The classic symptom of rosacea is flushing, although this is often lacking. Patients usually complain of a red nose or face. The condition is made worse by hot (temperature) or spicy foods or beverages, alcohol, and sunlight. The findings can be subtle and merely limited to mild telangiectasia and centrofacial erythema. More pronounced rosacea appears as acneiform facial papules, pustules, and frank ruddiness (Fig. 11-1). Some clinicians talk of the “rosacea oval,” a vertical pattern of erythema from the glabella to the chin. Thickening and enlargement of nasal skin can cause the characteristic bulbous nose of rhinophyma, but this is rare. Northern European and Celtic patients are affected most. Eye diseases, such as conjunctivitis, blepharitis, episcleritis, or keratitis, are common complications of rosacea.