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Granulomatous rosacea


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Granulomatous rosacea is a type of rosacea, a long-term (chronic) skin condition involving inflammation of the cheeks, nose, chin, forehead, or eyelids.[2238][1] Rosacea causes redness and pimples, mainly across the face. Granulomatous rosacea is a type of rosacea that occurs mainly around the cheeks, eyes, and mouth. The symptoms include yellowish-brown or pink bumps (papules) on the skin, thickening of the skin, and patchy redness.[2] The cause of granulomatous rosacea is unknown, but both genetic and non-genetic factors contribute to this condition. Granulomatous rosacea can look like other skin conditions and may be difficult to diagnose. The diagnosis is usually made based on the symptoms and characteristic findings seen from a skin biopsy.[3] Granulomatous rosacea usually occurs in adults, primarily in middle-aged women. Treatment is based on controlling the symptoms using medications, antibiotics, light therapy and other treatments.[2] The long-term outlook for people with granulomatous rosacea depends on the severity of symptoms and the response to treatment. The main complications of this condition is social isolation, depression and low self-esteem.[1] This type of rosacea is rare, but the exact prevalence is unknown.
Last updated: 3/15/2019
The symptoms of granulomatous rosacea will vary from person to person and may change over time. They include hard, yellow, brown, or red bumps on the face, especially around the cheeks, eyes and mouth. In addition, there may be skin thickening, flushing and redness, visible small widened blood vessels (telangiectasia) and eye irritation. Some people with this condition experience stinging or burning. The symptoms may periodically go away and come back. Only the skin is involved; other organs are not affected.[2][4]
Last updated: 3/15/2019
The exact cause for granulomatous rosacea is unknown. Both genetic and non-genetic factors may be involved. These factors may include systemic steroids, topical steroids, UV radiation, heat, spicy food, alcohol, infectious organisms (mites, gut bacteria), and immune suppression.[3] Genetic factors also seem to play a role [1]
Last updated: 3/15/2019
The genetic factors contributing to granulomatous rosacea are not well understood.  Having a family member with granulomatous rosacea increases the chance of developing this condition.[1]
Last updated: 3/15/2019
Granulomatous rosacea can be difficult to diagnose because it can look like other skin conditions. The diagnosis is often made based on the symptoms and after other skin conditions have been ruled out. A skin biopsy may be done to look for characteristic skin findings seen in granulomatous rosacea.[3]
Last updated: 3/15/2019
There is no standard treatment for granulomatous rosacea, but granulomatous rosacea is not treated differently than other forms of rosacea. Medications, including antibiotics, anti-inflammatories or isotretinoin may be used. In addition, this condition may be treated with light or laser therapies. People with granulomatous rosacea may be advised to avoid factors that may trigger the condition or make it worse, such as hot drinks, alcohol, sun exposure and hot temperature. Granulomatous rosacea is a long term (chronic) condition, and even with treatment, the symptoms may return.[2][5]
Last updated: 3/15/2019
The long-term outlook for people with granulomatous rosacea depends on the severity of symptoms and the response to treatment. Some people with this condition develop depression, low self-esteem and fear of social situations.[1][2][3]
Last updated: 3/15/2019
The exact prevalence of granulomatous rosacea is unknown.  It may account for about 10% of all types of rosacea.[3][5]
Last updated: 3/15/2019

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Where to Start

  • The MayoClinic.com web site provides information about granulomatous rosacea. Click on the above link to access this information.
  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases. Click on the link to view information on this topic.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Granulomatous rosacea. Click on the link to view a sample search on this topic.

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  1. Rosacea. Genetics Home Reference (GHR). Sept 2018; https://ghr.nlm.nih.gov/condition/rosacea#.
  2. Lee GL, Zirwas MJ. Granulomatous rosacea and Periorificial dermatitis: Controversies and Review of Management and Treatment. Dermatol Clin. July 2015; 33(3):447-455. https://www.ncbi.nlm.nih.gov/pubmed/26143424.
  3. Gallo RL, Granstein RD, Kang S, Mannis M, Steinhoff M, Tan J, Thiboutot D. Standard Classification and pathophysiology of rosacea; The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Derm. Jan 2018; 78(1):148-155. https://www.ncbi.nlm.nih.gov/pubmed/29089180.
  4. Wilkin J, Dahl M, Detmar M, et al.. Journal of the American Academy of Dermatology. April 2002; http://www.rosacea-research.org/rosacea_classification.htm. Accessed 4/26/2010.
  5. Banasikowska AK, Singh S. Rosacea. eMedicine. June 12, 2009; http://emedicine.medscape.com/article/1071429-overview. Accessed 4/26/2010.
  6. Vorvick LJ. Rosacea. MedlinePlus. Updated Sept 26, 2017; https://medlineplus.gov/ency/article/000879.htm.