Rosacea

Rosacea is a common rash, usually occurring on the face, and which predominantly affects both middle-aged (age range 30 to 60) and fair-skinned people.

This condition can generally be managed in Primary Care.

Referral Criteria:

Only required if:

  • Diagnostic uncertainty
  • Failure of primary care management
  • Severe and tetracycline resistant rosacea for consideration of isotretinoin

Assessment

Signs and Symptoms

  • Bimodal prevalence of 20-30 years of age and a larger peak at 40-50
  • Aggravated by anything that predisposes to flushing such as alcohol, spicy foods, hot drinks, temperature changes, sunlight, emotion and drugs that cause vasodilation

Clinical features

  • Sited on the central face with sparing of the perioral and periorbital skin
  • Telangiectasia
  • Papules and pustules on a background erythema
  • Facial disfigurement intermittent or permanent
  • Rhinophyma
  • As opposed to acne vulgaris – NO comedones
  • Ocular involvement in 50% of cases can cause gritty eyes, conjunctivitis, blepharitis episcleritis and chalazion. Keratitis is a more serious complication

Patient information leaflet

Referral

This condition can generally be managed in Primary Care.

Referral is only required if:

  • Diagnostic uncertainty
  • Failure of primary care management
  • Severe and tetracycline resistant rosacea for consideration of isotretinoin

Supporting Information

Evidence

North and East Devon formulary - Skin

The Primary Care Dermatology Society

Pathway Group

This guideline has been signed off by the Eastern Locality on behalf of NEW Devon CCG.

Publication date: 30 January 2017

 

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