoms of this subtype of rosacea.

Medications

Several medications are effective for treating various rosacea symptoms, including:

  • topical brimonidine and oxymetazoline to help lower skin redness
  • topical azelaic acid, ivermectin, metronidazole, and minocycline to help reduce papules and pustules
  • oral isotretinoin and doxycycline, which can also help reduce papules and pustules

Depending on the type and severity of your symptoms, your doctor may prescribe a combination of these medications to increase their effectiveness.

Procedures

Some procedures may also help reduce the severity of symptoms in people living with phymatous rosacea.

For example, laser treatments like erbium YAG laser and CO2 lasers are effective for treating rhinophyma, a complication of phymatous rosacea.

Other procedures, such as dermabrasion and cryosurgery, can also help remove some excess skin that can build up in phymatous rosacea.

Lifestyle changes

To manage rosacea symptoms in the long run, it’s also important to take steps to lower your exposure to triggers.

If you feel your rosacea flares up when you go out into harsh weather, drink alcohol, or eat spicy foods, consider limiting your exposure to these things. Over time, you’ll likely notice fewer flare-ups and symptoms as you avoid your triggers.

Is phymatous rosacea common?

Phymatous rosacea is one of the rarer subtypes of rosacea, affecting a much smaller portion of people living with the condition.

While exact numbers vary, one review from 2022, which included over 9,000 participants across 39 studies, found that the prevalence of phymatous rosacea was only 7%. Also, phymatous rosacea appears to be much more common in males than females. According to the review, it affects over 28% of males versus only 3.6% of females.

Phymatous rosacea is a rare subtype of rosacea. It causes thick, bumpy skin to appear on the face, in addition to the other common symptoms. If left untreated, phymatous rosacea can lead to a complication called rhinophyma, or a thick, bulbous nose.

Medication can help lower the symptoms of rosacea. But for people with phymatous rosacea, there are procedures that can target and reduce thickened skin.

With the right treatment, you can learn how to manage your phymatous rosacea symptoms and limit future flare-ups.