Understanding Rosacea: Causes, Symptoms, and Treatment

Rosacea is a common but often misunderstood chronic skin condition that primarily affects the face. Characterized by redness, visible blood vessels, and sometimes acne-like bumps, rosacea can impact both physical appearance and self-confidence. While it’s not a dangerous condition, it can be frustrating and sometimes emotionally distressing for those who live with it.

What is Rosacea?

Rosacea is a long-term inflammatory skin disorder that usually develops in adults over the age of 30. It tends to affect people with fair skin but can occur in all skin tones. The condition is more common in women, but men who have rosacea often experience more severe symptoms.

There are four main subtypes of rosacea:

Erythematotelangiectatic Rosacea (ETR) – Characterized by redness, flushing, and visible blood vessels.

Papulopustular Rosacea – Includes acne-like breakouts, redness, and swelling.

Phymatous Rosacea – Leads to thickening of the skin, most commonly on the nose (known as rhinophyma).

Ocular Rosacea – Affects the eyes, causing redness, irritation, and swollen eyelids.

What Causes Rosacea?

The exact cause of rosacea is unknown, but researchers believe it is due to a combination of genetic and environmental factors. Several triggers can cause flare-ups or worsen symptoms, including:

Sun exposure

Hot or cold weather

Stress and anxiety

Alcohol, especially red wine

Spicy foods

Caffeine

Hot beverages

Certain skincare products

Some studies suggest that an overactive immune response, skin mites called Demodex, or an imbalance in gut bacteria may also contribute to rosacea.

Symptoms of Rosacea

The signs and symptoms of rosacea can vary from person to person, but common symptoms include:

Persistent facial redness (especially on the cheeks, nose, chin, and forehead)

Small, red, pus-filled bumps or pimples

Visible blood vessels (telangiectasia)

Burning or stinging sensation

Dry, rough skin

Thickening of the skin (in severe cases)

Eye problems, such as dryness, irritation, or swollen eyelids

In TCM, rosacea is not viewed as a singular skin disease but rather as an external manifestation of internal imbalances. The skin, in this ancient system, is a reflection of the body's overall health, particularly the state of the digestive system, Liver, Lungs, and emotional wellbeing.

The TCM Perspective: Internal Heat, Dampness, and Blood Stagnation

In TCM rosacea is specifically linked to patterns of internal heat, disharmony of the organs, and poor circulation. Some of the main patterns associated with rosacea in TCM are:

1. Accumulation of Heat in the Lungs and Stomach

This is one of the most common patterns seen in rosacea patients. The Stomach and Lungs are both responsible for nourishing and moistening the skin. When excessive spicy food, alcohol, greasy food, or emotional stress generates heat in these organs, it can rise to the face and cause redness, burning sensations, and pimples.

Symptoms: Redness on the cheeks and nose, thirst, bad breath, constipation, and a yellow, greasy tongue coating.

2. Liver Qi Stagnation and Heat

Emotional stress, frustration, or anger can lead to stagnation of Liver Qi. Over time, this stagnation can transform into heat, which flares upward and manifests as facial flushing, visible blood vessels, and even sudden flare-ups.

Symptoms: Flushing triggered by emotions, mood swings, irritability, bitter taste in the mouth, and a wiry pulse.

3. Blood Heat and Blood Stasis

In chronic cases of rosacea, heat may enter the Blood level, leading to more severe symptoms such as persistent redness, visible capillaries (telangiectasia), and nodules. Long-term stagnation may even cause Blood Stasis, where circulation in the face is sluggish and toxins accumulate.

Symptoms: Persistent dark redness, broken capillaries, rough and thickened skin, purple tongue or spots on the tongue.

4. Spleen Deficiency with Dampness

In some cases, rosacea is related to an underlying weakness of the Spleen, one of the key digestive organs in TCM. A weak Spleen leads to internal Dampness and Phlegm accumulation, which can block the flow of Qi and Blood to the skin.

Symptoms: Facial puffiness, oiliness, papules with pus, digestive issues, fatigue, pale tongue with a greasy coating.

Treatment Strategies in TCM

TCM does not treat rosacea by targeting the skin alone. Instead, it aims to address the root cause and restore systemic balance. Acupuncture helps regulate Qi flow, reduce heat and inflammation, and calm emotional stress. Specific points are selected according to each patient’s pattern.