The cause of rosacea is not fully understood, but many think that the defect lies in the blood vessels in the skin of the face, which open (dilate) too easily. Rosacea is more common in women than in men, and in those with a fair skin who flush easily.
Many things seem to make rosacea worse, but probably do not cause it in the first place. They include alcohol, too much exercise, both high and low temperatures, hot spicy foods, stress, and sunlight. Things that make one person’s rosacea worse may well have no effect at all on the rosacea of someone else. The idea that rosacea is due to germs in the skin, or in the bowel, has not been proved. Rosacea is not catching.

Rosacea starts with a tendency to blush and flush easily. After a while, the central areas of the face become a deeper shade of red and end up staying this colour all the time. The area becomes studded with small red bumps (papules) and pus spots, which come and go in crops. Small, dilated blood vessels (telangiectasia) appear, looking like thin red streaks. Scarring is seldom a problem.
Other problems with rosacea include the following:
 Rosacea can lead to embarrassment, anxiety, or depression, and disrupt your social life.
 The face may swell (lymphoedema), especially around the eyes.
 The nose may grow big, red and bulbous (rhinophyma) due to the overgrowth of the sebaceous glands. This is more common in men than women.
 Some people with rosacea have eye symptoms (red, itchy, sore eyes and eyelids; a gritty feeling; sensitivity to light). A few patients with rosacea have more serious eye problems, such as rosacea keratitis that can interfere with vision.

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