Most Common Rosacea Treatments

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Andrews, Linda Wasmer

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If you think you have the skin condition rosacea, it’s important to see a doctor as soon as possible.
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Rosacea doesn’t have a single, one-size-fits-all treatment. The best option for you depends on the type of rosacea you have and the severity of your symptoms. Here’s an overview of the most common treatment options: topical and oral medications. 

Topical Medications: Applied Directly to the Skin

Topical medications are often used to treat the bumps, pus-filled pimples, and redness of rosacea. They work in various ways. Some reduce inflammation. Others help old skin shed more quickly or make it easier to wash away excess oil and dirt. 

Types of Topical Medications

  • Topical antibiotics (clindamycin, erythromycin, metronidazole)
  • Azelaic acid
  • Benzoyl peroxide
  • Ivermectin
  • Metronidazole
  • Oxymetazoline
  • Retinoid
  • Sulfacetamide
  • Sulfur lotions 

What to Expect from Topical Treatments

While these treatments can be effective, they usually don’t work as quickly as oral medications. It may take a couple of months before much improvement is seen. Possible side effects include:

  • Burning
  • Stinging
  • Itching
  • Skin irritation
  • Skin dryness or peeling
  • Increased sensitivity to sunlight, cold, or wind 

Oral Medications: Taken by Mouth

Oral medications are often prescribed for more severe rosacea. They can be effective at treating bumps and pus-filled pimples. 

Types of Oral Medications

  • Oral antibiotics, including:

    • Doxycycline
    • Erythromycin
    • Minocycline
    • Tetracycline
    • Azithromycin
    • Clarithromycin

  • Non-antibiotic orals, including doxycycline (Oracea), which is taken at a dose too low to act as an antibiotic. At this lower dose, doxycycline acts more like an anti-inflammatory medication. Oral isotretinoin may be prescribed to those who symptoms do not improve with topical or oral antibiotics.

What to Expect from Oral Medications

After starting these medications, it usually takes about three to four weeks to see improvement. Possible side effects of oral antibiotics include:

  • Upset stomach
  • Sun sensitivity
  • Yeast infections in women

Another concern is that frequent or long-term use of oral antibiotics to treat rosacea may contribute to antibiotic resistance. This is the tendency of bacteria to change over time in a way that reduces the ability of antibiotics to weaken or kill them. 

Non-antibiotic doxycycline decreases rosacea’s bumps and pimples by fighting inflammation. But since the dose of antibiotics prescribed in this treatment is so low, it doesn’t have the same side effects or risks as the full-strength dose. 

Other Therapies and Procedures to Treat Rosacea

Beyond the commonly prescribed approaches described above, other safe treatments include glycolic acid, eye medication specifically for ocular rosacea, laser and light therapies, electrosurgery, and dermabrasion. These alternatives are shown to be effective for treating specific symptoms of rosacea. 

In addition, recognizing your own personal triggers—the weather, certain foods, stress level—will help you understand and prevent the troubling flare-ups common with rosacea. 

In the end, no matter which options you choose, one thing holds true for all men and women with rosacea: The better you stick to your treatment plan, the more likely you are to produce the results you want.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Aug 12, 2017

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