Types of Rosacea Explained

By Dr Magnus Lynch
MA(Cantab) DPhil(Oxon) MRCS FRCP
Consultant Dermatologist & Dermatological Surgeon

Rosacea can be classified into four main subtypes, however there is a lot of overlap and you can suffer form more than one subtype at the same time. Nevertheless, ientifying your primary subtype can help in tailoring the most effective treatment plan.

How do I know which subtype I have?

The subtypes are identified by their primary symptoms.

• Erythematotelangiectatic Rosacea: Characterised by persistent facial redness, flushing, and visible tiny blood vessels.
• Papulopustular Rosacea: Involves red bumps (papules) and pus-filled spots (pustules), often mistaken for acne.
• Phymatous Rosacea: A less common subtype causing skin to thicken and enlarge, most commonly on the nose (rhinophyma) and/or the cheeks.
• Ocular Rosacea: Affects the eyes, causing redness, dryness, burning, stinging, and swollen eyelids. For more on this, see Blepharitis, Styes and Ocular Rosacea.

Does the type change which treatments work?

Yes, absolutely. Treatment is targeted to the specific symptoms of your subtype. For erythrotelangiectactic rosacea, lasers like VBeam or IPL are effective for redness and vessels. For papulopustular rosacea topical treatments (like ivermectin or azelaic acid) and oral antibiotics are the mainstay. Phymatous changes may require procedural intervention like laser resurfacing or surgery, while ocular rosacea is managed with eyelid hygiene, artificial tears, and sometimes oral antibiotics.

Related articles

• Do I Really Have Rosacea?
• Prescription Creams for Rosacea
• IPL vs VBeam (PDL) for Redness and Veins
• Blepharitis, Styes and Ocular Rosacea

About Dr Magnus Lynch

I am a London-based Consultant Dermatologist and Dermatological Surgeon. I am highly experienced in skin cancer diagnosis and treatment, Mohs micrographic surgery, facial reconstructive surgery, laser treatments, regenerative dermatology, acne, rosacea and acne scarring. Since 2019, I have been passionate about sharing information online about dermatology and skin care. I studied at the Universities of Cambridge and Oxford, and completed my dermatology training and Mohs fellowship at the prestigious St John’s Institute of Dermatology. I graduated from medical school in 2003 and have worked exclusively in Dermatology since 2012.

I lead a research team at King’s College London investigating the molecular biology of skin cancer and skin cancer diagnostics, and I constantly aim to translate the latest findings into better patient care. You can learn more about my Research.

In recent years I have been involved in Media Appearances, including the Channel 5 series 'Skin A&E', where I perform skin surgeries and treat various skin conditions. Filming for the next series has recently completed and the series will be released later in 2025.

How I can help

My NHS practice is at Guy's Hospital. I consult with private patients at several well-appointed and conveniently located sites across central London:

• London Bridge Hospital: Conveniently situated within The Shard, next to London Bridge station.
• Skin55 Ltd: Located at 55 Harley Street, this beautiful Edwardian building houses one of the largest private dermatology facilities in the UK with a comprehensive laser suite.
• OneWelbeck: Located close to Bond Street underground station. Mohs surgery, lasers, and other skin surgeries are performed in the state-of-the-art surgical suite here.

A new consultation is £250, a follow up consultation is £220. For more information on fees, please visit Prices.