Rosacea Treatment

First Steps

If you believe that you may have Rosacea, the first thing to do is to see your dermatologist.  Many of the symptoms of Rosacea could be the result of other ailments.  As always when dealing with this sort of situation, professional advice should be your first course of action.

If you have been diagnosed with Rosacea you need to know that there is currently no cure. In fact, the cause of Rosacea is still somewhat of a mystery. Having said this however, the good news is that there are many things that can be done to bring the disease under control and minimize the symptoms and also to prevent the disease from progressing further. In general, the treatment is aimed at the control of redness, inflammation, and skin eruptions. Treatment is necessary to prevent permanent damage.

Forms of Treatments

In most cases, once a diagnosis of Rosacea has been made a dermatologist will prescribed a combination of oral antibiotics and the use of antibiotic gel as initial treatment. The oral antibiotics will bring the condition under control (reducing redness and the formation of papules and pustules), then the topical treatments will be used to keep the symptoms under control. In all cases the dermatologist should help to determine the relevant lifestyle factors which may need modification to keep flushing/blushing from occurring. 

Long term use of Oral Antibiotics is not recommended due to a number of side effects which may occur including sun sensitivity and upset stomach.

A couple of important notes:

- It may take several weeks or more to see any improvement in the condition
- Since Rosacea cannot be cured it will often be necessary to continue with topical treatment (and modification of lifestyle factors) even after symptoms have been reduced or have disappeared.  Your dermatologist will make a recommendation based on your particular situation. 

Controlling Flushing and Blushing

It is important to control the flushing & blushing aspects of Rosacea to help prevent the Rosacea from becoming worse. This can be accomplished through various forms of treatment described below as well through lifestyle adjustments.

Treatments Taken Orally

  • Oral antibiotics used in rosacea treatment are tetracycline; Minocin®/minocycline; erythromicin

  • An alternative is a medication which is similar to Vitamin A called  Isotretinoin (sold under the brand names of Accutane or Roaccutane) that is sometimes effective against severe papopustular rosacea. According to the Rosacea FAQ (see below) It works by inhibiting sebaceous gland function and physically shrinking the glands and, since it has potent anti-inflammatory properties, it is ideal to treat resistant rosacea.  [Note that Isotretinoin is not to be taken by women who are, or may become pregnant due to the risk of birth defects.]

Topical Treatments

  • Metronidazole - In 1989 metronidazole was approved as the first topical treatment specifically for rosacea. It can help to reduce rosacea flare-ups once the rosacea is brought under control. In North America Metronidazole is sold under various brand names including Metrogel (and Metrolotion & Metrocream, all 3 contain .75% metronidazole and are manufacturered by Galderma Laboratories, Inc.) and Noritate (1% metronidazole cream). In Australia and New Zealand the equivalent of Metrogel is called Rozex. Metrocream, Metrolotion and Noritate are not available in Australia.
  • Rosacea-LTD III™  - The company's website says that almost all users of Rosacea-LTD III notice a substantial change within 40 days. The product contains zinc oxide, manganesium sterate, sodium chloride, iron oxide, polyethylene glycol, and sulfur. It may be ordered directly from the website.
  • Azelaic Acid, a treatment sometimes used for acne,  has been shown to be effective in treating papules & pustules.

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