Rosacea – Treatment

Rosacea is a very common skin disorder that on a typical day in my Woodlands dermatology and Conroe dermatology offices I will see between 5 and 10 patients with this skin disease.  There is no cure for rosacea but it can be managed.  Most important in any rosacea treatment regimen, is to use products that are gentle on the skin and to avoid all exacerbating factors.  Patients with rosacea have very sensitive skin and triggers such as sunlight, heat, spicy foods, stress, alcohol and caffeine can cause flare ups.   Sun protection with avoidance of UV light and physical blockers such as clothing and hats are ideal as some chemical sunscreens can irritate the skin in rosacea.  The best sunscreen is a physical blocker sunscreen containing titanium dioxide or zinc oxide. Acne medicines are too harsh for the dry sensitive skin of rosacea.  A gentle cleanser is very important and it should be applied without abrasive cloths.  The fingertips/hands are ideal for applying the cleanser. Cetaphil cleanser, Dove soap, or a sodium sulfacetamide product such as Plexion cleanser are good choices.  They can be used twice a day to cleanse the face.  Topical medicines such as Metrocream .75%, Metrogel 1%, azelaic acid gel 15% (Finacea), azelaic acid cream 20% (Azelex) are helpful in treating rosacea.  For patients with papules/pustules/cysts an oral antibiotic such as doxycycline or erythromycin taken twice a day can provide resolution of these lesions. The redness of rosacea can be masked with green tinted creams or makeup but can only be removed with a laser as it is small blood vessels in the skin producing the redness.  The typical rosacea regimen I prescribe is washing with Cetaphil cleanser, Metrocream .75% twice a day, and doxycycline 100mg twice a day.