Early Treatment Key
The best advice for anyone who thinks that he or she might have rosacea is to see a dermatologist as early as possible. Experts believe early diagnosis and treatment not only control the signs and symptoms of rosacea, but might actually reverse progression. Early treatment can prevent blood vessels from enlarging and rhinophyma from developing.
When left untreated, rosacea often becomes worse and more difficult to treat—especially if it progresses to telangiectasia and rhinophyma. People who have these more advanced signs of the disease, however, should not give up hope. They, too, can be treated and their signs alleviated.
Dermatologists, while unable to cure rosacea, have a variety of treatments that diminish the disease's signs and symptoms. According to a study of 1,077 rosacea patients, 87 percent said their rosacea was under control with treatment. 1 Today's treatments range from topical products and oral medications to treat the papules and pustules, to laser therapy for treating visible blood vessels on the face and laser surgery for rhinophyma.
Dermatologists often use a combination of treatments, depending on individual patients' needs. Sometimes doctors prescribe both an oral antibiotic and a topical product. The following describes treatments used for the various signs and symptoms of rosacea:
All lists appear alphabetically.
Bumps and Pus-filled Pimples
Topical (applied to the skin) medications used to reduce the number of papules and pustules include:
People using topical medications, including antibiotics, should be patient. Many note slight improvements within the first month of use; however, it usually takes about two months to notice more dramatic results.
Oral (taken by mouth) antibiotics tend to work faster than topical antibiotics, and dermatologists may prescribe the following oral antibiotics to treat the pimples and bumps:
Glycolic acid may also be used to gain faster control over rosacea. The following is often used in combination with oral antibiotics:
Glycolic acid peels - Given every two to four weeks, these peels are applied to the face for up to five minutes. Following treatment, the skin is red for a few hours, and patients should avoid sun exposure until their skin returns to its normal color.
Glycolic acid washes and creams – Dermatologists may use these in low concentrations to further enhance the peel's effect.
For severe cases, dermatologists may prescribe:
Isotretinoin – Off-label use (not FDA-approved for this condition) of isotretinoin may help shrink thickened facial skin and diminish nodular rosacea. Isotretinoin is a powerful medication, and only some patients are candidates for its use because of potential serious side effects.
Eyelid involvement can develop. Those with eyelid inflammation should clean their eyelids often by gently scrubbing the eyelids with diluted baby shampoo or an over-the-counter eyelid cleaning product and applying warm to hot (without burning) compresses several times daily.
Oral antibiotics can also be used successfully to treat eye problems associated with rosacea. Some antibiotics used for this purpose are:
Redness and Flushing
The redness and flushing of rosacea can present greater treatment challenges than other signs. Oral and topical therapies, which are described above, do not clear the redness nor reduce the appearance of dilated blood vessels below the skin.
To tackle the redness, some dermatologists prescribe:
Dermatologists may also use the following to destroy the visible blood vessels with little pain or discomfort:
Electrosurgery - A low-powered electrical device is used to destroy the visible blood vessels.
Intense light and laser therapy – Used to treat the persistent redness caused by rosacea, intense light and laser therapy treatments destroy the dilated blood vessels. Intense light and laser therapy treatments should be performed by or under the direct, on-site supervision of a physician with expertise in the skin, such as a dermatologist.
Vascular lasers - Vascular lasers heat up the visible blood vessels by emitting specific wavelengths of light. The vessels collapse and are absorbed by the body. The new vascular lasers do not cause bruising or scarring, but redness and some swelling may occur for up to 48 hours after treatment.
Patients undergoing vascular laser or intense light and laser therapy treatments find that multiple treatments are necessary to achieve the best results. Maintenance treatments also are necessary for long-term success. Electrosurgery may also require more than one treatment.
Changes due to rhinophyma can become permanent. But even this problem can be successfully treated by a dermatologist. Generally, surgery is necessary to remove thickened tissue that can occur around the nose.
Dermatologists may recommend the following surgeries to sculpt areas, such as the nose, to a more normal appearance:
Electrosurgery , using a small electric needle