What are the treatments for rosacea?
The goal of treatment for rosacea is to reduce or eliminate symptoms and stop the condition from getting worse. Presently, there is no cure for rosacea. Treatment is usually successful in minimizing symptoms and preventing disease progression and severe complications, especially if started when symptoms are first noticed. If untreated, rosacea symptoms can get
worse, recur more often, and eventually become permanent.
Treatment will control rosacea in most cases. It should be possible to control symptoms and keep rosacea from getting worse. Rosacea comes back in most of the patients in weeks to months of stopping treatment unless all trigger factors have been stopped.
The most effective treatments are oral tetracycline and similar antibiotics and low-dose oral accutane. Mild cases can be controlled by gels or creams such a Metrogel, Cleocin-T, Azelex, or sulfa. Often, full doses of pills are needed only for a short while. Maintenance treatment can be intermittent doses or just topical creams. For rosacea of the eyes warm compresses to lids (hot towel) for 5 minutes twice a day, liquefies the oil in the gland ducts-can be very helpful.
Makeup can be an effective aid in rosacea, will not make it worse, and even some male rosacea sufferers use a bit. A slightly more olive color than usual helps to hide the redness. For some women, hormone replacement pills may be given to reduce menopausal hot flashes. Many advances have been made in recent years. Regular visits are advised for most rosacea patients.
Oral antibiotics: Tetracycline antibiotics including doxycycline and minocycline reduce inflammation. They reduce the redness, papules, pustules and eye symptoms of rosacea. The antibiotics are usually prescribed for 6 to 12 weeks, the duration and dose depending on the severity of the rosacea. Further courses are often needed from time to time as the antibiotics don't cure the disorder. Sometimes other oral antibiotics such as cotrimoxasole or metronidazole are prescribed for resistant cases.
Topical treatment: Metronidazole cream or gel can be used intermittently or long term on its own for mild cases and in combination with oral antibiotics for more severe cases. Azelaic acid cream or lotion is also effective, applied twice daily to affected areas.
Isotretinoin: When antibiotics are ineffective or poorly tolerated, your dermatologist may recommend oral isotretinoin, which can be very effective. Although isotretinoin is often curative for acne, it may be needed in low dose long term for rosacea, sometimes for years. It has important side effects and is not suitable for everyone.
Vascular laser: Persistent telangiectasia can be successfully improved with vascular laser treatment. Where this is unavailable, cautery, diathermy or sclerotherapy (strong saline injections) may be helpful.
Surgery: Rhinophyma can be treated successfully by reshaping the nose surgically or with carbon dioxide laser by a dermatologic or plastic surgeon.