There are a number of ways that the symptoms of rosacea can be treated. These are described below.
Facial flushing
Making lifestyle changes, such as avoiding possible triggers, or wearing sunscreen, can be a good way of helping to control the symptoms of facial flushing.
See the 'prevention' section for more information about lifestyle changes and avoiding triggers.
Spots and pimples
There are a number of treatments that have proved effective in treating the spots and pimples that are caused by rosacea. Your GP will be able to recommend a cream, or gel, as the first treatment option.
Creams and gels
Metronidazole cream, or gel, (topical metronidazole) is usually recommended for the treatment of mild to moderate spots and pimples.
When applying metronidazole cream, or gel, you need to be careful not to get any in your eyes, or mouth.
An alternative to topical metronidazole is azelaic acid, which is also available in gel form. Azelaic acid helps to unblock pores and reduce any inflammation.
As with topical metronidazole, you may need to use azelaic acid for several months before you notice any significant improvement in symptoms.
The side effects of azelaic acid can include:
- burning and stinging of the skin,
- itchiness, and
- dry skin.
However, any side effects are usually only short-term.
Antibiotic tablets
For more serious symptoms of spots and pimples, antibiotic tablets (oral antibiotics) may be recommended. In this case, the antibiotics are used for their ability to reduce inflammation of the skin, rather than for their bacterial-killing properties.
As with the other treatments, you will need to take oral antibiotics for several months before you notice a significant improvement in your symptoms.
The two most commonly used antibiotics used in the treatment of rosacea are tetracyclines and erythromycin.
Tetracyclines
Tetracyclines are not suitable for women who are pregnant, or breastfeeding. This is because they can cause birth defects in unborn children, and interfere with normal bone development in breastfed children. Sexually active women of childbearing age should use a barrier method of contraception while taking tetracyclines, such as a condom, in order to prevent becoming pregnant.
Tetracyclines may cause oral contraceptives to fail during the first few weeks of treatment.
Tetracyclines are usually not suitable for people with a history of kidney disease. They can also make your skin more sensitive to the effects of sunlight, so you should avoid exposure to direct sunlight.
A rare, but potentially serious side-effect of tetracyclines is that it can cause an increase in the pressure of the fluid that surrounds your brain, which is known as benign intracranial hypertension. The symptoms of benign intracranial hypertension include:
- a severe headache, and
- a disturbance in your vision.
If you experience these symptoms, you should stop taking tetracyclines, and contact your GP.
Erythromycin
Erythromycin can increase the potency of certain medications, such as warfarin and statins. Your GP will be able to advise you if your dosage needs to be revised.
Visible blood vessels (telangiectasia)
The symptoms of visible blood vessels that are associated with rosacea are known as telangiectasia.
Treatment for telangiectasia will usually require a referral to a dermatologist (a specialist in treating skin conditions).
Laser treatment is one of the most widely used treatments for telangiectasia. The heat from the lasers is used to shrink the blood vessels.
While laser treatment can cause some skin pain, most people can tolerate it without the need for using anaesthetic.
Complications of laser treatment are rare but can include:
- bruising,
- crusting of the skin,
- swelling and redness of the skin, and very rarely
- infection.
Most complications that occur as a result of laser treatment will usually pass within a few weeks, although infection will require treatment with antibiotics.
Persistent redness
It may be possible to disguise patches of persistent red skin using specially designed 'camouflage' make-up. Your local British Red Cross branch office should be able to provide advice on this issue. See Useful links for more information.
Thickened skin (rhinophyma)
If you have thickened skin (rhinophyma) - a symptom of rosacea that often affects the nose - it is likely that treatment will involve a referral to a plastic surgeon.
A number of surgical treatments are available, such as using a laser, or a scalpel, to remove any excess tissue and remodel the nose into a more pleasing shape.
Cosmetic surgery is not usually available on the NHS.
