Which topical would be best to start (Finacea or Soolantra) for my rosacea? (photo)

I recommend getting a formal evaluation with a cosmetic dermatologist. For rosacea, I like a combination using lasers (ProYellow, Pulsed Dye/Vbeam, Excel V, Clear + Brilliant), peels and botox to the cheeks. This makes dramatic changes in color and symptoms. See an expert. Best, Dr. Emer

Vbeam laser is an excellent modality for patients who have rosacea, blushing of the skin, facial and body telangiectasia, spider veins, redness, post surgical redness, and skin flushing. It is a safe procedure that can be used at varying depths to help treat micro blood vessels in the skin. We also use it in our office for facial skin inflammation, keloids, and hypertrophic scarring. It is an important part of scar therapy. Vbeam can be combined with chemical peels and other lasers, but experience with the treatment is essential. The Vbeam laser does not affect deeper tissue. Schedule a consultation with an expert in Vbeam and you will find it to be an excellent modality for many skin types.

Best,
Dr. Karamanoukian
Realself100 Surgeon

If there was one stand out cream, then only one would exist, not a dozen prescription creams. Many factors to consider when you are considering a cream- namely what is the purpose? If its anti-inflammatory - try either Fiancea or Rozex, if you have demodex , Soolantra may work. If you are targeting redness, lasers help. Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)

To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. 

A detailed history, together with a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -

1. Lasers ( to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness. 

2. Creams - anti inflammatory

3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. 

4. For females- Mineral make up is recommend, over make up that contains parabens. 

For the best results, consult a dermatologist for both medical and laser treatment options. 

Kind regards.

Dr Davin S. Lim.
Laser Dermatologist