Is rosacea autoimmune or contagious?

Rosacea is not contagious. The American Academy of Dermatology (AAD) and the NHS both state this directly. Whether rosacea is autoimmune is a harder question. The major health sources describe it as an inflammatory skin condition in which the immune system plays a part, and none of the pages checked for this guide list it as an autoimmune disease. Research has found that some autoimmune diseases are more common in people with rosacea. This guide explains what the sources say, what the research found, and what it means for you. A doctor confirms rosacea by examining your skin and eyes, and a doctor is also the right person to ask about your own risk of other conditions.

For the full overview of the condition, start with what rosacea is.

What autoimmune means

The immune system protects the body from germs such as bacteria and viruses. In an autoimmune disease, the immune system attacks the body's own healthy tissue by mistake. Type 1 diabetes, celiac disease, multiple sclerosis and rheumatoid arthritis are examples.

People search "is rosacea autoimmune" because rosacea involves the immune system and inflammation, which are also part of autoimmune diseases. The two ideas overlap, so the answer takes some care.

What the sources say about rosacea and the immune system

NIAMS, the skin institute of the US National Institutes of Health (NIH), calls rosacea a long-term inflammatory skin condition. Inflammation is the body's response to injury or infection, with redness, heat and swelling.

The AAD explains the immune system's part. It says inflammation is a key part of how the body fights infection and heals injuries, and that the immune system turns on the cells that lead to inflammation. In rosacea, the AAD says, the immune system may be set off by triggers like sunlight, heat or spicy food.

The AAD also names an immune protein called cathelicidin. It normally protects the skin from infection. In rosacea, it may cause the color change and swelling, and how the body processes it may decide whether a person gets rosacea.

The AAD pages, the NHS page, the NIAMS pages and the MedlinePlus page on rosacea were all read for this guide. None of them calls rosacea an autoimmune disease. NIAMS says scientists do not fully understand why the inflammation happens, so this may change as research continues.

What the research found about autoimmune diseases

The clearest study on this question was published in the Journal of the American Academy of Dermatology in 2016. Researchers in Denmark started from an earlier finding: rosacea shares some genetic risk areas with autoimmune diseases such as type 1 diabetes and celiac disease.

They compared 6,759 people with rosacea to 33,795 people without it, matched by age and sex. After adjusting for smoking and income, four autoimmune diseases were more common in the people with rosacea:

• Type 1 diabetes
• Celiac disease
• Multiple sclerosis
• Rheumatoid arthritis

The link was seen mainly in women. In men, only rheumatoid arthritis showed a clear link. The authors said they could not separate people by type or severity of rosacea.

A study like this shows that two conditions appear together more often than chance would suggest. It cannot show that one causes the other, or which came first.

Other conditions linked with rosacea

The AAD says studies have linked rosacea with a higher risk of diabetes, heart disease, Alzheimer's disease, Crohn's disease and migraine headaches. It adds important limits:

• Many people with rosacea never develop any of these diseases.
• The studies used medical records, so they could not tell whether lifestyle, such as diet or exercise, explained the link.
• The studies could not tell whether rosacea itself caused the other diseases.

For heart disease, the AAD says there is still no clear answer. A few studies found that people with rosacea have more risk factors, such as high blood pressure and unhealthy cholesterol. Other studies did not find more heart disease in people with rosacea.

What to do with this information

The AAD's advice is practical. It recommends healthy habits that lower the risk of many diseases: a balanced diet, a healthy weight, exercise on most days, not smoking, limiting alcohol and managing stress. It also recommends check-ups with a primary care doctor as often as advised, where blood pressure, cholesterol and blood sugar can be tested.

The AAD adds that people with the most severe rosacea were more likely to have another disease. It says treating rosacea can reduce its severity, and that it is possible controlling rosacea could reduce the risk of other diseases, though more research is needed. The AAD also suggests watching for changes in your body and skin, and talking with your dermatologist and primary care doctor about any worries, so you understand your own risks.

Why rosacea cannot be caught

The AAD's overview answers "Is rosacea contagious?" with a single word: no. The NHS states that rosacea is not caused by poor hygiene and is not contagious.

Touching someone who has rosacea, or living with them, does not pass it on. The factors that raise the chance of getting rosacea, according to the AAD, are personal: being 30 or older, fair skin, a blood relative with rosacea or severe acne, many past acne breakouts, and menopause. A 2015 twin study published in JAMA Dermatology found that genes explain 46 percent of the rosacea score, which fits a condition that runs in families.

What about the skin mites?

The AAD says mites called Demodex live on nearly everyone's skin. Researchers often find more of them in people with rosacea, and the larger number may trigger an immune reaction. Because almost everyone already has these mites, their presence on the skin is normal. The sources checked do not discuss whether the mites pass between people. They do state that rosacea itself is not contagious.

The guide to what causes rosacea covers the mites and the other leading theories in more detail.

Rosacea can spread on your own skin

Rosacea stays with the person who has it, but it can spread across that person's skin. The AAD says rosacea usually appears across the nose and cheeks. With time it can reach the forehead, chin, ears, scalp, neck, upper chest or back. The AAD says repeated flushing can make rosacea appear on more of the skin.

Treatment helps prevent this. The AAD says treatment can stop rosacea from getting worse, and that the earlier it starts, the easier rosacea is to manage. The guide to how rosacea is treated explains the options a doctor may offer.

How rosacea can affect self-esteem

The AAD says many research studies have shown that constant redness, acne-like bumps and other signs of rosacea can lower a person's self-esteem. People often say they feel embarrassed by their skin, and some try to avoid contact with other people. The AAD reports a National Rosacea Society survey in which nearly two thirds of people with rosacea said they had avoided situations because they felt uncomfortable or embarrassed about a red face.

Knowing that rosacea is not contagious, is not caused by poor hygiene, and does not mean a person has a drinking problem can help when others make wrong guesses. The AAD also says treating rosacea can improve self-confidence and quality of life.

Styes and pinkeye in children

Parents sometimes worry when a child keeps getting styes or pinkeye. The AAD says styes and pinkeye that keep coming back, even after treatment, can be a warning sign of ocular rosacea, which is rosacea affecting the eyes. It says this condition is often missed in children, and that it responds well when treated early. A dermatologist or an eye doctor can check whether rosacea is the cause.

Questions to ask your doctor

• Is my redness rosacea, or could it be another condition?
• Do my other symptoms need their own check-up?
• Should I have my blood pressure, cholesterol and blood sugar checked, as the AAD suggests for people with rosacea?
• What can I do to lower my risk of the conditions linked with rosacea?

Rosacea and the way others see it

Wrong ideas about rosacea can hurt. The AAD says people wrongly believe that anyone with a red face drinks too much. It states that people who never drink alcohol can get rosacea, that alcoholism does not cause it, and that rosacea does not mean a person has a drinking problem.

Worry about what others think can keep people from getting help. The AAD encourages anyone with a red face that stays, or flushing that lasts, to see a dermatologist, because rosacea or another condition could be the cause. The AAD also says rosacea that lasts for years can lead to depression or anxiety in some people, and that these feelings ease as rosacea improves with treatment. NIH suggests a mental health professional or a support group if emotional problems arise.