Best Rosacea Treatment?

What is the best product or treatment for acne rosacea? The redness in my face is painful.

Doctor Answers 9

There are a variety of options, but a combination rosacea treatment is best

Thank you for your question. 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. In your case, Stage II papulopustular rosacea, my usual first line is finacea twice daily, and doxycycline 40-100 mg once to twice daily. In some cases, I've been able to add Elidel with some success, and am not sure why this has been effective.

The goal is to calm down the acne portion of your rosacea, then to perhaps do laser once that part of it is controlled. If all else fails, accutane is a reasonable option if you are a good candidate. Hope this helps!

Beverly Hills Dermatologist
5.0 out of 5 stars 1 review

Rosacea treatments

There is no one best treatment for rosacea. Treatment regimens chosen depend on severity of condition. Typically a combination of an oral antibiotic and topical creams can be very helpful. In long standing cases where broken blood vessels are noticeable, vascular lasers such as the Vbeam laser can be extremely effective.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
4.9 out of 5 stars 20 reviews

Best Rosacea Treatment

Dear aroman:

Unfortunately there is no single "best" treatment for rosacea as this varies from patient to patient.  It is important to remember to decrease risk of recurrence by decreasing exposure to triggers which include sun, alcohol, spicy foods, caffeine, stress, etc  For acne rosacea, along with decreased trigger exposure, I would suggest initial treatment with topical antibiotics followed by oral antibiotics. Hope this information helps.

Praven Chetty, MD
Kelowna Physician
5.0 out of 5 stars 9 reviews

Rosacea Treatment

Rosacea is a chronic, inflammatory skin condition that primarily affects the face, though it can sometimes appear on the neck, chest, scalp, or ears. It causes redness and small, red, pus-filled bumps, which can sometimes be mistaken for acne. Over time, visible blood vessels may occur on the skin as well. Although rosacea often affects people with fair skin who flush or blush easily, it can affect anyone.
But as we tell our patients, the right rosacea treatments and medical therapy can help control and manage this condition. Without treatment, the condition can get worse. Because the signs and symptoms of rosacea can vary from one patient to another, we customize treatments based on each individual patient.
These rosacea treatments can include a mix of topical treatments (including antibiotics and anti-inflammatory gels) and oral medications (including antibiotics), only if absolutely necessary. We try to avoid oral prescriptions and our patients appreciate our approach which is unique to our practice. Oral medications can help to reduce inflammation and clear up breakouts.
Our patients have achieved impressive results with our state-of-the-art lasers and/or intense pulsed light therapy; these treatments help to remove the visible blood vessels from the face—clearing up redness and dramatically improving the overall look of skin.

Dennis Gross, MD
New York Dermatologist
4.4 out of 5 stars 5 reviews

Try Mirvaso!

I’m really impressed with a new product on the market know as Mirvaso. Full disclosure, I hold no Galderma stock J, but topical brimonidine has a remarkable vaso-constrcitive effect on surface blood vessels thereby reversing the redness associated with rosacea. It’s fascinating to me that we put a man on the moon, but still don’t have a cause for rosacea that affects millions. Some experts think it’s caused by the same p. acnes bacteria that causes acne (in which case doxycycline should work); others think it’s caused by a tiny demodex mite that overruns pores of the face (in which case permethrin should work). Usually my patients who suffer from rosacea receive one or all of the above, and if still not improved, we move to the pulse-dye laser.

Bobby Buka, MD
New York Dermatologist
5.0 out of 5 stars 7 reviews

Re: Best Rosacea Treatment

The redness that you see in acne rosacea is due to tiny, active blood vessels close to the skin’s surface. Getting rid of the blood vessels can be accomplished with a laser like V-beam. This laser uses the 595nm wavelength which is specialized for entering the blood vessels in order to seal them up, rendering them as useless tissue. The 595nm is readily absorbed by the hemoglobin in your blood. So its function is very specific and ideal for clearing unwanted blood vessels in the skin.


Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 reviews

Finacea gel to treat rosacea

Most of my patients that have Rosacea do very well with Finacea gel. This is a prescription product that contains azelaic acid, which significantly reduces redness and bumps.

As this is a prescription medication, you will need to see your doctor for an evaluation to find out if it is right for you.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 40 reviews

Rosacea is a very common skin condition that affects millions

Rosacea is a very common skin condition that affects millions. There are several treatments for Rosacea -- they range from topical prescription creams to antibiotic pills to in-office laser treatments. All are effective depending on the type of rosacea and your board-certified dermatologist can help you decide which is best for you.  

Ava Shamban, MD
Santa Monica Dermatologic Surgeon
3.9 out of 5 stars 9 reviews

It all depends on which type of rosacea you have...

obviously it's important to get the right kind of therapy for the type of rosacea you improper selection will irritate the skin and not improve its appearance...

if it looks like acne (pimples)...then antibiotics and acne creams or metronidazole seem to work well...

if it looks more red or with dilated blood vessels then the treatment is avoidance of heat along with laser therapy with the VBeam as the optimal device...antibiotics and creams tend not to work very well for this stage...



Ken Landow, MD
Las Vegas Dermatologist
4.6 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.