Rosacea Treatment Options

Rosacea affects 14 million people in the U.S. It is a long-term condition, but it is manageable. Most treatment plans include medicine (pills, gels and creams) and procedures like laser treatment to reduce visible blood vessels.


Avoiding triggers (like alcohol, caffeine, spicy foods) and using good skin care can decrease rosacea symptoms. Getting medical help when they flare can also improve your quality of life.


For people who have rosacea, medications are the first line of treatment. They work by reducing inflammation and easing redness. Many are available over-the-counter or without prescription, but a dermatologist should be consulted for recommendations and to ensure that any new treatments are safe given your medical history.

Azelaic acid is a popular and effective medication for rosacea. It is available in gel, foam or cream form and may be applied once or twice a day. It can help reduce redness, itching and swelling. Metronidazole is another good topical option for rosacea. It is an antibiotic that helps reduce inflammation. It can be used once or twice a day and is typically applied to the affected area of the face.

Topical brimonidine (Mirvaso) or oxymetazoline (Rhofade) can also be used to reduce redness. It works by constricting the underlying blood vessels to reduce flushing. It can be applied once or twice a day and should be kept away from the eyes.

Antibiotics are commonly used to treat rosacea and can be taken at a low dose that does not cause resistance. Some examples of antibiotics include tetracycline, minocycline and doxycycline. Topical retinoids can also be used to control rosacea and help with the appearance of wrinkles. Your doctor can recommend the right one for you based on your skin type, symptoms and other factors.

Topical creams

Many rosacea symptoms can be treated with creams that are applied directly to the skin. These creams can include over-the-counter (OTC) products that treat different rosacea symptoms and improve overall skin health, as well as prescription medications.

Often, these topical medications are combined with oral treatments and light devices in order to get the best results for patients with rosacea. Your physician will select the most effective treatment for you based on the type of symptoms you have.

For example, if your redness is caused by blood vessels in the face, your dermatologist may prescribe a cream that reduces facial flushing. This can be a OTC product like a topical niacinamide (Vitamin B3) or a prescription medication called brimonidine. Another option to reduce redness is a topical alpha-adrenergic agonist, such as oxymetazoline hydrochloride (Rhofade).

If you have inflammatory papules and pus-filled spots on the face, you may need an antibiotic such as metronidazole. This is a prescription medication that can be used in gel, cream or lotion preparations of 0.5% formulations, applied one to three times daily as directed by your doctor.

If your rosacea symptoms involve your eyes, your physician may prescribe an oral medicine such as doxycycline (Oracea). Oral antibiotics are especially useful for treating rosacea that is caused by bacteria. These medicines are generally well-tolerated by patients and can be used long term without the development of resistance.


If creams and pills don’t help, you may be able to find some relief with laser treatment. The goal of laser therapy is to treat the redness, inflammation and enlarged blood vessels that can occur in rosacea. The type of laser used is dependent on the symptoms you have, but most treatments include a combination of pulsed dye laser and vascular lasers.

Lasers are unique in that they can produce very focused light. This means that the light stays very tightly focused on a very small spot, which makes it possible to perform delicate work in surgery, for example. We can also use lasers to store information that we can later retrieve. Lasers are found in everything from DVD players to bar code scanners.

The discovery of the laser, based on Max Planck’s understanding of quantum mechanics, is one of the most important scientific accomplishments of the 20th century. It is a revolutionary device that has revolutionized many areas of science and technology, including medicine, communications, manufacturing, and entertainment.

The simplest types of lasers have a single optical frequency (emission wavelength). However, for more complex applications, multiple frequencies can be combined into a single beam. The ability to do this requires a laser that has both temporal and spatial coherence. This is made possible by using a “cavity” that consists of mirrors and an optical gain medium. In this system, the emitted radiation is induced by intracavity resonator radiation that has been strongly coordinated by the circulating laser light.


Although rosacea does not have a cure, treatment can reduce the severity of symptoms. The most common feature is redness of the face, which may include visible blood vessels and inflammatory papules or pustules. It is usually centered on the nose and cheeks, but can extend to the forehead, ears, neck, chest and scalp. It can progress to more serious features such as ocular rosacea, which involves swollen, bloodshot eyes that may feel gritty or like there is something in them. It can also cause the skin to thicken, resulting in an enlarged and bulbous appearance of the nose (rhinophyma).

There are several treatment options for the cutaneous features of rosacea. They include avoidance of triggers, gentle skin care and sun protection with wide-brimmed hats and broad-spectrum sunscreens. Topical medications such as metronidazole and azelaic acid can reduce erythema. A once-daily brimonidine, an alpha-adrenergic receptor agonist, can help with flushing. Tetracyclines are effective in reducing inflammatory lesions, particularly in ocular rosacea.

Long-term management of rosacea can be difficult. Patients often feel embarrassed and frustrated by the changes in their appearance. In a survey by the National Rosacea Society, more than 90 percent of people with severe rosacea reported that it has negatively affected their social and professional lives. The Society recommends that anyone with rosacea seek the advice of a mental health professional.

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