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Global Look at Data Indicates Which Subtypes of Rosacea Are Most Prevalent


The researchers warned that while the data revealed into rosacea subtypes, their findings should be interpreted with caution due to a high degree of heterogeneity.

A systematic review of data from across the globe is characterizing the prevalence of 4 recognized subtypes of rosacea, which the researchers found varied based on gender, year of study publication, and the country the study was performed in.

Across the 9000 patients, erythematotelangiectatic (ETR) and papulopustular rosacea (PPR) were the most common subtypes of the condition, with a prevalence of 57% and 43%, respectively. The prevalence of phymatous rosacea (PhR) was 7% and the prevalence of ocular rosacea was 11%.

The researchers warned that while the data revealed into rosacea subtypes, their findings should be interpreted with caution due to a high degree of heterogeneity.

“Better and more detailed reporting is warranted in future studies to allow for new and improved insight into subtypes and their possible association with clinical characteristics and comorbidities,” emphasized the researchers. “We also strongly recommend that future studies use the phenotype-based approach to diagnose and report rosacea.”

The data, pulled from 39 studies, showed that the prevalence of subtypes was generally similar between genders, with the exception of PhR, which was more common among men. The researchers noted that they were not able to explore gender trends for ocular rosacea.

ETR was more common in general population studies while PPR was more common in clinical population studies. According to the researchers, the finding suggests that patients are more likely to seek medical help for PPR, which has been associated with slightly poorer quality of life compared with ETR.

“Data suggested that the proportion of patients with PPR was higher in studies with older publication dates, whereas the proportion of patients with ETR was higher in more recent publications,” wrote the researchers. “This may be explained by a change in environmental exposures leading to certain rosacea subtypes, better or earlier interventions to treat PPR, or increased awareness of rosacea; or it may be a random finding. Also, the increase in ETR could reflect overall increased numbers of patients with rosacea due to change in lifestyle, such as increased intake of alcohol and spicy food, increased UV exposure, or perhaps increased access to laser treatments.”

Across the included studies were populations of patients from different countries, which revealed differences in the presence of rosacea subtypes. Patients from Africa exhibited lower rates of ETR, which the researchers explained could be due to the patients having darker skin, making it harder to diagnose the subtype, or due to these patients not wanting to seek medical help because the burden of the condition is less severe than for patients with lighter skin.


Barakji Y, Rønnstad A, Christensen M, Zachariae C, et al. Assessment of frequency of rosacea subtypes in patients with rosacea: A systematic review and meta-analysis. JAMA Dermatol. Published online April 6, 2022. doi:10.1001/jamadermatol.2022.0526

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