Does Rosacea Progress in Stages?
an editorial by Brady Barrows

In many reports on rosacea, especially those written in the past, rosacea is spoken of as progressing in stages and that the progression leads to rhinophyma. Current thought on this subject is far from this idea and simply isn't proven to be true. For example note these reports:

“The notion that the erythematotelangiectatic stage generally transforms into the papulo-pustular, inflammatory stage is simply wrong and grossly misleading. Firstly, the papulo-pustular stage mainly occurs in males in whom rosacea is a more serious disease at all stages. The papulo-pustular stage is actually uncommon in females.”

Source:
A Personal Critique on the State of Knowledge of Rosacea Albert M. Kligman , M.D., Ph.D.
Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
The William J. Cunliffe Lectureship 2003—Manuscript

“Rosacea is often divided into four stages, according to the progressive nature of the condition. However, the progression is not absolute. For unknown reasons, certain patients may skip a stage. Others experience
ocular symptoms as the first manifestation of the condition.”

Source:
Consult Your Pharmacist
Differentiating Between Rosacea and Acne
W. Steven Pray, PhD, DPh; Joshua J. Pray, PharmD candidate :U.S. Pharmacist