Rosacea can be classified into four subtypes. It begins with pre-rosacea, with just redness and sensitivity and can evolve into full-blown rosacea with bumps, pimples and swelling and may involve the eyes, enlarge the nose and cause other disfiguring symptoms.
Rosacea Grade 1, also known as Rosacea Subtype 1 or Prerosacea, includes pink or red skin, with flushing or blushing that comes and goes initially, becoming persistent with time. Rosacea Grade 1 can include visible blood vessels that contribute to the appearance of redness along with stinging, burning, swelling and inflammation. Roughness, scaling or flaking, sensitivity and dryness of the skin may also occur.
Rosacea Grade 2 is characterized by persistent redness, possible bumps, pimples, red patches and roughness. Even though this grade is frequently called Acne Rosacea, rosacea and acne are not the same disorder. However, someone may have both skin conditions.
Rosacea Grade 3, or Phymatous Rosacea, manifests in thickening of the skin, irregular surface bumps and enlargement of the nose from excess tissue. This occurs more often in men, but women can have this type as well.
Rosacea Grade 4, also known as Ocular Rosacea, involves red, bloodshot, watery eyes with swollen eyelids. Sensitivity to light, styes and conjunctivitis (pink eye), along with irritation and even vision problems may be present. Triggers cause the blood vessels of the eye to dilate, which can result in irritation, burning, stinging, or intense pain. Inflammation of the thin tissue that covers the whites of the eye and the front part of the eye (corneal ulceration) can also occur.
Rosacea Conglobata is a rare, disfiguring form of rosacea that includes tender, pink to deep red, swollen, bleeding pus-filled sores, as well as hardened raised, solid flat-topped lesions. This form occurs mainly in females and is chronic.
Rosacea Fulminans is also rare and mimics severe cystic acne with bumps and pimples that appear suddenly, developing into hard round bumps. Facial swelling with a reddish blue color and possible scarring are also symptoms. Note, this is not acne rosacea and there is no flushing or eye involvement.
Neck Rosacea appears on the sides of the neck in a “v” shape and includes dilated capillaries with brownish/reddish color changes. It also exhibits a bumpy texture and appearance. This form is a direct result of UV overexposure and can include damage to the outer and deeper layers of skin (epidermis and dermis).