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Understanding erythematotelangiectatic rosacea: Symptoms, triggers, and treatment

Dermatology providers share what you need to know about this common cause of facial redness.

Curology Team Avatar
by Curology Team
Updated on Jan 25, 2024 • 11 min read
Medically reviewed by Jessica Mefford, NP
Erythematotelangiectatic Rosacea
Curology Team Avatar
by Curology Team
Updated on Jan 25, 2024 • 11 min read
Medically reviewed by Jessica Mefford, NP
We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.

In this article

First of all, what is rosacea? 
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Erythematotelangiectatic (e-rith-eh-ma-toe-tel-an-gee-ek-tat-ic) rosacea isn’t just a tongue twister; it can be equally as confusing to manage, especially when you’re trying to figure it all out on your own! This type of rosacea can really play tricks on your skin—and your confidence. 

Let’s take a closer look at this skin condition, from its tell-tale symptoms to its common triggers and, most importantly, the various treatment options. Let’s sift through the confusion together so you can better understand how to manage this condition effectively.

First of all, what is rosacea? 

Rosacea is a common and chronic inflammatory skin condition that might make you feel like your skin’s throwing a bit of a tantrum, with signs like:¹

  • Erythema (redness): Consistent redness, like a lingering blush, usually on the central part of your face.

  • Recurrent flushing: Blushing or flushing more than usual.

  • Telangiectasia: Tiny blood vessels on your skin, especially around your nose and cheeks.

  • Papules and pustules: Small red bumps or pimples, not unlike acne, mainly around your nose, chin, cheeks, and forehead.

There are four main types of rosacea; erythematotelangiectatic rosacea is one of them. The others are:²

  • Papulopustular rosacea: Similar to acne, it features red bumps and pimples.

  • Phymatous rosacea: This type involves skin thickening and irregular texture, often around the nose.

  • Ocular rosaceaRosacea may not just impact your skin; it can affect your eyes too, causing dryness, redness, and irritation.

Diagnosing rosacea involves looking at all these signs and considering any potential triggers. What makes it tricky is that you can have symptoms of more than one type at the same time. If you suspect you have rosacea, it’s a good idea to talk to a dermatologist to receive a proper diagnosis and rosacea treatment plan.

3 symptoms of erythematotelangiectatic rosacea 

You may experience these 3 symptoms if you are diagnosed with erythematotelangiectatic rosacea.³

  1. Flushing: This is like a sudden wave of redness that washes over your face. Think of it as transient redness that comes and goes, often triggered by various factors like hot drinks, spicy food, or emotional stress.

  2. Persistent central facial erythema: Unlike flushing, this redness decides to stick around. It’s a constant, noticeable redness right in the central part of your face. But it doesn’t always play by the rules—sometimes, it can spread to the peripheral face, ears, neck, and even the upper chest.

  3. Telangiectasias (visible blood vessels): These are tiny blood vessels that become visible on the skin, especially around the nose and cheeks. While they’re common in erythematotelangiectatic rosacea, you don’t necessarily need them to be diagnosed with this subtype.

The sooner you identify and understand what’s happening, the sooner you can get on the right treatment plan. Effective management of these symptoms helps keep erythematotelangiectatic rosacea in check.

Causes of erythematotelangiectatic rosacea

Erythematotelangiectatic rosacea, while a common skin condition, comes with a bit of mystery concerning its exact causes. However, researchers have identified several factors that likely play a role in its development. 

Let’s break them down.

Neurovascular dysregulation 

This fancy term essentially means that there are issues with how your blood vessels function. In erythematotelangiectatic rosacea, blood vessels tend to overreact to certain triggers like hot temperatures, spicy foods, or alcohol. When they dilate too much, it leads to the flushing and redness characteristic of the condition.⁴

Vasoactive peptides, which cause blood vessels to expand, are also culprits here. Your immune system might join this party, contributing to the condition’s development.⁵

Microorganisms 

Tiny critters called Demodex mites are often more abundant on the skin of those with rosacea. While the presence of these mites is linked with erythematotelangiectatic rosacea, whether or not they are a cause is still up for debate.⁶

Genetics

If rosacea runs in your family, you might have a higher chance of developing it. This suggests that genes could play a behind-the-scenes role in who gets erythematotelangiectatic rosacea.⁷

Environmental factors

Good old sunlight and its UV rays can trigger or worsen rosacea symptoms in some people.⁸ So, if you have this condition, you might notice it flares up more during sunny days or after spending time outdoors. Remember, it’s important to wear sunscreen each and every day (even if you’re inside). Using a sunscreen for rosacea-prone skin is a great way to help keep flushing to a minimum and help protect your skin from harmful sun damage.

It’s important to remember that erythematotelangiectatic rosacea is quite complex. The way these factors interact and contribute to the condition can vary from person to person. Understanding these potential causes can be helpful in managing the condition and identifying triggers that might worsen your symptoms.

Common triggers

Navigating the world of rosacea triggers can be a bit like walking through a minefield, and what sets off symptoms can vary widely from person to person. However, understanding some of the common triggers can help you better manage your condition

Let’s look at a few.⁹

  • AlcoholCheers or tears? Unfortunately, for some with rosacea, alcohol, especially red wine and spirits, can mean more flare-ups. It’s known to increase the risk of rosacea and can intensify symptoms like flushing.

  • Spicy foods: Love a bit of spice in your life? If you have rosacea, it might be a trigger. Foods with capsaicin can cause flushing, stinging, and burning sensations.

  • Cinnamaldehyde-containing foods: Found in foods like tomatoes, citrus fruits, and chocolate, cinnamaldehyde might be a hidden trigger, potentially leading to redness and visible blood vessels.

  • Hot drinks: Though high amounts of caffeine may lower the risk of rosacea, that comforting hot cup of coffee or tea could also be a trigger, likely due to its heat-induced vasodilation effects.

  • Histamine-rich foods: Foods high in histamine, such as aged cheese, wine, and processed meats, might contribute to your rosacea symptoms.

  • Fatty foods: A diet high in fatty foods, like fatty meat and fried foods can also trigger your rosacea, especially the erythematotelangiectatic and phymatous subtypes.

Remember, while these triggers are common, not everyone with rosacea will react to all of them. It’s a highly individualized condition. Keeping a diary of your flare-ups and what you ate or did prior can be super helpful in identifying your personal triggers. 

And as always, if you’re struggling to manage your rosacea, don’t hesitate to reach out to a dermatology provider. They can help you tailor a treatment and management plan that’s right for you. 

Treatment for erythematotelangiectatic rosacea 

When you’re dealing with erythematotelangiectatic rosacea, your treatment will involve a mix of general strategies, personalized skincare routines, and specific topical treatments. 

Here’s how you can tackle this type of rosacea.

Rosacea best practices

First, recognize rosacea as a chronic condition and educate yourself about its nuances. This knowledge empowers you to make informed decisions about your care. Sun protection is another key aspect of managing rosacea. Prioritize sun avoidance and photoprotection, as ultraviolet radiation can make your symptoms worse.* 

Identifying and avoiding your personal triggers, which might include extreme temperatures, spicy foods, hot beverages, and even stress, is essential. It’s also wise to review your current medications with a doctor, as some over-the-counter or prescription drugs might worsen rosacea symptoms.¹⁰

Skincare for rosacea

When it comes to your rosacea skincare routine, take a gentle and nurturing approach. Using a mild facial cleanser can help you avoid further skin irritation. Following up with a moisturizer or barrier repair product is essential to keep your skin hydrated and reduce irritation. You can also consider using cosmetic products, particularly those with a green tint, to help camouflage the redness of rosacea.¹¹

Topical treatments

Topical treatments play a significant role in managing this condition.¹² Metronidazole, for instance, is a topical medication known for its anti-inflammatory properties, helping reduce erythema, papules, and pustules. Azelaic acid, available in gel and lotion forms, can be applied once or twice daily for its anti-inflammatory, anti-keratinizing, and antibacterial effects.¹³ 

Furthermore, ivermectin cream is useful for its anti-inflammatory properties and for targeting Demodex mites, which are often associated with rosacea.¹⁴ Laser therapy, such as vascular lasers or intense pulsed light, can also be effective in reducing persistent redness and visible blood vessels, though it should be administered by an experienced therapist.¹⁵

Oral medications

In some cases, oral medications may be necessary and can be combined with topical treatments for more comprehensive management.¹⁶ Oral antibiotics like doxycycline or minocycline are often used for their anti-inflammatory effects. For severe or stubborn cases of rosacea, oral isotretinoin might be considered, though it requires close monitoring due to potential side effects.¹⁷

Remember, it’s important to work closely with a licensed dermatology provider to determine the most suitable treatment plan for your specific condition and to monitor your progress throughout the treatment. With the right combination of knowledge, skincare practices, and medical treatments, managing erythematotelangiectatic rosacea can become a more achievable task.

Foods that can help rosacea

There’s some suggestion that dairy might actually protect against certain types of rosacea, like erythematotelangiectatic and papulopustular rosacea, but this needs more research.¹⁸

Omega-3s might also be beneficial, especially for ocular rosacea, in easing symptoms like dry eyes. Zinc and probiotics are also being explored for their potential benefits in rosacea, but their effects aren’t entirely clear and seem to vary among individuals.¹⁹

The key takeaways

  • Erythematotelangiectatic rosacea is a common subtype of rosacea, characterized by recurrent flushing, persistent central facial redness, and visible blood vessels.

  • Its exact causes are unclear, but factors like neurovascular dysregulation, microorganisms like Demodex mites, genetics, and environmental triggers may play a role.

  • Common triggers may include alcohol, spicy foods, cinnamaldehyde-containing foods, hot drinks, and fatty foods.

  • Treatment involves general strategies like using gentle skincare and avoiding triggers, as well as applying specific topical treatments like metronidazoleazelaic acid, and ivermectin.

  • In severe cases, oral medications like doxycycline or isotretinoin may be necessary.

  • Struggling with rosacea? Curology offers personalized rosacea treatment, providing tailored skincare solutions for individuals with this condition.

Help manage your symptoms with Curology’s personalized rosacea treatment 

Living with rosacea, particularly the erythematotelangiectatic subtype, can sometimes feel like a constant battle with your skin. But it’s important to remember that with the right knowledge and treatment approach, managing rosacea can become a more navigable journey. 

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At Curology, we understand that everyone’s skin is unique, especially when it comes to conditions like rosacea. Our approach is to provide personalized skincare solutions, crafted to address your specific skin concerns.

We invite you to start your journey to better skin health with our personalized rosacea treatment.** Explore our products and see how we can help you achieve clearer, more comfortable skin!***

FAQs

How do you fix erythematotelangiectatic rosacea?

To manage erythematotelangiectatic rosacea effectively, start by educating yourself about this chronic condition. Protect your skin from the sun and identify personal triggers like extreme temperatures or spicy foods. 

For skincare, use gentle cleansers and moisturizers, and consider green-tinted cosmetics to cover redness. Topical treatments like metronidazole, azelaic acid, and ivermectin can help, as can laser therapy for persistent redness.²⁰ In more severe cases, oral medications like doxycycline might be necessary.²¹ It’s crucial to work with a dermatology provider for a tailored treatment plan.

What are the different types of rosacea?

Rosacea has four main subtypes: erythematotelangiectatic (characterized by flushing and visible blood vessels), papulopustular (similar to acne with red bumps and pimples), phymatous (involving skin thickening and irregular texture), and ocular (affecting the eyes with symptoms like dryness and irritation). To get a proper diagnosis of what type of rosacea or skin condition you have, it’s best to connect with a dermatology provider. 

What does erythematotelangiectatic rosacea mean?

Erythematotelangiectatic rosacea is a term that describes a specific subtype of rosacea. Let’s break down what each part of the term means:

  • Erythema: This refers to redness of the skin due to inflammation.²²

  • Telangiectasia: This part of the term describes the presence of visible small blood vessels near the surface of the skin.²³

So, erythematotelangiectatic rosacea is a form of rosacea where the primary symptoms are persistent facial redness (erythema) and visible small blood vessels (telangiectasia). It’s one of the four major subtypes of rosacea and is often marked by episodes of flushing or blushing, which can be triggered by various factors such as temperature changes, certain foods, or stress.²⁴

How common is erythematotelangiectatic rosacea?

Erythematotelangiectatic rosacea is quite common among individuals with rosacea. Based on global data, erythematotelangiectatic rosacea accounts for 57% of rosacea cases, making it the most prevalent subtype of rosacea!²⁵

Why is my skin so sensitive?

If you have erythematotelangiectatic rosacea, your skin may be more sensitive due to factors like neurovascular dysregulation, the presence of microorganisms like Demodex mites, genetic predispositions, and environmental triggers like UV radiation.

• • •

P.S. We did the homework so you don’t have to:

  1. Farshchian, M, and Daveluy, S. Rosacea. StatPearls. (2023, August 8).

  2. Farshchian, M, and Daveluy, S. Rosacea. StatPearls. Ibid.

  3. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. (February 2018).

  4. Farshchian, M, and Daveluy, S. Rosacea. StatPearls. Ibid.

  5. Farshchian, M, and Daveluy, S. Rosacea. StatPearls. Ibid.

  6. Farshchian, M, and Daveluy, S. Rosacea StatPearls. Ibid.

  7. Farshchian, M, and Daveluy, S. Rosacea. StatPearls. Ibid.

  8. Farshchian, M, and Daveluy, S. Rosacea. StatPearls. Ibid.

  9. Searle, T., et al. Rosacea and Diet: What is New in 2021? J Clin Aesthet Dermatol. (December 2021).

  10. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  11. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  12. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  13. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  14. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  15. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  16. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  17. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  18. Searle, T., et al. Rosacea and Diet: What is New in 2021? J Clin Aesthet Dermatol. Ibid.

  19. Searle, T., et al. Rosacea and Diet: What is New in 2021? J Clin Aesthet Dermatol. Ibid.

  20. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  21. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  22. Merriam-Webster. Erythema. (n.d.).

  23. Merriam-Webster. Telangiectasia. (n.d.).

  24. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. Ibid.

  25. Barakji,Y.A., et al. Assessment of Frequency of Rosacea Subtypes in Patients With Rosacea: A Systematic Review and Meta-analysis. JAMA Dermatol. (June 2022).

Jessica Lee is a certified Nurse Practitioner at Curology. She received her Master in Nursing from Samuel Merritt University in Oakland, CA.

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• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
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