Types of Rosacea: Erythematotelangiectatic Rosacea - Gladskin

Types of Rosacea: Erythematotelangiectatic Rosacea

Did you know there are four distinct types of rosacea? These include papulopustular rosacea, ocular rosacea, phymatous rosacea, and erythematotelangiectatic rosacea. When you think of rosacea, you likely think of erythematotelangiectatic rosacea.

Erythematotelangiectatic rosacea, also sometimes called ETR or vascular rosacea (because let’s face it, “erythematotelangiectatic rosacea” is a mouthful to say), affects nearly half of the 16 million Americans who live with rosacea.

ETR is often referred to as the first stage of rosacea, because ocular, phymatous, and papulopustular rosacea symptoms typically come after the development of ETR symptoms.


Erythematotelangiectatic Rosacea Symptoms

This form of rosacea causes blushing and redness, also known as erythema, of the face, commonly across the nose and cheeks. However, facial redness can also show up on the forehead, scalp, neck, and chin. 

You may also experience more visible blood vessels. The name “erythematotelangiectatic rosacea” actually comes from the words “erythema,” which refers to reddening of the skin on the surface, and “telangiectasia,” which refers to dilated blood vessels just below the skin surface.

While redness and visible blood vessels (particularly in lighter skin tones) are the most common symptoms of ETR, you may also experience dry and scaly patches of skin in the affected area or sensations of warmth and tingling.

Like with most forms of rosacea, women are more likely than men to develop ETR symptoms. Although rosacea is more common in people with lighter skin, it can occur in skin of color too.


What Causes Erythematotelangiectatic Rosacea?

The exact cause of rosacea, including erythematotelangiectatic rosacea, remains unknown. In fact, there likely isn’t one singular cause — but multiple underlying factors. Inflammation is often thought to be one of them.

In the case of ETR, the release of nitric oxide, which is produced by your body’s cells and can cause the blood vessels to dilate, as well as a miscommunication between the nervous system and blood vessels could be at play. In fact, these two factors are likely related. The nitric oxide that is created by your body’s cells is used by the nervous, immune, and cardiovascular systems.

While doctors and researchers remain uncertain about the exact reasons why rosacea develops, researchers have recognized the existence of several factors that can worsen rosacea symptoms and cause flare-ups, including:

  • Emotional stress and anxiety
  • Spicy foods
  • Alcohol
  • Hot beverages
  • Extreme heat (weather, hot baths and showers, saunas, etc.)
  • Extreme cold
  • Strong winds
  • UV rays
  • Physical exertion
  • Foods high in histamines

Because triggers vary from person to person, not everyone who experiences rosacea will find that all of these factors will irritate their skin. 


Erythematotelangiectatic Rosacea Treatment

When ETR symptoms are left untreated, symptoms can escalate and flare0ups can become more frequent.  That’s why it’s crucial to visit a board-certified dermatologist to develop a personalized treatment plan for your skin.

Your provider may recommend:


Topical Vasoconstrictors

Doctors frequently treat the facial redness associated with ETR with topical creams that work to constrict the dilation of blood vessels beneath the skin’s surface. The two topical vasoconstrictors currently approved by the FDA for rosacea are oxymetazoline and brimonidine.

When applied in the morning, these creams work rapidly and can typically keep facial redness at bay throughout the entirety of the day.

Unfortunately, though, these creams can only constrict the blood vessel dilation when they’re applied to the skin. When you discontinue the use of these medicated creams, the benefits wear off. That means your facial redness will likely reappear.


Laser Treatment

Laser treatment is a well-liked form of ETR treatment because it offers a more permanent solution than topical creams. Laser treatment targets dilated blood vessels to reduce both the appearance of blood vessels and skin redness.

These lasers work by using yellow or green light to target the hemoglobin in your blood, the protein that gives blood its red color. This light converts to heat energy and can get rid of the visible blood vessels.

According to the American Academy of Dermatology, most patients will see a 50–75% reduction in visible blood vessels after receiving one to three laser treatments. 

 In the case of multiple treatments (which are often needed), appointments will likely be spaced out three to four weeks apart. Downtime after appointments is often quite minimal; however, you can experience increased redness for two weeks after your appointment. This will fade.


Once a blood vessel has been treated with the laser, it won’t reappear. That’s why laser treatment results are often quite permanent. The only way you’d start to see dilated blood vessels under the surface of the skin again is if new ones form.


Unfortunately, not many insurance companies will cover this form of treatment for rosacea — yet.


Avoiding Triggers

One of the simplest ways to help reduce rosacea symptoms is to avoid potential rosacea triggers. Everyone responds different to possible irritants like spicy foods and hot beverages, so if you’re having trouble pinpointing your triggers, try keeping a journal to document when your rosacea symptoms worsen and what you’ve been doing, how you’ve been feeling, what you’ve eaten, and how the weather is.

Together with your dermatologist you can then better determine what the main culprit behind worsening symptoms may be. Once you’ve done that, you can do your best to avoid your personal irritants.

Factors like weather changes can be tough to avoid altogether, but you can implement practices to protect your skin from the sun — and focus on what you can control, not what you can’t.


Using Gentle Skin Care Products

Harsh skin care ingredients can be quite irritating to people with facial redness and sensitive skin, which means it may be time to clean out your skin care cabinet. Drying alcohols and fragrances can easily hide in products that look totally natural and harmless! 

With persistent facial redness, it may be best to look out for and avoid:

Instead, opt for minimally formulated, hypoallergenic products 

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