Rosacea In Children: Causes, Symptoms, Treatment And Prevention

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Rosacea is an inflammatory condition that causes skin redness, commonly on the face and neck. Rosacea in children is uncommon, and it is usually seen in adults. If a child has rosacea, they can have flare-ups that may become frequent and intense over time.

Moreover, a delayed diagnosis could lead to issues such as pimples, pustules, broken blood vessels, and other skin conditions (1) (2). This non-contagious, chronic skin condition has no cure, but the right management steps can prevent the symptoms from worsening.

Read this post to know more about rosacea, its causes, diagnosis, treatment, and effective prevention.

In This Article

Is Rosacea Common In Children?

Rosacea rarely affects children and is more common in 30 to 60-year-olds. If your child has been experiencing temporary facial redness, it is more likely due to sun damage. In most cases, children with fair skin tone experience thinning of the skin due to sun damage, resulting in visible blood vessels around the cheeks (1) (3).

However, a few children may show early signs of rosacea, such as flushed skin, redness of eyes and red, and swollen eyelids for long durations (4).

protip_icon Expert says
According to Dr. Amy Paller, professor of pediatrics and dermatology at Northwestern University Medical School, US, “Rosacea is commonly mistaken for other childhood facial rashes, and treatments for these can actually exacerbate the rosacea. Thus, parents should take their child to see a dermatologist for any unusual skin problems (18).”

What Are The Causes And Risk Factors Of Rosacea In Children?

Rosacea in children may occur due to sun exposure
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The exact cause of rosacea is unknown, but the following could be the causative factors of this chronic condition (1) (5)

  • Abnormal immune system response
  • Genetic factors
  • Reaction towards mites and microbial organisms
  • Blood vessel disorders
  • Family history of rosacea
  • Fair skin
  • Sun exposure
  • Scandinavian or Celtic ethnicity

Further, the following factors may trigger rosacea flare-ups and irritation (1) (6) :

  • Sun exposure
  • Hot baths
  • Spicy foods
  • Extreme temperature
  • Cosmetics
  • Hot beverages
  • Aerobic exercises
  • Some medicines

protip_icon Quick fact
Emotional stress, overheating, especially in bed at night, and anxiety are other factors that can trigger or worsen rosacea in children (8).

What Are The Symptoms Of Rosacea In Children?

Rosacea is characterized by a series of clinical manifestations, which may vary among children. The common signs of childhood rosacea are (1) (4) (7)

  1. Long-lasting redness: Red flushes may appear on the cheeks, chin, nose, forehead, or neck and aggravate when in contact with a trigger. The redness may only last for a while but reappears occasionally.
Red flushes may appear on the cheeks, chin, and nose
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  1. Visible blood vessels: Dilated, small blood vessels (telangiectasia) that seem webbed may appear on the face.
  1. Small bumps and pimples: Skin bumps such as papules and pustules (filled with pus) may occasionally appear in the reddened areas.
  1. Skin plaques: Raised patches of skin that may sting.
  1. Thick skin: The skin becomes tight and thick, especially around the nose (rhinophyma), giving it a bulbous appearance. It may also appear on the forehead, cheek, ears, and chin. This is not a primary symptom of rosacea but may follow the other symptoms. Rather, it is very rare in children.
  1. Ocular rosacea (around the eyes): Recurrent pink eye (conjunctivitis or styes (pimples on the edge of the eyelid), watery eyes, swollen eyelids, burning or stinging sensations, redness, or irritation as if there is sand in the eyes are a few signs of ocular rosacea. In some children, eye symptoms may appear before the skin symptoms.
  1. Stinging or burning: You may get sensations like your skin is burning or stinging. Sometimes, it may be accompanied by itching.
  1. Dryness: Sometimes, you may feel that the center of your skin is dry, rough, or even scaly.
Swollen eyelids is a sign of ocular rosacea
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What Are The Complications Of Rosacea In Children?

Untreated rosacea may result in the following complications (4) (8):

  • Permanent redness on the face
  • Conjunctivitis (inflammation of the eye’s outer membrane)
  • Rhinophyma (bumpy and bulbous nose due to swollen nasal sebaceous glands)
  • Partial or complete visual impairment due to progressed ocular manifestations of rosacea

How Is Rosacea Diagnosed In Children?

Rosacea is mostly diagnosed based on a physical examination and medical history. Occasionally, the medical care advisor may suggest blood tests to rule out the possibility of lupus (an autoimmune disease) (1) (9)

They may also try to rule out other skin conditions such as acne, periorificial dermatitis (inflammation of the skin around the mouth), or allergies (4) (10) Skin biopsy may be required in severe cases, not responding to treatment.

What Is The Treatment For Rosacea In Children?

Oral antibiotic therapy may help reduce inflammation
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The treatment for childhood rosacea aims at managing the symptoms since there is no permanent cure. Your medical care supervisor may advise a combination of treatment options for increased effectiveness. These may include (4) (11)

  • Medication: Based on the symptoms, the dermatologist may suggest gels or creams. Oral antibiotic therapy or topical steroids may help reduce inflammation. Over-the-counter medications may be ineffective in treating childhood rosacea and, hence, should be avoided.
protip_icon Caution
Unless directed otherwise by the doctor, don’t apply steroid cream on sores as they may worsen rosacea (1).
  • Alternative treatment: If telangiectasia is observed, laser therapy may be advised to shrink the enlarged blood vessels. In case rosacea leads to rhinophyma, surgery of the nose may be recommended by the doctor.

If left untreated, rosacea can worsen and long-lasting flushing can lead to permanent redness in those affected regions of the face and body.

How Can You Prevent And Manage Rosacea In Children?

Daily use of sunscreen may prevent rosacea in children
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Although your child cannot prevent the onset of rosacea, they can curb the flaring up of its symptoms. Here are some tips to help prevent rosacea in children (12) (13):

  1. Identify the triggers: As triggers may aggravate sensitive skin, identify and eliminate the triggers to help reduce the irritation.
  1. Apply sunscreen: Daily use of sunscreen is recommended. Dermatologists may suggest fragrance-free and SPF 30 sunscreens containing titanium oxide, zinc oxide, or both.
  1. Protect the affected area: As hot and cold temperatures may trigger rosacea, ask your child to drape a scarf in extreme conditions. Opt for silk or acrylic scarves as they may be less triggering.
  1. Avoid heat: Avoid hot baths and excessive clothing. Ensure they maintain distance from heat sources such as heaters, and keep a cold water bottle or cold towel handy during intense activities.
  1. Consume the right foods and beverages: Avoid spicy foods and hot drinks. Opt for cold or room-temperature beverages instead.
  1. Read labels: Many cosmetics and skin care products contain ingredients that may trigger rosacea, such as sodium lauryl sulfate (common in shampoos and toothpaste), alcohol, camphor, or menthol.
  1. Subtle skin care: Choose a gentle skincare routine for your child. Use a gentle cleanser on their face and pat it dry. Avoid scrubbing or massaging their face, and use products recommended by your dermatologist.
  1. Perform patch tests: Always perform a patch test for new products to check if they cause any reactions.
  1. Moisturize: Studies show that moisturizing a dry or oily skin with a prescribed product could be helpful.

Frequently Asked Questions

1. What are the four stages of rosacea?

According to the National Rosacea Society (NRS), the following are the four stages of rosacea (14):

  • Stage 1: Erythematotelangiectatic rosacea
  • Stage 2: Papulopustular rosacea
  • Stage 3: Phymas
  • Stage 4: Ocular rosacea

2. What can be mistaken for rosacea?

Seborrheic dermatitis, eczema, lupus erythematosus, and other types of dermatitis may be mistaken for rosacea (15) (16). A healthcare professional can help you differentiate between these conditions.

3. Can seasonal allergies trigger rosacea in children?

Yes, seasonal allergies can trigger rosacea in children (17). Maintaining a healthy lifestyle and seeking medical care promptly during these seasonal changes may help prevent flare-ups.

Rosacea in children is an inflammatory disease of a rare occurrence. It is preventable and also treatable by medications and alternative therapies. Although the cause for this condition is not well-known, it could be more prevalent in children with prolonged sun exposure, abnormal immune response, and genetic predisposition. Therefore, if you notice any typical symptoms such as continued redness, or dilated and visible blood vessels on your child’s face, it is vital to see a doctor for appropriate diagnosis and prompt treatment to prevent the risk of complications.

Infographic: Does Your Child Have Rosacea Or Acne?

Rosacea may be mistaken for other look-alike skin conditions, one of them being acne. But rosacea is a more complex condition than acne requiring accurate management to avoid uncomfortable complications. This infographic will help you spot the subtle differences and manage the condition better.

is it acne or rosacea (infographic)

Illustration: Momjunction Design Team

Get the high-quality PDF version of this infographic.

Download Infographic in PDF version

Key Pointers

  • Rosacea is a skin condition less common in children.
  • However, certain factors such as family history, frequent sun exposure, and abnormal immune responses might contribute to the development of this condition in children.
  • If left untreated, rosacea may lead to further complications like conjunctivitis, acne, and enduring facial redness.
  • Nevertheless, the skin condition is easily manageable by identifying triggers, avoiding excessive heat, moisturizing, and following a gentle skin care routine for your child.
Rosacea In Children_illustration

Image: Stable Diffusion/MomJunction Design Team

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
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  2. Rosacea.
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  3. Can Children Get Rosacea?
    https://www.sutterhealth.org/ask-an-expert/answers/can-children-get-rosacea
  4. Could My Child Have Rosacea?
    https://www.aad.org/public/diseases/rosacea/what-is/children
  5. Risk Factors For Rosacea.
    https://winchesterhospital.org/health-library/article?id=20097
  6. Rosacea.
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  7. Rosacea: Signs And Symptoms.
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  8. Rosacea.
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  9. Diagnosis Of Rosacea.
    https://winchesterhospital.org/health-library/article?id=20091
  10. Why Is Perioral Dermatitis Often Mistaken For Rosacea?
    https://www.rosacea.org/blog/2021/march/why-perioral-periorificial-dermatitis-mistaken-rosacea
  11. Treatment For Rosacea.
    https://winchesterhospital.org/health-library/article?id=20102
  12. 8 Tips To Help Prevent Rosacea Flare-Ups.
    https://www.aad.org/news/prevent-rosacea-flareups
  13. 6 Rosacea Skin Care Tips Dermatologists Give Their Patients
    https://www.aad.org/public/diseases/rosacea/triggers/tips
  14. J-L Schmutz; Signs and symptoms of rosacea.
    https://pubmed.ncbi.nlm.nih.gov/25151930/
  15. Red Skin & Rashes Are Not Always The Result Of Rosacea.
    https://www.rosacea.org/blog/2016/june/red-skin-rashes-are-not-always-the-result-of-rosacea#:~:text=There%20are%20many%20different%20types,%2C%20itchy%2C%20red%20and%20cracked
  16. Rosacea Differential Diagnoses.
    https://emedicine.medscape.com/article/1071429-differential#:~:text=The%20differential%20diagnosis%20largely%20depends,causes%20of%20erythema%20and%20telangiectasia
  17. Spring Forward, Not Backwards With Your Rosacea.
    https://www.rosacea.org/blog/2014/march/spring-forward-not-backwards-with-your-rosacea
  18. Will Your Children Have Rosacea?
    https://www.rosacea.org/rosacea-review/1999/fall/will-your-children-have-rosacea
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