There are multiple treatments for rosacea that are split into two distinct groups - one to reduce the symptoms of redness and flushing, and the other to fight the infection on the skin that often causes rosacea. The groups and treatments are compared below:
Papules and pustules - These are lumps and bumps on the surface of the skin which may be red, hot and tender to touch. They are normally caused by bacteria that live on the skin.
Azelaic Acid and Metronidazole are used to treat mild to moderate pustules and papules. They are applied once or twice a day. The Azelaic Acid is more effective but comes with a greater incidence of side effects. Treatment needs to be continued for a few weeks before a significant difference is usually seen.
Erythromycin (antibiotic) is used to treat papules and pustules which are greater in number and severity and unresponsive to other medicines. It is also used when there is inflammation. Erythromycin needs to be taken for 4 - 6 weeks before a significant difference is seen.
Facial redness and flushing - symptoms caused by expanded blood vessels.
Mirvaso reduces the blood flow thought to be responsible for the redness and flushing. When it is applied once a day a difference can be seen in as little as 30 minutes, lasting for up to 12 hours. Some patients may experience a worsening of the redness, usually within the first 2 weeks of treatment. If you stop using the gel this will get better by itself. You should test a small portion of the skin with the gel before restarting and if it occurs again the treatment should be discontinued.
Oral Treatments – Clonidine, beta-blockers and anxiety medication prescribed under the supervision of a dermatologist can reduce redness and flushing. The mode of action in reducing rosacea symptoms remains unclear.
Thickened Skin
This usually occurs on the nose (rhinophyma) and if severe can be treated with surgery, dermabrasion or laser treatment. Laser treatment involves having narrow lasers aimed at the visible blood vessels in the skin, causing them to shrink so they're no longer visible. It can be mildly painful, with possible side effects including temporary bruising and swelling.