Rosacea Subtypes: How to Tell Which Type You Have
- Debora Tentiș
- 3 days ago
- 4 min read
Rosacea isn’t a one-size-fits-all condition. In fact, there are several different subtypes of rosacea, and knowing which one you have is essential for finding the right treatment, avoiding unnecessary irritation, and understanding your skin better.
Many people don’t realise there are different types of rosacea — they just know their skin gets red, breaks out, or feels uncomfortable. But each subtype has its own pattern, triggers, and best-practice care. If you’ve ever wondered why rosacea looks so different from one person to another, this guide will help you spot the difference — and identify your own.
🔍 Why Knowing Your Rosacea Subtype Matters
Your rosacea subtype tells you a lot:
What symptoms you’re likely to experience
Which skincare products to avoid
What treatments or prescriptions might help
Whether to see a GP, pharmacist, dermatologist or eye specialist
How your symptoms might progress without support
Some people have one clear subtype, while others have a combination of symptoms from more than one. Your rosacea may even change over time — for example, beginning with flushing and later developing breakouts or eye issues.
🩺 The 4 Main Subtypes of Rosacea
1. Erythematotelangiectatic Rosacea (ETR)
Key features: Flushing, redness, visible blood vessels, sensitive skin
This is the most common and often the earliest form of rosacea. It’s often mistaken for “rosy cheeks,” sun damage, or sensitive skin — but it’s actually chronic vascular inflammation.
Signs you may have ETR:
Flushing that comes and goes, especially after heat, exercise, or emotions
Persistent redness that doesn’t fade
Skin that stings, burns, or reacts to skincare
Visible thread veins or broken capillaries (telangiectasia)
Skin feels hot or tight even without applying products
Who it affects most:Women aged 30+, people with fair skin, those with a history of flushing or blushing easily
Best care approach:
Calm the vascular system with gentle, anti-inflammatory skincare
Use daily SPF50
Avoid alcohol-based products, essential oils, scrubs, and hot treatments
Consider vascular laser or IPL for visible capillaries (done in-clinic)
Red LED light can be soothing at home
2. Papulopustular Rosacea
Key features: Acne-like breakouts, bumps, inflammation, persistent redness
Often confused with adult acne, this subtype is inflammatory in nature. The redness may be similar to ETR, but with the addition of pimples, which are not caused by clogged pores like traditional acne.
Signs you may have this subtype:
Red, swollen papules or pustules that resemble acne
No blackheads or whiteheads
Breakouts occur alongside persistent redness and sensitive skin
Bumps worsen with stress, weather changes, or spicy food
Skin may feel sore, dry, or tight even with visible oil
Who it affects most:Both men and women, often in their 30s–50s. Frequently seen in people with hormonal or metabolic changes.
Best care approach:
Avoid acne products with salicylic acid or benzoyl peroxide — they often worsen rosacea
Use azelaic acid (prescription or over-the-counter), topical ivermectin, or metronidazole
Cleanse with barrier-supporting, fragrance-free products
Consider a short course of oral antibiotics for flare-ups (under medical supervision)
Apply calming moisturisers and always wear SPF
3. Phymatous Rosacea (Rhinophyma)
Key features: Thickened, bumpy, or enlarged skin, most often on the nose
This form is much less common, and usually develops later in life. It often begins with subtle thickening of the skin on the nose, forehead, or chin, and progresses slowly over time.
Signs you may have this subtype:
Gradual thickening or bumpy texture, especially on the nose
Skin feels coarse, swollen, or uneven
Enlarged pores or tissue buildup
Often appears with subtype 2 or 1 symptoms
Most commonly affects men
Who it affects most:Men aged 50+, particularly those who delay rosacea treatment
Best care approach:
Seek professional support early — this subtype often requires derm-led care
Avoid aggressive scrubs or retinoids without guidance
Skincare should be barrier-supportive and anti-inflammatory
For moderate to advanced cases, laser or surgical reshaping may be needed
4. Ocular Rosacea
Key features: Eye irritation, dryness, redness, or lid swelling
Often missed or misdiagnosed, ocular rosacea can occur before or without visible facial redness. It can seriously affect comfort, vision, and confidence — especially if not treated.
Signs you may have this subtype:
Gritty, dry, or burning eyes
Light sensitivity
Watery or red eyes
Swollen or crusted eyelids (especially in the morning)
Styes or recurrent infections
Who it affects most:Anyone with rosacea — up to 50% of rosacea sufferers develop ocular symptoms
Best care approach:
Use preservative-free lubricating eye drops (e.g., Hycosan, Thealoz Duo)
Maintain lid hygiene with blepharitis wipes (Blephaclean or Optase)
Consider warm compresses daily
Speak to an optometrist or GP for referral
Prescription ciclosporin or oral antibiotics may be recommended
🧠 How to Tell Which Type You Have
Ask yourself:
Do I flush easily or feel hot/red? (ETR)
Do I have red bumps that aren’t acne? (Papulopustular)
Is my skin thickening or bumpy around the nose? (Phymatous)
Are my eyes dry, red, or irritated? (Ocular)
You might have more than one subtype, or see symptoms shift over time — especially during hormonal changes, stress, or lifestyle shifts.
🧴 Why Personalised Care is Essential
Because each subtype of rosacea behaves differently, the wrong product or treatment can actually make things worse. This is why “acne” face washes or harsh actives often leave rosacea-prone skin redder, more inflamed, and reactive.
Personalised skincare plans based on your subtype can help you:
Calm inflammation
Reduce redness and sensitivity
Clear bumps without over-drying
Strengthen the skin barrier
Avoid common triggers and flare-ups
Rosacea isn’t just one condition — it’s a spectrum. And the key to managing it well is understanding which part of the spectrum you’re on.
If you’re unsure where to start, speak to a pharmacist, aesthetician, or GP who understands rosacea subtypes. You deserve care that works with your skin, not against it — and that starts with recognising the signs and responding gently, intentionally, and consistently.
Comments