Childhood Rosacea: Clinical, Diagnostic, and Therapeutic Insights into an Underestimated Pediatric Condition

Introduction: Rosacea is a very frequent skin disease; however, its prevalence in children is underestimated, and there are not enough data on this dermatosis in the pediatric population. Objective: This study aimed to give comprehensive insight into childhood rosacea (CR), pointing out predisposing factors, clinical presentation, diagnostic clues, and therapy of this subgroup of the disease spectrum. Methods: This is a narrative review of the existing data on rosacea in children. Results: Children affected by rosacea often present with recurrent erythema of the convex areas of the face as an early sign of the disease, mostly occurring after cold/heat/sun exposure or triggered by crying/playing/exercise. Phymatous lesions do not occur in children, and Morbihan disease has been very rarely reported. On the other hand, special rosacea subtypes, such as periorificial dermatitis, granulomatous rosacea, or idiopathic facial aseptic granuloma, are observed more often in children. The diagnosis is usually made based on the clinical picture; however, dermoscopy, and in some cases other imaging techniques, may aid the diagnosis. It is still a matter of debate whether a child affected by rosacea will become an adult with rosacea over time. The holistic approach to therapy of rosacea in children should include in particular the avoidance of triggering factors, proper skin care, and finally, adequate pharmacological treatment. Although procedural therapeutic options are frequently used in adults, their use in children should be tailored to the patient's age and discussed with the parents or caregivers. Conclusion: Rosacea may occur also in children. Therapeutic options do not significantly differ from those in adults; however, they must be adjusted to the child’s age.