What is the best rosacea treatment?

Rosacea can flare for various reasons: too much fun in the sun, too many alcoholic beverages, or too much stress to name a few.

As rosacea is a chronic skin condition that can come and go, rosacea treatment isn’t one size fits all. Your clinician will recommend a plan of care that focuses on controlling symptoms and flares. Getting rosacea under control involves a multi-faceted approach that includes at-home care and prescription medications.

For rosacea flares, you may be prescribed topical and/or oral medications. Your dermatologist may suggest other lifestyle changes and education on avoiding triggers. The length of treatment varies depending on the type and severity of your rosacea.

If you’ve been diagnosed with rosacea, you may experience recurrent outbreaks or flares. Your dermatologist may start with a more aggressive rosacea treatment plan until your skin improves. As your symptoms improve, learning to manage the condition will help prevent future outbreaks.

What is rosacea?

As the name implies, rosacea is characterized as flushing of the skin on the face. The exact cause is still unknown. Hereditary and environmental factors have been linked to the condition. Rosacea can get worse over time, especially if left untreated. You may notice red bumps on your cheeks or visibly broken blood vessels.

Common symptoms include:

• Redness or bumps
• Acne-like breakouts
• Broken blood vessels
• Thick skin on nose, chin, forehead, cheeks
• Swollen or sensitive skin
• Stinging and burning sensation
• Dryness or rough patches
• Spider veins
• Easily blush or get flushed

There are four main subtypes of rosacea. Each type presents with different symptoms.

Erythematotelangiectatic rosacea: Most commonly associated with visible blood vessels, redness, and flushing on the face.

Ocular rosacea: Symptoms around the eye area, typically becomes red and swollen.

Papulopustular rosacea: Often resembles acne and presents as breakouts, often affecting middle-aged women.

Phymatous rosacea: Facial skin thickens and becomes bumpy and red. Large areas of the face can be affected.

What causes rosacea?

Rosacea is a skin condition that is chronic and long-term, with no known cure. Lifestyle and dietary choices play a role in active flare-ups.

Known triggers include:

• Alcohol
• Extreme temperatures
• Hot baths or saunas
• Intensive exercise
• Inflammatory foods
• Irritating skin care ingredients
• Getting too hot/cold
• Spicy foods
• Stress and emotional upheaval
• Sunlight

What is the best treatment for rosacea?

The first step is to receive a proper diagnosis and understand your type of rosacea. Your clinician may suggest you record and monitor any triggers and make necessary lifestyle changes. You can take an active role in managing the condition on your own. That may include avoiding certain activities, foods, and alcohol.

Other cases may require ongoing medical treatment, at least until your symptoms subside. This can range from oral antibiotics to prescription creams, or just an over-the-counter skin care regimen. Your dermatologist may recommend other treatments to manage subsequent flares or for long-term results.

Lifestyle changes

• Implement good self-care and skin practices.
• Pay attention to what causes flare-ups and avoid them.
• Protect your face and skin. Wear a hat and avoid direct sun in the summer. Wear a scarf, ski mask, or hat and gloves when it’s cold or windy.
• Be gentle with your skin. Use dermatologist-recommended cleansers and lotions.
• Carefully select skin and hair products. APDerm offers a variety of products, including some specifically for rosacea.
• Wear sunscreen daily and avoid excessive sun exposure.
• Don’t rub or touch your face or scratch inflamed areas.
• Avoid irritants and harsh chemicals in skin products, detergents, and the environment.
• Avoid extremely hot water and long baths.
• Use rosacea-friendly makeup to reduce redness, such as powder cosmetics with a green tone and matte finish.
• Check your medications, especially ones for high blood pressure, heart issues, anxiety, migraines, and glaucoma.
• Apply moisturizer to your face and skin frequently.
• Gentle daily facial massage may help reduce swelling.
• Limit hot beverages and alcohol.

Medication

A variety of rosacea medications are available for severe cases or if you can’t seem to control it with lifestyle changes alone. The type of medication can vary depending on the severity and type of rosacea you have.

Drug therapies for rosacea include:

Topical creams and gels – Medications that can prevent flares include azelaic acid (Azelex, Finacea), metronidazole (Metrogel, Noritate, others), ivermectin (Soolantra), and sodium sulfacetamide/sulfur. Brimonidine (Mirvaso) and oxymetazoline (Rhofade) can reduce flushing and redness.

Oral antibiotics – Tetracycline antibiotics have been used to treat rosacea for over 50 years.  Most commonly, these include doxycycline and minocycline.  Other antibiotics, such as erythromycin, are also sometimes used to treat worsening flares.

Other systemic therapies – Medication including isotretinoin (Amnesteem, Claravis, others) may be an option. It’s typically used to treat severe acne or severe rosacea that doesn’t respond to other therapies. It can reduce redness and acne-like breakouts but has side effects. This medication is not recommended for all patients, especially pregnant women as it can cause severe birth defects.

OTC and drugstore creams and serums – There are a variety of products on the market designed for sensitive skin and rosacea. You can look for special skin care products, such as sunscreen, serums, masks, and night creams, at your favorite drug or department store.

Other therapies

• Laser therapy
• Other light-based therapies

These procedures can reduce redness associated with enlarged or broken blood vessels and acne-like breakouts. They require several treatments to achieve the best results.  These treatments are unlikely to be covered by insurance and are considered cosmetic in nature.

What can you do to maximize your rosacea treatment? 

It may take some trial and error to find the right treatment and the right medication. You may need a combination of oral and topical medications. You have options, so stick with it until you find a treatment that works for you.

• Follow your dermatologist’s advice on the length of treatment.
• Keep follow-up appointments with your dermatologist.
• Be mindful of your triggers or when you have an active outbreak. It may be helpful to keep a journal. Jot down any changes to your skin or changes to your diet, daily routine, skin care products, stress levels, or other things you notice.
• If you’re seeing positive results, you may need to continue the treatment for a few more weeks.
• If not, talk to your dermatologist about trying something different or any side effects, allergic reactions, or other concerns.
• Be prepared to make some lifestyle and dietary changes. Read up on rosacea, and ask your dermatologist for some tips. The goal is to prevent flares and avoid triggers.

You can learn to tame your rosacea – or at least reduce unwanted symptoms associated with the condition. Don’t lose hope! Your dermatologist can work with you to find an effective treatment, helping you control flares and keep redness away.

APDerm offers a variety of medical, cosmetic, and surgical dermatology services. Contact APDerm today if you are concerned about rosacea or other chronic skin problems.