Gram-Negative rosacea

Gram-negative rosacea is a subtype of rosacea, a skin condition that causes redness, flushing, and pimple-like bumps on the face. Unlike the more common gram-positive rosacea, which is caused by bacteria such as Staphylococcus and Streptococcus, gram-negative rosacea is caused by gram-negative bacteria such as Klebsiella, Proteus, and Escherichia coli.

Gram-negative rosacea is often accompanied by other symptoms such as burning, itching, and eye irritation. The condition is more common in people with weakened immune systems, and can be triggered by factors such as stress, alcohol consumption, and certain foods.


Rosacea is a chronic skin condition that causes redness, inflammation, and pimple-like bumps on the face, particularly the cheeks, nose, and forehead. In gram-negative rosacea, these symptoms are thought to be caused by an overreaction of the immune system to the presence of these gram-negative bacteria.

Other potential causes of gram-negative rosacea include:

  1. Hormonal changes: Hormonal fluctuations, such as those during menopause, can cause gram-negative rosacea to worsen.
  2. Medications: Certain medications, such as corticosteroids and blood pressure medications, may trigger or worsen gram-negative rosacea.
  3. Environmental triggers: Exposure to sun, wind, cold, and hot temperatures can exacerbate gram-negative rosacea.
  4. Certain foods and drinks: Spicy foods, alcohol, and hot drinks can trigger rosacea, including gram-negative rosacea.
  5. Chronic sinusitis: Chronic sinusitis or other respiratory infections may play a role in the development of gram-negative rosacea.

It is important to note that the exact cause of gram-negative rosacea is still not fully understood and more research is needed to determine the underlying mechanisms


The main symptoms of this condition include:

  1. Inflammation and redness of the skin, particularly on the cheeks, nose, chin, and forehead.
  2. Pustules, papules, and cysts, which can be painful and unsightly.
  3. Flushing and blushing, which may be accompanied by a burning or stinging sensation.
  4. Enlarged pores, which may appear more noticeable due to the redness and inflammation.
  5. Dry, rough, and scaly skin, which can be itchy and uncomfortable.
  6. Eye irritation, including redness, itching, and burning.
  7. Rhinophyma, a condition in which the nose becomes swollen and bulbous.

These symptoms can be persistent and may get worse over time if left untreated. If you experience any of these symptoms, it is important to see a dermatologist for proper diagnosis and treatment.


The main diagnosis for gram-negative rosacea is through a physical examination and a review of the patient’s medical history. A physician may also perform a skin culture or biopsy to confirm the presence of gram-negative bacteria.

The most common tests used to diagnose gram-negative rosacea include:

  1. Microscopic examination: A skin scraping or biopsy is taken and examined under a microscope to identify the presence of gram-negative bacteria.
  2. Skin Culture: A sample of the affected skin is taken and grown in a laboratory to identify the type of bacteria present.
  3. Polymerase Chain Reaction (PCR): A molecular test that detects the DNA of the bacteria in the skin.
  4. Blood Tests: Blood tests may be ordered to check for any underlying medical conditions that may be contributing to the development of rosacea.

It is important to consult with a dermatologist for an accurate diagnosis and appropriate treatment for gram-negative rosacea.


The main treatment for gram-negative rosacea involves antibiotics to eliminate the underlying bacteria causing the condition. Antibiotics that are commonly used to treat this subtype of rosacea include tetracyclines (such as doxycycline or minocycline), macrolides (such as erythromycin or azithromycin), and metronidazole.

In addition to antibiotics, topical medications and skin care products may be used to help manage symptoms and improve the appearance of the skin. These may include topical antibiotics, retinoids, and anti-inflammatory creams.

It is important to work with a dermatologist to develop an effective treatment plan for gram-negative rosacea. This may involve adjusting the type and frequency of antibiotics and other medications, as well as incorporating lifestyle changes such as avoiding triggers that can worsen symptoms.