10 Fast Ways to Spot Rosacea

“Most often, rosacea appears as fixed redness in the center of the face,” says Ivy Lee, M.D., a dermatologist at Pasadena Premier Dermatology in Pasadena, CA. “This redness can intensify and flare due to exogenous or endogenous factors”—meaning it’s sensitive to triggers both inside and outside your body. Stress, heat, sunlight, spicy foods, and alcohol can all contribute to a rosacea flare. Over time, these flares may lead to thickened skin, visible blood vessels, and a permanent or long-term appearance of facial redness.

We’re not talking about the type that makes you resilient to criticism. Rosacea redness is often accompanied by a “thickening of the skin and pores on the nose or chin,” says Dr. Lee. This is caused by excess tissue growth in the nose area and is also known by its technical term, “rhinophyma.” If rhinophyma is allowed to go on for years without treatment, it can lead to problems with nasal air flow.

You grew out of your acne—but now rosacea is creating that same swollen, bumpy effect. “Rosacea is sometimes called adult acne,” says Laura Ferris, M.D., Ph.D., an associate professor of dermatology at the University of Pittsburgh School of Medicine. “It is caused by inflammation in the skin, sometimes driven by a mite called demodex that lives in hair follicles and oil glands but can appear on the skin surface and make rosacea worse.” (Yes, mites! Sorry to say, but everyone has them on their face, even if they aren’t causing rosacea-related inflammation.)

Not every type of rosacea impacts the eyes, but when it does, it can be aggravating. “Some people get ocular (eye) rosacea, and this can cause eye irritation and redness,” Dr. Ferris explains. Your eyes may appear red and bloodshot, with a scaly texture around them that itches or burns. Crust can start to accumulate and irritate your peepers even further. In serious cases, rosacea can result in blurry vision and even corneal damage, so it’s important to get it examined by a doctor ASAP.

Even if rosacea doesn’t change the texture of your skin surface, you may notice underlying blood vessels that start to look broken or inflamed. The scientific word for this is telangiectasias, and it often appears on the cheeks and center of the face. It is especially likely to occur in people with extremely fair or sensitive skin, although Dr. Lee notes that anyone can develop rosacea, and the condition “can be seen in patients of all skin colors.”

Do you feel your face flush when you eat curry dishes or salsa? People with rosacea often experience flares when they consume spicy food, drink alcohol, are exposed to hot weather, or have a bout of strong emotions, says Dr. Ferris. During a flare, you may feel a burning or stinging sensation in your face, like there is literally heat radiating from your cheeks or nose. Your skin may also feel excessively tight or irritated, and it will only calm down once you remove yourself from the trigger.

Get ready to layer on that sunscreen: Rosacea tends to get worse in hot weather and intense sunlight. When you’re out running or biking in hot weather, you’re even more likely to develop rosacea redness and irritation. While some degree of rosy cheeks is normal in the heat, if you find yourself with a flushed face that doesn’t go away after you stop exercising and head indoors, it could be a sign of the skin condition.

All that inflammation on your face can lead to some seriously dry and parched skin. Erythematotelangiectatic rosacea (let’s just call it ETR), a subtype of the skin disease, tends to cause dryness as well as visible blood vessels, swelling, and scaly patches on the face. These symptoms may be more noticeable in the winter, when most people’s skin tends to dry out anyway because of a lack of moisture in the air. That said, the cool weather can also be a balm for your rosacea, which often flares in the heat.

Just to confuse things a little: Dry skin is a possible sign of rosacea, but so is oily skin. This rosacea subtype tends to affect middle-aged women and features greasy skin and acne-like bumps. Although it may look like a breakout, you won’t see any blackheads here, and you’re more likely to feel burning than acute pain (like you might feel with a typical pimple). The bumps and oily skin come and go depending on exposure to triggers.

The more inflamed your skin gets, the more you’ll notice swollen patches that are sensitive to the touch. If you have inflammation going on, it’s important to see your doc quickly, since a variety of things—some dangerous, others not so much—may be responsible. “The best thing to do is to see a board-certified dermatologist to make sure you are getting a correct diagnosis and you can be provided with a sound treatment plan,” says Dr. Ferris. Your doctor can help you eliminate other potential conditions such as eczema or allergies, and to determine what steps you can take for relief.