Rosacea + Swelling?

I saw a patient for a partner in clinic recently who has rosacea. She has struggled with it for years, but it has gotten worse recently. She has agreed to have a picture of her condition posted here for everyone to see:

55y female w/ Rosacea

Rosacea is a common skin condition. The most frequent symptom is facial flushing, usually right over the cheek bones. Also common are erythema (redness), sometimes with little red blood vessels visible under the skin and sometimes roughness also. There’s actually 4 types, but the biggest thing for most people is the redness. Nobody knows what causes the problem. We know genetics play a role, but it also seems to be brought on most commonly by things like: emotional stress, hot drinks, alcohol, spicy foods, exercise, cold or hot weather, and hot baths and showers.

The problem for this patient is that the areas are also swelling. It’s hard to see in the picture, but at times she has had swelling to the point that a friend wondered if maybe she had elephantiasis (lymphedema) of the face. This patient has said that the swelling is as distressing as the bright red cheeks.

Historically, the pt. has taken amoxicillin for about 8-10 days to treat the problem and things have improved. This isn’t the most common antibiotic for rosacea, but it has worked for her. However, she has had 3 outbreaks in the past month, all with bad swelling. As soon as she stops the antibiotics, the problem comes back.

I’ve already seen this pt. together with a dermatologist, and he was a bit intrigued himself, so I’m not the only ingnoramous at this party. Her primary care doc – who knows her best and has treated her outbreaks many times – is suspicious that she may have another problem entirely. While seeing her, I took blood tests that argue against lupus, infection or other systemic inflammatory problems.

So, what does she have?

Don’t know for certain. Rashes are lame. I never know what they are for sure. The swelling is not a symptom that is commonly seen in association with the rosacea seen by some of the senior docs in our clinic. However, at least one source I found says that the swelling can be even the ONLY symptom at presentation.

So, I’m going with rosacea. Of the 4 types, I think she has Erythematotelangiectatic type. I picked that one of the four because it’s the longest and least-pronounceable and thus makes me appear smart and medicaly. But is also seems to most closely fit her symptoms. Why it is worsening is another question I can’t answer. I can only hope it gets better on our treatment plan. Like many autoimmune conditions, rosacea doesn’t really ever go away, we just keep it under control as much as possible.

And, sometimes, we give it really long sub-names too.

16 thoughts on “Rosacea + Swelling?

  1. Jude

    I can’t believe it has taken me so long to find your article. I have struggled – and I DO mean “STRUGGLED” – with a very similar medical problem for years. I have been seen by some very talented doctors, and none of their prescription meds have helped long-term. This has been extremely discouraging, because not only is the condition hard to manage, but the rash has made me feel uncomfortable about going out in public. It is impossible to mask the rash with makeup, as foundations only make the rash more obvious.

    My situation is further complicated by the fact that I was diagnosed with sero-negative (sp??) rheumatoid arthritis 22 years ago, so have a lot of inflammation in my body. I also have a congenital skin disorder, Benign Familial Phemphigus, inherited from my father. No surprise that I have SUFFERED all my life with a variety of skin rashes. Contact Dermatitis used to be a daily occurrence.

    At this time I am dealing with small areas of Psoriasis on my legs and arms, following a major outbreak in January of 2006 in which all my limbs and upper back were nearly completely covered with the painful, burning rash. After several months of treatments which made me feel as if I was going to die, the rash finally retreated, leaving a few small patches on the legs and arms. But the itching never stopped, and I remained on prescription antihistimines, unable to stay awake – but not wanting to be awake because the itching drove me insane. Sigh …

    In January of this year I began taking Quercetin Complex in capsule form (Vitamin C as ascorbic acid 100 mg; Magnesium from magnesium carbonate 15 mg; Bromelain from Pineapple 25 mg; Lemon bioflavonoid complex 50 mg; Quercetin 250 mg). THE ITCHING STOPPED! completely within three days. I have been taking 6 capsules every day – so gentle I can take them on an empty stomach – and will probably never be without this wonder “drug” for the rest of my life. It has even reduced the inflammation and swelling caused by the RA.

    Now to Rosacea with swelling. After trying many different treatments, I finally found a MIRACLE that keeps the Rosacea almost completely under control without the use of any drugs.

    I wash my face daily with Aveeno “Ultra-Calming” Foaming Cleanser, and follow with the accompanying Moisturizer. There is also a concentrated Moisture Creme for overnight use. This product line contains Feverfew, which is known as “Nature’s Aspirin” (anti-inflammatory). It has done wonders for my face. I have no connections with the Aveeno line; I am simply a completely thrilled customer.

    I believe the swelling could be reduced by placing thin slices of cold cucumber on your patient’s closed eyes and cheeks (while she is resting, of course).

    And I am certain your patient would benefit from the Quercetin Complex.

    Other VERY IMPORTANT issue: NO WHITENING toothpastes should be used. Use only Tom’s of Maine baking soda toothpaste with NO whitening agents. If this formula of Tom’s cannot be found, just use good ole’ Baking Soda right out of the box.

    I have done a lot of research, and when I read that whitening pastes commonly cause rashes on the face, I threw away my Crest and started using Tom’s. The change in my face was DRAMATIC and IMMEDIATE. And an annoying dry, cracking rash behind my right ear VANISHED in 2 days!

    While I do not have a medical degree, I do have years and years and years of first-hand experience with my various skin issues. Based on everything I have learned, I am convinced that Rosacea is not caused by stress – but does CAUSE stress. I believe that Rosacea is the inflammatory reaction of the delicate facial skin to the toxic substances in our environments … cleaning and laundry products, cosmetics, shampoos, even Pam cooking spray.

    That’s my story … and I’m sticking to it. Hope the information is helpful.


  2. GingerB

    Rosecea is hard. I read this crazy book about changing the PH balance in your body to be less acidic, which I’ve since decided is bunk.

    But, it convinced me to quit with the daily diet sodas, and I think that, along with washing regularly with a gentle soap (something I’d not been doing because I thought it would dry my skin) helps. Who knows what’s in those sodas?


  3. I am not a doctor, but a scientist who has suffered for more than 15 years from rosacea.

    There are a few possibilities: the patient may be suffering from extreme anxiety and that can be a major source of aggravating rosacea. I have seen swelling on my own face when I was suffereing from anxiety and during periods of heavy stress.

    I also react with swelling to a wide variety of lotions and creams (sunblock lotions are the worst and I was never able to use antibiotic creams).

    Another thing to look at may be her thyroid function?

    You can read more about rosacea food triggers on my blog:


  4. Elaine

    Yes, I’m starting to look like Bill Clinton. what can be done for the nose swelling. I even had laser treatment – very expensive – no change.


  5. Heartburn Home Remedy

    Not that I’m totally impressed, but this is more than I expected when I stumpled upon a link on Digg telling that the info is awesome. Thanks.


  6. Alexia

    just been diagnosed with Rosacea. I was given Rosex to clear away the mild going on moderate pustule red patches. It got worse plus welts, etc. I got some on my lip and it swelled plus welts. I was then given benzoyl peroxide to try. This may help but the swelling is also occuring on the red pustule patch on my cheek. Swelling was not a problem before. I feel the thing to do is not to put anything on my face but I am not sure I have the courage to leave well alone for a while in case the symptoms spread… My heart goes out to others who have worse symptoms then me.


  7. Annie

    Is it better to use Quercetin with Bromelain or without in regards to Rosacea? I don’t have a red face but have had small red rashes off and on for years after being in the heat. I thought since I didn’t have a permanent red face as many do, that I was still in a mild stage. Well, I have skipped the red face stage ( I only get pink when in the sun and then as soon as I return indoors it lightens back to normal) and now am having mild swellings on the nostril area as well as the nostril crease. Needless to say, I am reading everything I can to educate myself and am very freightened that even if I’m able to halt the progression that I will be stuck with these swelled areas. I would love to hear from anyone that has had these types of swellings that later receded. That would be absolutely wonderful to hear.


  8. jenniferL5

    For over 7 years I have been battling Adult Acne Rosacea with little success. I have used prescribed creams, facialists, OTC products, diet changes, etc. with minimal effects. With the onset of winter I wanted to ensure my face was moisturized with the very low humidity.

    While ordering a Volume Shampoo from Shielo, I noticed many people also ordered the Shielo Hydrate Mist, which I thought was just for hair – but its for skin also.

    I thought “why not”? The results were almost immediate! The redness and breakouts have greatly diminished and I’m once again getting comments from people on how very nice my skin is looking. You couldn’t ask for an easier application and it doesn’t give my skin a claustraphobic feeling. And, the scent is revitalizing and calming. The Shielo Hydrate Mist is the best thing I’ve used in over 6 years. I wholeheartedly recommend it, especially to premenopausal women who are experiencing skin dryness.


  9. vicky

    Hi i have been diagnosed with mild rosacea on my nose
    and have been taking antibiotics for 3 weeks without seeing any improvement but understand this is not uncommon. My question is this is it normal to have 2 like nodule things on my nose and will these clear up with the antibiotics? Also sure my nose is bigger then it used to be and also think it look sort of swollen is this normal and will the antibiotics help to clear this up? Seen some awful pic of severe rosacea that has never been treated and has developed into rhinophyma i won’t get this will i when been early diagnosed and on treatment please some1 put my mind at ease and tell me what i’m experiencing is a normal symptom of rosacea need reasurring that there is a light at the end of the tunnel. Thankyou


    1. MaryO

      Hi, sorry I can’t help but going through the same thing and feeling very very anxious. Do you mind me asking if your anti-biotics worked and if your nose reduced back to its normal size? Thank you.


  10. jane kearney

    i was diagnosed with rosacea two years ago and i have been experimenting with diet.I have cut lots of things out from my diet and this has been very effective.I no longer eat sugar..when i do which isn’t that often i get red pustules and burst blood vessels on my face near the bridge of my nose.I find that if i make a juice from celery cucumber and apple and other cooling vegetables or fruit my spots when i have a binge i have the juice,i hope this helps.


  11. Dianne

    Hi – I’ve had it a decade at least. Its sounds hard to do, but I cut out sugar entirely 10 yrs ago and have rarely had a breakout since. If I eat something with a lot of natural occurring sugar it can make my redness on my cheeks flare up. But no pimples in years. Good luck to us all…


  12. KRC

    Doctors don’t pick up on patients facial edema because they have no frame of reference for a patient’s normal appearance. Hell I have fairly dramatic edema and my own spouse doesn’t see it!!! Generally people just don’t care how other people look as they are too self absorbed. Cynical? Perhaps, but that is how I feel. I have been that way myself at times. We are all on overload. Doctors just don’t pick up on it.


  13. Lulu

    Please please tell me did that woman figure out what was the root of her problems? I have exact same thing happening to me. Facial flushing (cheeks) burning sensation with swelling, also dry lips and burning tingling sensation. I don’t know if it’s really Rosacea. Also I know it’s not caused by anything food related as I did a 3 day water fast and had a flare on the 3 rd day of not eating anything. ??? Please help


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s