Multiple rosacea treatment options will focus on diminishing redness caused by increased blood flow to the facial area and widening (or dilating) of the blood vessels underneath the skin. This flushing is common in a subtype of the condition known as erythematotelangiectatic rosacea.
Topical Treatments for Redness
To combat redness, your doctor may prescribe a topical gel or cream designed to constrict your blood vessels and reduce discoloration.
Medications often prescribed for redness include:
The drug brimonidine topical (Mirvaso) can also be used but it is known for sometimes leading to “rebound” redness that can be worse than original symptoms.
Although effective, topical gels applied to the skin only temporarily reduce superficial redness, according to Tsippora Shainhouse, MD, a board-certified dermatologist based in Beverly Hills, California. Since rosacea redness can return after the medication wears off, you’ll need to reapply these products daily.
Be mindful that side effects can occur with topical creams and gels. You may have increased redness, burning, pain, or itching. Side effects are generally mild and lessen over time, but they can also persist and become bothersome.
See a doctor if side effects are severe or don’t resolve. You may need an alternative medication to get rid of rosacea symptoms.
Topical Gels and Creams for Breakouts
Topical gels and creams are also effective for treating acne-like bumps or pimples caused by papulopustular rosacea.
These medications reduce swelling and redness. Side effects of these medications can include burning, itching, dryness, or tingling. The good news is that side effects may lessen with continual use.
Effective treatments for these types of breakouts include:
azelaic acid (Finacea)
metronidazole (Metrogel, Noritate)
sulfacetamide sodium and sulfur (Plexion)
ivermectin cream (Soolantra)
benzoyl peroxide (Epsolay)
Antibiotics
Antibiotic treatment either oral or topical can have an anti-inflammatory and anti-bacterial effect that can help calm the skin.
Initially, your doctor may prescribe a low dose of the antibiotic doxycycline (Oracea), which is safer to take long-term.
If that doesn’t work, there are other antibiotic treatments that can be effective.
Retinoid
In some cases, a dermatologist may recommend using a retinoid to help unclog pores and reduce inflammation.
A retinoid is a form of vitamin A. While often used for acne and anti-aging treatment, the medication can be irritating to the skin, especially for people with sensitive rosacea. As a result this medication is not advised for everyone with rosacea. If you have questions be sure to talk to your physician about whether or not this treatment makes sense for you.
Retinoids that can help with rosacea flares include:
tretinoin
adapalene gel
Your doctor may prescribe an oral form of retinoid called isotretinoin (Accutane) for four to six months. For rosacea, the drug is prescribed at a much lower dose compared with when it’s prescribed for acne.
If you’re pregnant or thinking about becoming pregnant, be sure to talk to your doctor before taking isotretinoin, which can cause birth defects.
Eye Drops
Rosacea can also affect your eyes. This is known as ocular rosacea, and it can produce symptoms similar to eye allergies. Topical ophthalmic eye drops can reduce red eyelids, pink eye, itching, sensitivity to light, tearing, and grittiness.
Eye drops used for ocular rosacea include:
cyclosporine eyedrops (Restasis)
Antibiotic eye treatment drops
Artificial tears
Some ocular rosacea patients require a low dose of oral antibiotics.
A recent study also found that omega-3 fatty acid pills may help with dry eye symptoms that are associated with ocular rosacea.
