Rosacea Medication: What Are My Options?

Rosacea is a common, chronic skin condition that typically affects the face, resulting in visibly irritated skin in the affected area. People of all skin tones can have rosacea. There are various treatment options to help control and reduce symptoms.1 Finding the right treatment depends on the type of rosacea you have and its severity.

Understanding these options can help you make an informed decision about which is best for you.

Medications for Rosacea

Treating rosacea often requires a combination of therapies tailored to your specific symptoms and type of rosacea to help manage flare-ups, reduce redness, and control inflammation.2

Topical treatments are often the first line of defense for managing mild to moderate rosacea. These medications help reduce redness, inflammation, and bumps and may include:3

• Finacea (azelaic acid)
• Metrogel (metronidazole)
• Mirvaso (brimonidine)
• Rhofade (oxymetazoline)
• Soolantra (topical ivermectin)

Oral medications are often prescribed for moderate to severe rosacea or for people who don’t respond well to topical treatments. Commonly used oral therapies include:3

• Absorbica (isotretinoin), often used to treat painful, nodular acne
• Antibiotics (such as doxycycline and minocycline)
  
• Blood pressure–lowering medications (such as beta-blockers)
• Plaquenil (hydroxychloroquine), which is used off-label to treat rosacea

For advanced cases of phymatous rosacea, in which thickening of the skin occurs, interventions such as dermabrasion, electrosurgery, and other forms of surgery may be necessary. Laser and light therapies are also effective in reducing redness, visible blood vessels, and thickened skin.3

For those with mild symptoms, over-the-counter (OTC) products such as gentle cleansers and moisturizers, as well as daily sunscreen use, can help soothe irritation and reduce flare-ups.3

Recent advancements in rosacea treatment, such as topical minocycline and oxymetolazone, focus on reducing inflammation and addressing the underlying immune system reactions that contribute to the condition.3

What Treatment Option Is Best?

First-line therapy for mild to moderate rosacea includes:4

• Finacea
• Laser therapy
• Metrogel
• Mirvaso
• Soolantra
  

Restasis (topical cyclosporine) eye drops may be used to manage symptoms associated with mild ocular rosacea.4 The fastest-acting treatment for rosacea typically involves topical vasoconstrictors at low doses, such as Mirvaso.5

Laser treatments can also offer relatively quick improvements but may require multiple sessions.

Doxycycline at the subantimicrobial dose of 40 milligrams (mg) daily or 20 mg twice daily is the only approved systemic therapy for the treatment of rosacea.4 When treating more persistent symptoms, doxycycline may start to show results in a few days to a week, but full effects are usually seen after several weeks of consistent use.

The most effective treatment for rosacea depends on the type of rosacea and severity of symptoms.

Understanding Rosacea

Rosacea is a chronic condition, meaning its effects are usually long-lasting.6 It develops gradually and may worsen if left untreated. Rosacea can affect people of all skin tones, but it’s most frequently reported in individuals with fair skin. It commonly arises after age 30.7

There’s no cure for rosacea, and it can be frustrating to manage, but there are ways to manage symptoms and reduce flare-ups through various treatment options.8

Each form of rosacea has unique symptoms.7 The four main types of rosacea are:2

• Erythematotelangiectatic rosacea (ETR)
• Papulopustular rosacea
• Phymatous rosacea
• Ocular rosacea

Causes

While its exact cause is not fully understood, research suggests the following factors may lead to rosacea:7

• Environmental factors (such as sun exposure)
• Genetics
• Immune system reactions (abnormal inflammation)

Understanding what causes rosacea, recognizing its symptoms, and identifying your triggers can help you better manage flare-ups and work with your healthcare provider to develop a treatment plan that suits your needs.

Symptoms

Rosacea often starts with symptoms such as persistent facial redness, particularly on the cheeks, nose, forehead, or chin.8 Visible blood vessels, small red bumps, and skin thickening can develop over time.8

Those with lighter skin tones may notice facial redness, whereas skin may appear brown or violet in those with darker skin tones.1

Eye irritation, dryness, redness, and burning may occur with ocular rosacea. Rosacea symptoms can vary in intensity and may come and go in cycles.8

Triggers

Rosacea can flare up unexpectedly. The following triggers are known to worsen symptoms:10

• Alcohol
• Harsh skin care products
• Hot or cold weather
• Spicy foods
• Stress
• Sun exposure

Identifying and avoiding your triggers can minimize flare-ups and help you maintain clearer skin.

Prevention

While rosacea cannot be completely prevented, there are several steps you can take to minimize flare-ups and avoid worsening symptoms. Managing rosacea often involves identifying and avoiding triggers that cause or exacerbate your symptoms, as well as adopting skin care and lifestyle habits that help protect your skin, such as:10

• Avoiding hot beverages (such as coffee and tea) and spicy foods
• Avoiding warm environments and staying cool
• Identifying and avoiding triggers
• Limiting alcohol
• Managing stress
• Using gentle skin care products

By avoiding triggers, adopting a gentle skin care routine, and being mindful of your environment, you can reduce the frequency and severity of rosacea flare-ups. Partnering with a healthcare provider to develop a personalized management plan is also key to long-term success.

Summary

Rosacea is a chronic skin condition that causes redness, visible blood vessels, and sometimes acne-like bumps, primarily on the face. Factors like sun exposure, stress, spicy foods, or certain skin care products can trigger it. While there’s no cure, many treatments are available to manage symptoms.

Treatment options include topical treatment options, oral therapies, and laser therapies to minimize symptoms. Rosacea is usually best managed with targeted treatment options and avoidance of triggers. Treatment options vary depending on the type, cause, and severity of the condition.

Identifying and avoiding personal triggers, targeting symptoms, and working with a healthcare provider can help control rosacea and improve skin health.