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Rosacea

Although there is no cure for rosacea, a variety of rosacea treatments are available that will reduce its appearance and prevent further progression. If allowed to worsen over a long period, rosacea may become more difficult to treat, and it could take longer to see positive results.

Treatments for rosacea include oral and topical medications, lifestyle modifications, laser and light therapies, and surgical procedures (used mostly for advanced cases).  These treatments are often combined for better results.

Your doctor will recommend a treatment plan based on the following:
  • The rosacea subtype(s) you have developed
  • The severity of rosacea
  • Your skin type (light vs. dark, oily vs. dry)
  • Results from previous treatments
  • Your personal preferences
There are several safe and effective medications for rosacea.

Topical medications (applied to the skin) include:
  • Azelaic acid (Azelex®, Finacea®)
  • Clindamycin
  • Erythromycin
  • Metronidazole (MetroGel®)
  • Sulfacetamide and sulfur lotions (Clenia®, Plexion®)
Oral medications (taken by mouth) include:
  • Anti-inflammatory dose doxycycline (Oracea®)
  • Doxycycline
  • Erythromycin
  • Minocycline 
  • Tetracycline
A combination of medications may be recommended. For instance, an oral medication, such as doxycycline, may be combined with an antibiotic applied to the skin, such as metronidazole or azelaic acid.

Anti-inflammatory dose doxycycline

Doxycycline is most commonly used as an antibiotic for the treatment of bacterial infections, including the bacteria associated with acne. However, doctors rely on its anti-inflammatory properties when prescribing it for rosacea.

Your doctor may prescribe a form of doxycycline created specifically for rosacea (anti-inflammatory-dose doxycycline).

When doxycycline is used to reduce the inflammation associated with rosacea, it is usually prescribed in 40mg daily doses. These are below the standard antimicrobial doses of doxycycline and thus reduce the risk of yeast overgrowth, diarrhea, and other side effects commonly associated with higher antibiotic doses.
Your doctor may also recommend one of following procedures:
  • Laser therapy—used to shrink a bumpy or swollen nose, reduce  persistent redness, or decrease the number of visible blood vessels (telangiectasias)
  • Electrosurgery—a procedure in which the skin is numbed and a small electric needle is used to destroy visible blood vessels (telangiectasias)
Multiple treatments may be necessary to achieve optimal results. Your doctor may also recommend future treatments to maintain long-term results.

If left untreated, chronic rosacea can lead to rhinophyma and skin thickening, which are more difficult to treat. Your doctor may recommend procedures to reshape areas, such as your nose or forehead, to a more normal appearance:

Ocular rosacea

Most cases of ocular rosacea start off with mildly irritating symptoms, such as watery or itchy eyes, but these symptoms can progress and become more serious. Your doctor may prescribe topical medications, oral antibiotics, or anti-inflammatory drugs, alone or in combination with each other.
It takes time for rosacea medications and other therapies to work, but many rosacea treatments will show results within the first two months. Your doctor can provide a reasonable estimate for results, depending on the treatment(s) prescribed and any lifestyle changes you make.

Continue with your treatment regimen and lifestyle modifications even if your rosacea clears up.

Stopping your rosacea medication too soon can lead to a relapse of symptoms.


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