Do all the symptoms of rosacea appear at once, or over time? We take a look at the four stages of clinical rosacea.
Rosacea is a progressive skin condition, affecting the central part of the face, so the cheeks, forehead, chin, and nose. Dermatologists have identified four distinct stages:
- STAGE 1 - Pre-Rosacea: People that blush easily and often, or regularly experience facial flushing, are vulnerable to rosacea. It can begin with various triggers, including intense exercise; hot or spicy foods; hot drinks; alcoholic drinks, or overexposure to sunlight. In Stage 1 the initial reddening of the face can come and go over a period of time, from weeks to months. It can look like sunburn, and the redness appears as a consequence of excess blood flowing rapidly through the blood vessels of the face, which enlarge and widen to cope with the increased blood flow. Although the redness can intermittently appear and disappear, when it takes hold it will stay, as Stage 2 begins.
- STAGE 2 – Mild Rosacea: Stage 2 is the point at which the facial blood vessels that had enlarged to handle the increased flow of blood through them remain open, so the redness becomes persistent, lasting longer than previously before disappearing for an indeterminate period. The skin of the face becomes sensitive to the extent that when trying to apply makeup or lotion there could be an uncomfortable burning sensation.
- STAGE 3 - Moderate Rosacea: At this point in its progression the rosacea has persisted without disappearing for days or weeks, so as such has worsened to become noticeable, and is becoming permanent. Structural damage of the blood vessels in the the face will have occurred, possibly to different extents - from retaining normal functionality to irremediable. The blood vessels that are most severely damaged can become chronically inflamed and expand, showing on the face – particularly the cheeks - as red lines called telangiectasias. Pimples, red bumps (called papules), and pustules can also begin to appear.
- STAGE 4 – Severe Rosacea: This is the most advanced stage, presenting the sufferer with a great many challenges, including facial pain, burning sensations, intense flushing, swelling, and inflammation from clusters of papules and pustules. The facial skin is now a deep red and damage to the blood vessels is severe. By Stage 4 of rosacea around 50 percent of sufferers may have developed eye problems, which although usually mild, can bring dryness and irritation. One potential major problem that Severe Rosacea can bring is rhinophyma - or ‘bulbous nose’ – being a swollen enlargement of the nose as a consequence of leaving nasal bumps untreated. It’s not known exactly why, but this particularly difficult aspect of Stage 4 is considerably more common in men than in women, in whom it’s quite rare.
What can you do to manage rosacea?
For more information about managing rosacea, see our article How Do You Clear Up Rosacea?
Recommended products for rosacea-prone skin:
Balmonds have four different emollients that are particularly suitable for rosacea and which you can use in combination to keep your face well-nourished and well-hydrated, plus a non-irritant natural shampoo and body wash.
Balmonds Intensive Facial Oil
with rosehip, calendula, lavender & chamomile
Balmonds Daily Moisturising Cream
with shea butter and calendula
Balmonds Cooling Cream
with shea, menthol, aloe vera & lavender
Balmonds Skin Salvation
with hemp and beeswax
Balmonds Natural Shampoo & Body Wash
with calendula & chamomile
If you require medical advice we recommend you always contact your healthcare professional.
If you or someone you are caring for seems very unwell, is getting worse or you think there's something seriously wrong, call for emergency services straight away. For general medical advice, please contact your healthcare professional, this article does not contain or replace medical advice.
Do not delay getting help if you're worried. Trust your instincts.