Mild Rosacea: What It Is, How to Identify It and How to Treat It

• Rosacea is a skin condition that is graded as mild, moderate or severe
• Anyone at any age can develop rosacea but it is most common in women
• Triggers include spicy foods, hot beverages, weather extremes and emotional stress
• Rosacea is not curable but symptoms can be managed through medical care and the right combination of treatments

Mild rosacea is a common, chronic skin condition that usually affects the face and includes flare-ups of redness, inflammation and burning, bumps and swelling. Rosacea exists on a spectrum and may be related to immune system issues. 

There is no cure for rosacea, but it is highly manageable when treatment is started early. 

Doing so will help prevent damage to the skin and other related complications; untreated rosacea can lead to progressively worse symptoms. 

What Is Mild Rosacea?

When rosacea is diagnosed, it’s rated as either mild, moderate or severe. Mild rosacea usually includes many of the same symptoms as moderate or severe cases, but symptoms are less severe.

The subtypes of rosacea that are part of the mild category include acne rosacea (papulopustular rosacea), erythematotelangiectatic rosacea (ETR), and ocular rosacea. Each of these subtypes can manifest in a mild form, and symptoms from each subtype can overlap.

Long-term outlook

In the long term, the symptoms of rosacea are manageable with the right combination of treatments. 

Left untreated, rosacea is a progressive condition; symptoms will worsen over time, and could deteriorate to moderate or severe. Flushing of skin can become permanently red or spider veins may develop. For others, acne-like symptoms can develop. 

A fourth type of rosacea, called rhinophyma, is a severe form of rosacea and can develop if mild symptoms are left untreated. This type typically affects the nose and causes dramatic changes such as a bulbous shape, redness, enlarged pores and thickened skin.   

How do you know you have mild rosacea?

For many people, mild rosacea appears as a red flush beneath the skin. For others, it manifests as pimples and pustules. If you have mild rosacea, your symptoms may be intermittent, can fluctuate or be barely noticeable. Because of this, mild rosacea can be difficult to diagnose.

To complicate the diagnostic process, mild rosacea is often confused with other conditions that cause persistent redness or facial flushing. Some of these conditions include acne, lupus, psoriasis, seborrheic dermatitis and steroid-induced acne. 

Because rosacea symptoms can be attributed to so many skin conditions, it’s not possible to self-diagnose. If you suspect you may have rosacea, see a dermatologist as soon as possible to be properly diagnosed so that you can begin an appropriate treatment regimen.  

Symptoms of mild rosacea

Mild rosacea shares many of the same symptoms that are present in moderate to severe cases but are less severe:

• Dryness
• Facial redness
• Flushing
• Papules
• Pustules
• Stinging
• Warm sensation
• Visible capillaries
• Watery or irritated eyes (in the case of ocular rosacea)

Symptoms of mild rosacea are those that manifest on a much lower scale compared to moderate or severe cases. For example, mild rosacea with pustules would exhibit fewer pustules than severe rosacea.

It’s also possible to have ocular rosacea without any other symptoms, including skin redness. Sometimes, ocular rosacea is the first indication of rosacea. Your doctor will be able to identify rosacea based on your specific combination of symptoms, as symptoms vary from one person to the next. 

Causes

Rosacea has a number of probable causes that researchers continue to study. Some of these include: 

• Demodex mites: A specific type of dust mite called Demodex folliculorum can live in eyelashes’ hair follicles, leading to symptoms of mild rosacea or a rosacea flare-up
• Dilated blood vessels: When the small blood vessels of the face are abnormally dilated, blood flow beneath the skin is more noticeable, causing the face to appear red or flushed
• Environmental factors: Cold, dry, windy and hot climates can trigger or worsen mild rosacea; temperature and weather extremes can aggravate sensitive skin, causing redness and irritation 
• Genetics: People who are genetically predisposed most often have fair skin or a Northern European ancestry 
• Immune system condition: People with autoimmune disorders are often predisposed to rosacea

Overall, the exact cause of rosacea isn’t thoroughly understood nor the link to severity or fluctuation of symptoms.  Research shows that women are more likely than men to develop rosacea, in general, but the reasons why haven’t been established.

Common triggers

Rosacea triggers vary from person to person and include the following: 

• Emotional stress
• Excessive heat, cold or wind, or a dry environment
• Food and drink including spicy, fried and processed foods, and alcohol
• Heavy exercise
• Hot baths and showers
• Skin care products such as witch hazel, alcohol, fragrances and peppermint
• Sun exposure
• Underlying health issues

Rosacea is a reactive condition that flares easily when a person comes in contact with a trigger. For people with mild rosacea, triggers do not cause a severe flare, although symptoms will temporarily become more apparent. 

Treatments for Mild Rosacea

Treatments for mild rosacea are as individualized as each person’s unique set of symptoms and triggers. Your doctor will recommend a regimen they think is best for your combination of symptoms. Medications may need to be adjusted or changed until you find what works best for you. 

Oral antibiotics

Studies in recent years have found an association between Helicobacter pylori bacterial infection and the occurrence of acne rosacea. Antibacterial treatments have therefore been found to be particularly effective against mild rosacea.

Oral antibiotics, including doxycycline and tetracycline, are either prescribed for short-term treatment, or long term at a lower dose. 

Creams 

Topical creams and ointments such as azelaic acid, metronidazole, brimonidine tartrate or oxymetazoline hydrochloride are used long term to control symptoms of mild rosacea. Some creams work to reduce redness by helping constrict dilated blood vessels under the skin; others reduce the inflammation and swelling associated with this condition. 

Laser treatments

Laser treatments can also be effective in reducing the size of dilated blood vessels that cause reddened skin. Multiple treatments are often required before you’ll see a significant difference. Laser treatments also can’t prevent new blood vessels from forming beneath the skin’s surface. 

IPL treatments 

Intense pulsed light is a procedure that uses several wavelengths of light to penetrate the outer layer of skin and improve skin’s appearance. This light therapy can eliminate dilated blood vessels in mild rosacea and the redness that accompanies them.  

Natural remedies

There are a number of natural remedies that are inexpensive and easily available to offer relief from rosacea symptoms. 

• Aloe vera can soothe redness and burning 
• Coconut oil can both fight inflammation and moisturize skin
• Chamomile is a moisturizer with anti-inflammatory and antioxidant properties
• Lavender essential oil can calm inflammation
• Niacinamide can effectively reduce redness
• Kanuka honey has anti-inflammatory and healing properties to reduce skin irritation and redness
• Tea tree oil has anti-inflammatory properties to target itching 

While natural products can help reduce redness and inflammation, you should proceed with caution before applying any topicals – whether OTC, prescription or natural. A mild case of rosacea could be made worse by applying the wrong product to your skin.

How to Care for Rosacea-Prone Skin

In addition to following your doctor’s instructions for taking or using medication for mild rosacea, you’ll need to pay careful attention to your skin care routine to avoid exacerbating your skin condition. Make lifestyle changes to help you reduce flare-ups.

Common irritants to avoid in skin care products include alcohol, witch hazel, peppermint and eucalyptus oil. Avoid strong synthetic fragrances and ingredients. Opt for simple, gentle products with calming ingredients such as oatmeal and chamomile in addition to lactic and mandelic acid. 

Protect your skin from sun exposure and weather extremes by wearing sunscreen and moisturizer to form a barrier between the elements and your sensitive skin. Use a gentle cleanser and moisturizer morning and night and avoid astringent and abrasive products. Don’t scrub your face with a washcloth or soak in a hot bathtub.

Take steps to avoid foods that can cause flare-ups. Red wine, coffee and spicy food are all known triggers. Avoid processed food that contains additives, added sugar and preservatives.

When to See a Doctor

If you think you may have mild rosacea, it’s important to see a doctor as early as possible. Rosacea is a progressive condition and if left untreated, will worsen over time; the sooner you receive professional treatment, the better.

Takeaway

Mild rosacea is a chronic skin condition that usually affects the face and is characterized by flare-ups of redness, inflammation, bumps and swelling. 

A number of causes have been identified to include Demodex mites, dilated blood vessels, environmental and genetic factors. It is also related to autoimmune disorders. 

A number of OTC and prescription treatments are available to reduce irritating skin symptoms and include oral antibiotics, topical creams, and professional laser and IPL procedures. Natural remedies can also help soothe rosacea symptoms, but should be used with caution to avoid further irritating skin.

It is important to adopt a skin care regimen and avoid any known triggers to keep flare-ups at bay.

While mild rosacea is not curable, it is a manageable condition when identified early and treated promptly. With the right combination of treatments, you have the opportunity to prevent your symptoms from worsening.