Rosacea: I. Etiology, pathogenesis, and subtype classification

J Am Acad Dermatol. 2004 Sep;51(3):327-41; quiz 342-4. doi: 10.1016/j.jaad.2004.03.030.


Rosacea is one of the most common conditions dermatologists treat. Rosacea is most often characterized by transient or persistent central facial erythema, visible blood vessels, and often papules and pustules. Based on patterns of physical findings, rosacea can be classified into 4 broad subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular. The cause of rosacea remains somewhat of a mystery. Several hypotheses have been documented in the literature and include potential roles for vascular abnormalities, dermal matrix degeneration, environmental factors, and microorganisms such as Demodex folliculorum and Helicobacter pylori. This article reviews the current literature on rosacea with emphasis placed on the new classification system and the main pathogenic theories. Learning objective At the conclusion of this learning activity, participants should be acquainted with rosacea's defining characteristics, the new subtype classification system, and the main theories on pathogenesis.

Publication types

  • Comment
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Diet
  • Expert Testimony
  • Extracellular Matrix / pathology
  • Female
  • Flushing / etiology
  • Forecasting
  • Hair Follicle / pathology
  • Helicobacter Infections / complications
  • Humans
  • Irritants / adverse effects
  • Male
  • Mite Infestations / complications
  • Photosensitivity Disorders / complications
  • Rosacea* / classification
  • Rosacea* / etiology
  • Rosacea* / microbiology
  • Rosacea* / parasitology
  • Rosacea* / physiopathology
  • Sebaceous Glands / physiopathology
  • Skin / blood supply
  • Vasodilation


  • Adrenal Cortex Hormones
  • Irritants