Rosacea Treatment Overview
Rosacea is a chronic skin condition that causes facial redness and small pustules, often called acne rosacea, to appear on the chin, cheeks, nose, and forehead. Other symptoms of rosacea may include a red, enlarged nose (rhinopyma), the appearance of small, red facial veins, a tendency to blush or flush easily, and a burning, irritated sensation in the eyes.
Rosacea often occurs in phases (pre-rosacea, vascular rosacea, and inflammatory rosacea), and can worsen over time.
There is no cure for rosacea, but there are options for treating the symptoms of rosacea. Rosacea treatment options may include:
- topical or oral antibiotics
- isotretinoin (Accutane)
- tretinoin (Retin-A)
- laser resurfacing such as V-beam
- Oracea oral therapy
The cause of rosacea is not well known. There are several theories including infestation with a skin mite called Demodex follicularum and infestation with helicobacter pylori, the same bacteria associated with stomach ulcers. Other theories point to a malfunction in the body’s temperature control system.
There appears to be a genetic predisposition as 40% of people with rosacea have a family member with the disease. While the cause has not been clearly identified several factors have been identified which contribute to the condition including: sun exposure, stress, hot and cold weather, alcohol, spicy foods, exercise, wind, hot baths, hot drinks, certain drugs, skin care products, and topical or oral steroid treatment.
There are a variety of treatments available for rosacea patients. Briefly, rosacea is divided into three stages.
- Stage I is the general redness and flushness on the cheeks, nose, and central face.
- Stage II is the addition of papules or pustules, and is referred to as acne rosacea.
- Stage III includes the changes associated with long standing rosacea, namely a larger bulbous nose or chin. In addition, rosacea patients can also suffer from blepharitis (inflammation of the eyelid margin) and the formation of styes.
For stage I rosacea, treatments include a topical medication such as metronidazole, sodium sulfacetamide, or azaleic acid twice a day. The effects of these topicals are varied. Laser is an excellent treatment for these cases, and sometimes the only acceptable cosmetic treatment.
For both stage I and stage II rosacea, the addition of doxycycline, minocycline, or tetracycline is usually added. Low-dose accutane can also be used in these cases.For stage III changes, a small surgical procedure or laser can correct some of the changes seen with long standing rosacea.
The goal is to calm down the acne portion of the rosacea, then to perhaps do laser once that part of it is controlled. If all else fails, accutane is a reasonable option for certain people.
Related Rosacea Information
- What is the best rosacea treatment?
- Are there different types of rosacea?
- Is there a cure for rosacea?
Sources: Don Mehrabi, MD and D.J. Verret MD
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