Rosacea is a common but often misunderstood condition that is estimated to affect over 45 million people worldwide. It affects fair-skinned people of mostly north-western European descent, and has been nicknamed the 'curse of the Celts' by some in Ireland. It begins as erythema (flushing and redness) on the central face and across the cheeks, nose, or forehead but can also less commonly affect the neck and chest. As rosacea progresses, other symptoms can develop such as semi-permanent erythema, telangiectasia (dilation of superficial blood vessels on the face), red domed papules (small bumps) and pustules, red gritty eyes, burning and stinging sensations, and in some advanced cases, a red lobulated nose (rhinophyma). The disorder can be confused and co-exist with acne vulgaris and/or seborrheic dermatitis. Rosacea affects both sexes, but is almost three times more common in women, and has a peak age of onset between 30 and 60. The presence of rash on the scalp or ears suggests a different or co-exisitng diagnosis, as rosacea is primarily a facial diagnosis.

Some people may notice that their skin has become very sensitive or that they blush easily before they notice other symptoms of rosacea. Facial products, for example, may burn their skin.
As rosacea develops, redness on the cheeks lingers, like a slight sunburn. This redness and other symptoms of rosacea come and go. The main symptoms include:

• Facial redness/flushing. Triggers, such as sun exposure or alcohol, stimulate increased blood flow, which causes blood vessels to expand and facial redness to appear. In women, the redness usually appears on the cheeks, nose, chin, and forehead. The redness may appear in a "butterfly" pattern across the cheeks and nose. Facial redness in men typically appears on the nose, although symptoms can appear on other areas of the face. In some cases, redness may also occur on the neck and upper chest.
• Pimples on the face. Small pimples may occur on the red areas of skin or on the edges. These pimples—red, round bumps in the skin—are different than acne pimples, which have blackheads or whiteheads.
• Red lines on the face (telangiectasia). These small, thin, red lines, which are tiny blood vessels that look like spiderwebs, usually appear on the cheeks.
• Swollen bumps on the nose. In severe cases, mostly in men, the nose appears enlarged, bulbous, and red, a condition called rhinophyma.
• Eye irritation. Symptoms include redness, dryness, burning, crusted mucus, tearing, a gritty sensation like that of sand in the eye, pinkeye (conjunctivitis), and swelling in the eyelid. The eyes may not tolerate contact lenses, and styes may develop. In some cases, vision may be blurry, but only in severe cases is vision damaged. About half of the people who have rosacea may have some eye irritation or symptoms.

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