BACKGROUND: No rosacea-specific quality-of-life (QOL) instrument exists. OBJECTIVE: We sought to develop a validated, reliable rosacea-specific instrument. METHODS: From 6 in-depth interviews, we composed 21 rosacea-specific items. These items and Skindex-29 were administered in a validation cohort (n = 59). Internal consistency reliability and reproducibility were measured with Cronbach's coefficient alpha and intraclass correlation coefficient, respectively. Responsiveness was assessed comparing baseline with 4- to 6-month responses. Construct validity was assessed with principal axes factor analyses. Discriminant validity was examined with an additional 38 patients comparing differences in responsiveness between the rosacea-specific QOL instrument and Skindex. RESULTS: Reliability was high (Cronbach's alpha: 0.82-0.97, intraclass correlation coefficient: 0.70-0.95). The rosacea-specific QOL instrument showed preliminary responsiveness for patients with improved disease (P