What Treatments Work for Ocular Rosacea?


Ramos Hegwer, Laura

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Talking With Your Doctor About Rosacea Treatment

If you think you have the skin condition rosacea, it’s important to see a doctor as soon as possible.

Up to 60 percent of people with rosacea develop itchy eyes, swollen eyelids, and other eye problems. This is called ocular rosacea. For some people, these annoying eye symptoms show up before they experience any skin changes. Others develop them later on.

What to look for

Some of the symptoms of ocular rosacea include:

  • Swollen skin on the eyelids and around the lashes

  • Irritation on the surface of the eyes, which causes dryness

  • Burning, itchy, bloodshot, or watery eyes

  • Sensitivity to light

Usually, these problems affect both eyes. Symptoms can come and go, or they may last a long time.

Treatment is key

You're smart not to ignore signs of ocular rosacea. Without treatment, it can lead to vision loss. An ophthalmologist, or eye disease specialist, can work with you to help keep your eyes healthy.

While there is no cure for ocular rosacea, there are treatments that can help manage this stubborn condition. A topical antibiotic ointment or gel can help reduce the bacteria on the eyelids that cause swelling and irritation. You'll probably need to apply it more frequently at first to get the inflammation under control.

Taking an oral antibiotic, such as tetracycline, may also be helpful if you have more severe symptoms. Tip: Try not to take this medicine with food, particularly dairy, which makes it harder for the body to absorb.

Other medicines, such as topical corticosteroids, may be needed if you have severe inflammation.

If you have dry eyes, artificial tears can make you more comfortable, at least temporarily. Taking a fish oil or flaxseed supplement may also help reduce inflammation and improve tear function.

Ocular rosacea in children

Although rosacea mainly affects adults, it can occur in children. When it does, many of these youngsters have eye problems. However, some of the medicines used by adults, such as tetracycline, aren't recommended for young children. Medicines that can be helpful for younger patients include topical metronidazole, azelaic acid, and niacinamide.

Other ways to see clearly

Besides taking medication, there are other ways you can make your eyes feel better. To soothe sore eyes and eyelids:

  • Apply a washcloth soaked in warm water to the eyes for up to 10 minutes. Try this twice daily or more often as needed.

  • Give yourself a massage. Hold your eyelid taut at the outer corner with one hand. Use the index finger of your other hand to apply gentle pressure from the inner corner of your eyelid toward your ear. Repeat and switch sides.

To keep swelling under control, one of the best things you can do is follow a good eye hygiene routine. After showering or washing your face, use a cotton ball or wet washcloth to apply a 50-50 mixture of water and baby shampoo to gently clean around the base of the eyelashes. You can also buy ready-made eyelid cleansers.

Some advice on cosmetics

Sometimes it's tough to feel beautiful when you have rosacea, but playing up your assets with makeup can make a difference. If you wear cosmetics, it's best to avoid waterproof formulas. They're often difficult to remove, and makeup removers may contain chemicals that irritate your eyes. 

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Jan 27, 2018

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