Rosacea Diagnosis Gap Identified in Skin of Color
New research suggests clinicians often underdiagnose rosacea in patients with darker skin tones.
Updated on Oct. 12, 2026 in Beauty
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A 2025 study of 109,866 patients found that rosacea is diagnosed at significantly lower rates in patients of color compared to White patients. The findings highlight a persistent diagnostic challenge for approximately 16 million people living with the condition across the United States.
Why it matters
Clinicians have historically struggled to recognize rosacea symptoms in darker skin, where redness is more difficult to visualize. This low index of suspicion can delay appropriate care for patients experiencing irritation or flushing.
A 2025 analysis of 109,866 patients revealed that 1.7% of White patients received a rosacea diagnosis, compared with 0.9% of patients of color and 0.1% of Black patients. While researchers note a 46% genetic contribution to the condition, these diagnostic disparities remain a focus of current clinical investigation.
The players
Hilary Baldwin
A dermatologist based in Brooklyn, New York, who developed the ALTER framework to improve rosacea diagnosis.
The details
Standard diagnostic criteria for rosacea often rely on identifying centrofacial erythema and phymas, which can be difficult to discern in richly pigmented skin. Hilary Baldwin proposed the ALTER framework to help clinicians improve detection by emphasizing patient-reported symptoms like flushing and skin irritation. Clinicians are encouraged to use dermoscopy for viewing telangiectasias and diascopy to confirm erythema in skin of color, as some expert reviews have historically misidentified other skin conditions as rosacea.
Timeline
A cross-sectional study of 109,866 primary care patients was conducted in 2025.
The Skin of Color Update 2026 conference was held from October 9-11, 2026.
Health Landscape
The Skin of Color Update 2026 conference highlighted critical gaps in dermatological diagnostic criteria that currently favor White skin types. This development represents a broader effort to modernize clinical assessment tools to ensure accurate identification across diverse patient populations.
If you notice persistent flushing, skin irritation, or eye irritation, it is worth discussing the possibility of rosacea with your dermatologist. Be prepared to describe your symptoms clearly, especially if you have skin of color, as redness can be harder to spot in a clinical exam.
The takeaway
Clinicians may sometimes misidentify acne or hyperpigmentation as rosacea, leading to potential delays in finding the right treatment. If you are concerned about persistent skin changes, keep a log of your symptoms and potential triggers to share during your next visit with a physician.
Further reading
Learn more about the latest research and clinical standards for skin health in the Beauty section.
Source note: This article includes information reported by Ajmc.
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