Rosacea treatment

Treating rosacea²² focuses on the management of your signs and symptoms. This can involve both medical and lifestyle interventions.

The duration and intensity of your treatment will depend on the type and severity of your symptoms. Because rosacea often goes away before recurring or flaring up, you may have to repeat treatments as needed.

Lifestyle changes for rosacea

A combination of awareness and action may help you manage your condition. These practices may be effective in controlling and treating your rosacea:

• Identify and avoid triggers: Make a note of any foods, activities, or environments that cause your rosacea to flare. Avoiding these in the future may prevent the aggravation of your symptoms.
• Protect your face: People with rosacea should be especially conscientious about applying sunscreen daily. Use a broad-spectrum sunscreen with an SPF of 30 or higher, especially after applying topical medications (as some of these can increase your skin’s susceptibility to sunburn). Wearing a hat, avoiding the sun at the height of the day, and covering your face in cold, windy weather can also help protect your skin from irritation.
• Be gentle on your skin: Avoid touching your face more than is necessary. Use an oil- and alcohol-free cleanser, and moisturize frequently. Try to avoid wearing makeup, when possible.

Medical treatment for rosacea

A combination of oral and topical medications²³ may be prescribed to help treat the signs and symptoms of rosacea. What your healthcare provider decides to prescribe will depend largely on the type and severity of the symptoms you experience. It may take some time to try different options or combinations to find the right treatment for you.

Some prescription treatments for rosacea include:

• Topical medications: Mild-to-moderate rosacea may sometimes be treatable with topical treatments that reduce redness. Some creams or gels work to temporarily reduce redness by constricting the blood vessels in the applied areas. These may provide results within 12 hours after application. Other topical products that are designed to target bumps rather than redness may take 2–6 weeks to provide noticeable improvement.
• Oral antibiotics: Oral antibiotics can help improve moderate-to-severe rosacea with bumps and pimples.
• Oral acne treatments: If your rosacea is severe and doesn’t respond to other therapies, you may be prescribed an oral acne treatment like isotretinoin (generic Amnesteem, Claravis). These medications are strong—while they are often effective at clearing acne-like bumps, they can have serious side effects, such as birth defects, and must not be used during pregnancy to avoid birth defects.

Laser treatment²⁴ has also proven effective in treating enlarged blood vessels (telangiectasias).

Rhinophyma treatment

As it takes years for rhinophyma to develop, the best course of action is to prevent rhinophyma by treating rosacea early. When rhinophyma does develop, it can be difficult to treat.

The use of medications and the avoidance of trigger factors may help improve signs and symptoms. However, surgery²⁷ or medical procedures are generally required to eliminate rhinophyma. These procedures may include:

• Mechanical dermabrasion
• Ablative CO2 laser treatment
• Cryosurgery
• Radiofrequency ablation
• Electrosurgery
• Tangential excision with scissor sculpting, skin grafting, or dermabrasion
• CO2 laser treatment

Seeking advice, diagnosis, and treatment from your healthcare provider is the best way to catch rosacea before it progresses (and to correct rhinophyma, if it does develop).

Rosacea medication

Your healthcare provider may recommend the following prescriptions to treat rosacea.

Rosacea diet

For some people with rosacea, certain foods²⁵ can trigger flare-ups.

One of the biggest culprits is vasodilators: foods that widen the blood vessels and allow for increased blood flow. Seemingly dissimilar foods like tomatoes, chocolate, and citrus all contain cinnamaldehyde, a vasodilating compound.

Dietary triggers for rosacea can be generally grouped into four categories: cinnamaldehyde-related, capsaicin-related (an irritant that’s an active component of chili peppers and many spicy foods), heat-related, and alcohol-related.

While there is no one diet that will work for everyone, keeping track of what you eat and when you experience aggravated symptoms can help you identify what foods to avoid. Try eliminating potential triggers for eight weeks and adding them back into your diet individually to find what particular foods worsen your symptoms.

Recent studies²⁶ have indicated an association between rosacea and an increased risk of certain gastrointestinal diseases. In addition to identifying and avoiding triggers, Dr. Katta from the Baylor College of Medicine recommends incorporating more probiotics (such as yogurt and fermented foods) and prebiotics (like legumes, vegetables, and whole grains) into your diet.

Ocular rosacea treatment

Ocular rosacea cannot be cured—it generally remains chronic or comes and goes with flare-ups. However, the signs and symptoms of the condition can usually be managed²⁸ with combinations of medication and eye care.

Some medical treatments and prescriptions used to treat ocular rosacea²⁹ include:

• Steroid eye drops and ointments to help reduce redness and swelling
• Antibiotic pills or ointments to treat eye infection and rosacea of the skin
• Artificial tears to help keep eyes moist (do not take eye drops meant to treat bloodshot eyes, as this can make the symptoms of ocular rosacea worse)

You can also manage your ocular rosacea by carefully maintaining your eye health. You may benefit from incorporating the following into your routine:

• Keeping your eyelids clean: Gently wash your eyelids at least twice a day with warm water (and other products, if recommended or prescribed by your healthcare provider)
• Avoid makeup when your eyes are inflamed, and use non-comedogenic (oil-free), fragrance-free makeup when you’re able to
• Avoid contact lenses when your ocular rosacea is flaring up, particularly if you experience dry eyes
• Use eyelid scrubs to keep your eyes clean and infection-free (as directed by your healthcare provider)

Always consult your healthcare provider before beginning a new eye care routine.