In advanced cases of rosacea, the nose becomes red and enlarged, leading to a condition known as rhinophyma, caused by progressive oil gland enlargement on the nose. The late comedian W. C. Fields, with his distinctive, bulbous red nose and puffy cheeks, displayed all the characteristics of rosacea which have come to be associated with alcohol abuse, though it is possible to have this disorder and not be a heavy drinker or in fact, a drinker at all. While rosacea certainly doesn't kill anyone, it can mark a person for life. Although rosacea typically strikes people in their 30's and 40's, its signs may be found in people as young as 20. Sensitivity to various cosmetics or acne medications and flushing reactions after eating spicy foods may all be clues that a young person is in the developing stages of rosacea.
Family history is also a contributing factor.
Fair skinned people who tend to flush or blush easily are most at risk. Early in the course of rosacea, there are no permanent features, but as the disorder progresses, a more persistent redness develops around the cheeks and nose. While we really don't understand all of the factors which cause rosacea, we do know some of the factors which clearly make it worse, besides alcohol ingestion. The worst of the worsening factors is ingestion of hot liquids, which causes worsening of the reddish component of the problem. The other most common irritant to this problem is caffeine.