There are various treatment options that people with rosacea can choose from depending on the severity of their condition. These can be classified into six categories, namely: topical creams and gels, oral medications, laser and light treatments, surgical procedure, chemical peels, and natural remedies.
These refer to products that are applied directly on the skin to reduce the redness, to calm the skin, and to control the flare-ups.
OTC Creams and Gels
There is a wide range of topical over-the-counter treatment products on the market. They require no prescription, but you should consult a dermatologist or learn more about a product before you decide to use it. The ingredients vary from one product to another. Thus, the ways by which they act on rosacea inflicted skin also vary. Those made from gentle natural ingredients work best because most people with rosacea have sensitive skin.
There are also prescription topical products, which are antibiotic creams in the form of metronidazole 1% and metronidazole 0.75%. These are FDA approved for the treatment of rosacea, particularly papulopustular rosacea involving lesions and pimple-like bumps. Metronidazole is applied once or twice a day. The results of using it differ for each individual, and it may take months before a change becomes noticeable. Side effects include skin irritation and allergic contact dermatitis. If you are using this topical antibiotic treatment, apply it away from your eyes and mouth, and avoid excessive sunlight exposure. Metronidazole is not recommended for pregnant women, in which case topical clindamycin or erythromycin is a good alternative.
Azelaic acid 15% is another topical treatment used for rosacea. Applied twice a day, it reduces the skin’s redness and inflammation. It also unclogs your pores, which helps avoid further inflammation. As with metronidazole, the effects of using azelaic acid are not the same for each individual, and it may be months before the skin shows improvement. Azelaic acid has several side effects, including itchiness, stinging sensation, and drying of the skin. It is known to have a greater chance of irritating the skin compared to metronidazole.
Sometimes, people employ a combination treatment involving alternating applications of metronidazole in the morning and azelaic acid in the evening. This combination treatment may show good results for some rosacea sufferers.
Antibiotics, oral contraceptives, and isotretinoin are among the common oral medications that are being used to relieve the symptoms of rosacea, especially for the more severe cases.
Doctors commonly prescribe the antibiotics doxycycline, tetracycline, amoxicillin, erythromycin, and minocycline for rosacea. These medicines are used not really for their ability to fight bacterial infection but for their effectivity to reduce the skin’s inflammation.
Usually, a person starts with a high dose of antibiotics, which is reduced gradually as the days progress. You should note that although antibiotics do reduce inflammation, they may have negative results for some people. That’s why you have to consider the possible side effects before you decide to take them to treat your rosacea. If you are pregnant or breastfeeding, for example, you should stay away from certain antibiotics like tetracyclines, which are known to cause abnormalities in unborn children. Antibiotics should not be taken for the long term.
Hormonal Treatments (Oral Contraceptives)
Hormonal treatments in the form of oral contraceptives are likewise used to fight against the symptoms of rosacea. Among those considered effective include cyproterone and chlormadinon acetate. However, oral contraceptives have side effects, too, so you should carefully consider if the pros outweigh the cons.
Isotretinoin, an oral medication often prescribed for the treatment of acne, is also being used to treat rosacea. This drug is derived from Vitamin A. Although isotretinoin is effective in treating rosacea, it is also known to cause many serious side effects, such as back pain, having a greater tendency to bleed or bruise, abnormalities in unborn children, and having blood in the urine. Some people also report experiencing joint aches, headaches, and drying of the eyes, skin, and lips.
Because of these side effects, isotretinoin is usually the last resort in the treatment of rosacea and is recommended only when the case is severe and other agents and methods have failed. Pregnant women are advised not to take isotretinoin, and women who are taking this medication should make sure that they do not become pregnant while they are on it.
Laser and Light Treatments
Laser and light treatments are ideal for reducing the appearance of thread veins and vascular lesions.
Pulsed Dye Laser (PDL)
The pulsed dye laser is one of the most commonly used type of lasers for treating rosacea. PDL works by focusing pulses of laser into the affected areas. The light, when absorbed by the red blood cells, shrinks the blood vessels’ lining, thus effectively reducing the visible thread veins on the face. It also eases the skin’s redness and decreases the flushing.
PDL has been shown to be effective, although its effect varies for each individual. You can expect the affected area to swell and have a reddish appearance for up to 48 hours after PDL treatment. Ice packs may help ease the swelling. After undergoing PDL, you should avoid being exposed to sunlight and make sure that your face is protected by a sunscreen of at least SPF 30. In addition, you should put off your workout routine for at least 24 hours to give your face a chance to heal.
Intense Pulsed Light (IPL)
Intense Pulsed Light treatment is also used for the treatment of rosacea. Unlike laser treatment, which uses a single wavelength of light, IPL uses narrow beams of broad spectrum light over the affected area. Its effect on the blood vessels is similar to that of PDL in that it shrinks the dilated blood vessels that appear as thread veins on the skin. IPL treatment may result in some usually mild and temporary side effects, such as swelling, bruising of the skin, redness, blisters, and in rare cases, infection.
Photodynamic Therapy (PDT)
Another method used in reducing the symptoms of rosacea is through the use of Photodynamic Therapy or PDT. This procedure is used primarily for the treatment of precancerous cells but it has been found to be effective for rosacea inflicted skin. It employs a light source that works on a photosensitizing drug, which destroys the affected cells and makes the skin clear.
These phototherapy methods cause minimal damage to the skin. They are all very effective in reducing the effects of rosacea on the skin and in improving skin tone and texture, and the results last a long time. They also have minimal side effects. However, they are expensive, that’s why many people opt for laser and light treatments only when their rosacea has become severe or when other options have not worked out.
Some people resort to chemical peels to remove the unsightly effects of rosacea on their skin. However, many dermatologists do not recommend this because people with rosacea have sensitive skin, and using chemical peels may aggravate their skin’s condition instead of improve it. Furthermore, it does not address the root of the problem. Basically, chemical peels work by applying certain chemicals that induce the removal of the top layer, and sometimes up to the second layer, of the skin in order to give way to new skin. This method is effective in removing light acne scars and uneven skin pigmentation. However, it does not improve the dilated blood vessels that cause the redness and the facial veins.
Surgery is used primarily to remove thickened skin. The procedure is also employed to remove the blood vessels that show through the skin.
Carbon Dioxide Laser Surgery
Carbon dioxide laser surgery is one of the best procedures in removing the thickened skin caused by rosacea, particularly the skin around the nose. It can get rid of excess tissue, remove the bumps, make the skin smooth, and improve the shape of the nose. After the procedure, the treated area will be red and sore. It may stay red for up to two weeks but it will gradually improve.
Electrocautery is another surgical procedure that takes out the thickened skin by making use of a burning device. Like carbon dioxide laser surgery, it can be used to improve the shape of the nose by taking out the excess tissue and making the skin smooth.
You can always resort to natural remedies to calm your skin and control the symptoms of rosacea. The first thing you should do is to make adjustments in your lifestyle. If you are used to doing one rigorous workout routine daily, you need to switch to lower intensity exercises that are done in short durations within the day. This is because vigorous exercise triggers flushing.
You also need to avoid certain kinds of food that trigger rosacea. These include spicy food, alcohol, hot food, chocolate, all kinds of dairy, and others. And you need to protect yourself against sun exposure by consistently applying an SPF 30 sunscreen and wearing a hat or using an umbrella to keep the sun’s rays away from your face. Finally, practice stress management techniques to keep yourself stress free.
Use of Natural Products
Aside from adapting these lifestyle changes, you can use creams made from natural ingredients such as niacinamide and Chrysantellum indicum. Niacinamide is a from of vitamin B3. When used in a moisturizing cream, it effectively improves and strengthens the skin’s protective barrier. Creams containing an extract of Chrysantellum indicum have been shown to reduce the flushing and the redness. . Creams containing green tea likewise reduce inflammation. Furthermore, they help protect the skin from the sun because of green tea’s natural photoprotective properties.
There are other natural remedies that you can do at home to relieve the flushing. A cold compress made of chamomile and water can soothe and calm the skin. Lavender oil, which has natural anti-inflammatory properties, can reduce inflammation when applied with a cotton ball over the affected areas. However, you should note that some rosacea sufferers are allergic to lavender oil because of its geraniol content, so test a portion of the skin first before applying it to the rest of your face.