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Treatment options

General Considerations

There are several different types of rosacea and various treatments for these different types. Your doctor may suggest prescription drugs and over-the-counter medications. Some of these will be applied directly to the skin, while others are pills or capsules that are meant to be swallowed. In some cases laser treatments may be used to reduce the appearance of visible blood vessels. Your treatment will depend on the particular type of rosacea as well as the severity.

It’s important to always take rosacea treatments as prescribed by your doctor. Rosacea treatment can be very effective at reducing pimples and improving the appearance of skin, but this does not happen overnight. Don’t be discouraged if your rosacea does not improve in a few days. There are several effective treatment options for rosacea. The aim of the treatment is to manage symptoms. Many rosacea medications are taken over long term periods because rosacea tends to recur.Odom 2009a

Stopping treatment can result in disease relapse. In some cases, your doctor may prescribe an initial treatment to get your rosacea under control, followed by another type of treatment that can help keep it from returning.Del Rosso 2008

The Right Treatment for You

Your doctor will help you to decide which treatment is best for you and the type of rosacea you have.  Also, your lifestyle and preferences should be taken into account when discussing treatment options with your doctor:

  • First, the treatment should never be worse than the rosacea itself!
  • Consider your lifestyle, available time and the cost to help you decide among the options
  • The treatment may need to be used for prolonged periods of time  in order to manage rosacea symptoms over the long term
  • If you are pregnant or plan on becoming pregnant during rosacea treatment it is important to talk to your doctor about what treatment options are appropriate
  • Topical rosacea treatments may initially irritate the skin and cause rosacea flare-ups; these can resolve after continued use of the treatment
  • Keep in mind: treatment adherence strongly influences treatment effectiveness (If you don’t use it, it won’t work!)



How it Works in rosacea


Potential Side Effects


Topical use

anti-acne preparations
azelaic acid

Main mechanisms of action are anti-inflammatory and antimicrobial

Used to treat papules and pustules of rosacea




Application site irritation : dryness, stinging and burning, and redness. Care should be taken not to get these products into the eyes.


Antibacterials for systemic use

Main mechanisms of action are anti-inflammatory and antibacterial (antibiotic doses only)

Used to treat papules and pustules of rosacea




High doses of tetracyclines or doxcycylines can cause tooth changes in the fetus. Typical side effects include nausea, diarrhea and other GI upsets, which can occur at all doses of these products, but are more frequent with the higher doses.

In addition, high doses of these products may result in organisms becoming antibiotic resistant


Transmit special light that is absorbed by hemoglobin in the blood. The light destroys blood vessels.

Controlled exposure to laser treatments in short bursts

Treatment with lasers and/or intense pulsed light may induce pain, redness, purple discoloration,or swelling, all being transient.

Pregnant or breastfeeding women should consult a pharmacist or physician before taking any medication, in order to avoid doing harm to themselves or their babies. Make certain that you read the specific safety information about the therapy(s) prescribed for you, and speak to your physician about safety issues or concerns.

Practical Treatment Tips

Cleansing National Rosacea Society

Cleansing is an important aspect of managing rosacea. The following tips may help soothe your skin and minimize symptoms like redness, stinging, burning, and tightness. These often involve minor modifications to your existing cleansing routine, and focus on treating your skin gently and avoiding potential triggers for exacerbating your rosacea

Skin Care Tips National Rosacea Society

  • Use a gentle cleanser to thoroughly cleanse your skin each morning and evening, using your fingertips to apply it to your entire face
  • Avoid ingredients that sting, burn or cause facial redness. Examples may include alcohol, witch hazel, menthol, peppermint, eucalyptus oil or clove oil
  • Use fragrance-free products. If you must choose a product that contains a fragrance, be sure that it appears at the end of the list of ingredients. The further down it appears, the less fragrance the product contains
  • Rinse with lukewarm water to remove all dirt and soap, and use a thick cotton towel to gently blot the face dry
  • Let your face thoroughly air dry before applying medication or skin-care products, and wait a few minutes before applying topical medication. Then allow the medication to dry completely for 5 to 10 minutes before applying any moisturizer or makeup
  • Men should ideally use an electric shaver rather than a blade. If a blade must be used, never use a dull blade, which might require extra scraping for a clean shave. Avoid shaving lotions and aftershaves that burn or sting
  • Use makeup to hide blemishes and cover redness. Green-tinted prefoundations are available at many cosmetic counters that can mask general redness. These can be followed by a skin-tone foundation. Avoid powders, which can make dry, flaky skin look worse



Avoid hot water, hot tubs and saunas. These can trigger flushing and aggravate your rosacea.


Never pull, tug, scratch or treat your face harshly. Avoid any rough washcloths, loofahs, brushes or sponges.

Recording Symptoms or Triggers
Many patients find their rosacea easier to manage when using a diary or journal to record symptoms and triggers. Use the dairy from the Rosacea Awareness Program to identify the trigger factors and record important details of your rosacea. Over time this may help you to better understand your condition.

OR Link to Rosacea Awareness Program page: http://www.rosaceainfo.com/pdf/en/Symptom%20Trigger%20Journal.pdf

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