Edmonds Medical Clinic Articles


Always red like Rudolph the Red-Nosed Reindeer?

Because your nose is always red, are you mistaken for a drinker?

It is a common skin condition that caused redness and visible blood vessels in your face, as if drinking alcohol.

What is Rosacea?

Rosacea is a chronic skin disease in which the blood vessels are always dilated or gradually worsen, causing pus, swelling, etc., as the blood vessels are dilated more easily than normal people and do not decrease well after being dilated again.

Especially, erythema, papules, and vasodilation appear continuously on protruding areas such as nose, jaw, and forehead.


  • Typical onset ages 30-50 years old
  • More common in female
  • 1.3-2.1% of in U.S. population.

Risk Factors?

Excessive sun exposure, alcohol, hot food, exposure to extreme heat, mental stress, and hair follicle mites.

Symptoms of Rosacea

  1. Erythematotelangiectactic type
    – It is caused by various non-specific stimuli (ultraviolet rays, heat, chemical stimuli, emotional excitement, alcohol, hot food, etc.). When given such a non-specific stimulus, a burning or burning erythema may develop, which lasts from hours to days. As the time passes, it progresses with continuous erythema and capillary dilation.
  2. Papulopustular type
    – Inflammatory papules and pus blisters appear on the hair follicle in the center of the face, and a burning sensation appears.
    – In a more advanced state, inflammation scars may appear on the face and scars may also appear on the scalp.
  3. Phymatous type
    – Large inflammatory nodules, irregular nodules, and skin thickening occur.
    – It transforms into a bumpy and thick orange peel-like skin. This type is more common in men.
  4. Ocular type
    – Rash around the eyelids, swelling of the eyelids, conjunctivitis, iritis, keratitis, dry eye, and foreign body sensation in the eye may occur.


Most are diagnosed through clinical exam. If necessary, a skin tissue biopsy is performed to diagnose.

Rosacea Treatment

  • Topical medications: metronidazole, azelaic acid, tretinoin, brimonidine, ivermectin
  • Oral medications: doxycycline, erythromycin, tretinoin, Accutane
  • Other treatment: Electrocoagulation, laser, surgical resection.


  • Avoid prolonged sun exposure and apply sunscreen.
  • You should refrain from using cosmetics and perfumes that are highly irritating.
  • Avoid cosmetics that contain alcohol.
  • Use a mild facial cleanser rather than soap.
  • Avoid hot water baths and saunas.
  • Avoid severe skin massage.
  • Avoid excessive alcohol, hot food/drinks, and irritating and spicy foods as blood vessels may dilate.

Steven Koh, MD
Family Medicine
Edmonds Medical Clinic