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Acne Rosacea Treatment Overview

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Care Plan

1

First steps to consider

  • You can usually treat mild to moderate rosacea at home.
  • Try to limit triggers like spicy food, mint, alcohol, sun exposure (wear sunscreen), heat, and harsh cosmetic products.
  • Use a gentle moisturizer that repairs the skin barrier. Look for products that contain ceramides.
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2

When you may need a provider

  • You’ve tried home treatments for 4–6 weeks with no improvement in the rosacea.
  • You have lots of pimples or pus-filled bumps (pustules) on your face.
  • Your skin hurts or is constantly red.
  • You have eye pain or grittiness (feels like there is sand in your eye), which may be a sign of ocular rosacea.
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Emergency Care

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Go to the ER if you have any of these symptoms:

  • Severe skin or facial pain along with a fever

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When to see a healthcare provider

If for about a month you have tried OTC treatments and did your best to avoid triggers and your rosacea hasn’t improved, you should see a healthcare provider like a dermatologist. Also see a provider if you have pain or numerous papules or inflamed pimples.

If you have symptoms of ocular rosacea—eyelid swelling, grittiness or eye pain—you should see an ophthalmologist right away to help relieve the symptoms and prevent it from getting worse.

Getting diagnosed

Rosacea is usually diagnosed by a thorough skin exam. Sometimes a dermatologist may take a culture of one of the pustules of rosacea to look for bacteria.

What to expect from your doctor visit

  • Your dermatologist will likely start you with a topical skin care regimen that may include topical anti-inflammatories and anti-demodex (mite) medications.
  • You may also be prescribed topical medications that constrict blood vessels to make the skin appear less red. These may be enough to control the redness and pimples of rosacea.
  • If skin treatments don’t work, your dermatologist may recommend taking oral antibiotics or oral anti-demodex medications to help reduce inflammation.
  • For facial redness that does not improve with topical medications, laser treatment may be recommended.
  • For severe cases, oral isotretinoin (Accutane) is sometimes recommended.

Prescription rosacea medications

  • Ivermectin Cream 1% (Soolantra)
  • Metronidazole gel or cream (Metrogel)
  • Doxycycline (Oracea, Doryx, Monodox)
  • Sulfacetamide-sodium sulfur wash, lotion or cream (Plexion, Avar)
  • Azelaic acid foam (Finacea foam)
  • Oxymetazoline cream 1% (Rhofade)
  • Brimonidine topical gel 0.33% (Mirvaso)
  • Isotretinoin (Accutane)
  • Ivermectin (Stromectol)

Types of providers who treat rosacea

  • A dermatologist (skin doctor) can treat rosacea and should be seen early on to help prevent the condition from getting worse.
  • An ophthalmologist can evaluate and treat ocular rosacea.
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