Treatments for Rosacea

Treatment list for Rosacea: The list of treatments mentioned in various sources for Rosacea includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Antibiotics
- Topical antibiotic
- Metronidazole
- Topical metronidazole
- Oral antibiotic
- Tetracycline
- Minocycline
- Erythromycin
- Doxycycline
Isotretinoin - for severe cases; women must avoid pregnancy during treatment.
Eyelid hygiene
Surgery
- Electrosurgery
- Laser surgery
- Nose surgery - for rhinophyma
Avoid triggers that worsen rosacea
- Avoid triggers of facial flushing
- Avoid alcohol
- Avoid heat
- Avoid strenuous exercise
- Avoid sunlight
- Avoid UV light
- Sunscreens - daily use helps avoid UVA and UVB light.
- Avoid wind
- Avoid cold
- Avoid hot drinks
- Avoid caffeine
- Avoid spicy foods
- Avoid emotional stress
- Avoid coughing
- Avoid certain facial products
- Symptom diary - helps to identify what triggers rosacea flares.
- Avoid certain steroid creams

Treatments of Rosacea discussion: While rosacea cannot be cured, it can be treated and controlled. A dermatologist, a medical doctor who specializes in diseases of the skin, often treats rosacea. Treatment goals are to control the condition and improve appearance. Doctors usually prescribe a topical antibiotic, such as metronidazole, that is applied directly to the affected skin.

For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. Tetracycline, minocycline, erythromycin, and doxycycline are the most common antibiotics used to treat rosacea. Some people respond quickly, while others require long-term therapy.

Isotretinoin may be considered as a treatment option for all forms of severe or therapy-resistant rosacea. However, isotretinoin is linked to a number of adverse effects, some of which can be severe. The most serious potential adverse effect is that it is teratogenic; that is, it can cause birth defects in pregnant women who take it. Therefore, it is crucial that women of childbearing age are not pregnant and do not get pregnant while taking isotretinoin. Women must use an appropriate birth control method 1 month before the initiation of therapy, during the entire course of therapy, and until 2 months after cessation of the drug. The doctor will order a blood pregnancy test before therapy is started and every month during therapy.

Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. People who develop infections of the eyelids must practice frequent lid hygiene. Doctors recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaning product and applying warm (not hot) compresses several times a day.

Electrosurgery and laser surgery may be options to treat redness, enlarged blood vessels, and rhinophyma. In some patients, laser surgery may result in improved skin appearance with little scarring or damage. For patients with rhinophyma, several surgical methods may help reduce the size of the nose and improve appearance.

Finally, sunscreens, particularly those that protect against ultraviolet A and B light waves and have a sun-protecting factor (SPF) of 13 or higher, are recommended for all people with rosacea.

Working With Your Doctor To Help Manage Rosacea

The role you play in managing your rosacea is just as important as your doctor’s. You can take several steps to keep rosacea under control.

Keep a written record of factors that seem to trigger flareups.
Develop a plan to avoid or minimize your exposure to these triggers. By doing this, you may actually reduce or eliminate the need for medication to control your rosacea.
Use a sunscreen with a sun-protecting factor (SPF) of 13 or higher every day.
Avoid using facial cleaning products, moisturizers, and cosmetics with alcohol or other ingredients that irritate your skin.
If your eyes are affected, faithfully follow your doctor’s treatment plan and clean your eyelids as instructed.
Try to minimize your stress level.

Acne rosacea can usually be treated with antibiotic lotions or gels. The formulas used for these are often different than those used by young women with acne, because the skin of women with acne rosacea tends to be dry, not oily. Sometimes, antibiotic pills need to be taken. All these treatments require a prescription, so consult your health care provider if you think you have acne rosacea. ²

Footnotes:
1. excerpt from Questions and Answers About Rosacea: NIAMS
2. excerpt from Acne: NWHIC

Last revision: June 13, 2003

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