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Rosacea is a long-term facial skin disorder, but a variety of treatments, cleansers, and moisturizers can help ease the symptoms.
Rosacea causes inflammatory lesions and thickening of the underlying connective tissue of the face.
In lighter skin, it causes redness, which may appear as lines or patterns. In darker skin, it can also cause discoloration. Patches of skin may feel dry, swollen, thick or rough, and a person’s face may feel warm and flushed. In some people, symptoms also affect the eyes.
Doctors recommend that people with rosacea avoid triggers, which may include:
- alcoholic drinks
- hot drinks
- spicy food
- aerobic exercise
People with rosacea also require sun protection, such as sunscreen and wide-brimmed hats.
Using mild cleansers and moisturizing regularly can also help ease the symptoms. In this article, we describe treatments and cleansers for people with rosacea.
Please note, however, that the statements below are based only on research. No one at Medical News Today, including the writer, has tried these products.
The treatment that a doctor prescribes depends largely on the specific changes to the skin and the person’s response to earlier treatments.
The Food and Drug Administration (FDA) have approved five medicinal ingredients for the treatment of rosacea:
Metronidazole 0.75% and 1%
The first line of treatment for rosacea is the antibiotic metronidazole. Depending on the severity, a person may need this in combination with another medication.
Metronidazole may reduce oxidative stress, discoloration, and inflammation, and it comes as a lotion, cream, or gel.
For example, Metrolotion and Metrocream both contain 0.75% metronidazole. Metrogel contains 1% metronidazole.
Side effects of metronidazole, such as dryness, irritation, and itchiness, are typically mild.
Azelaic acid 15%
People can apply these products once or twice a day. In an older study, from 2008, researchers found no differences between once- and twice-daily dosing.
Typical side effects include mild, short-term burning, stinging, and irritation.
Sulfacetamide 10% with sulfur 5%
Rinses containing these two ingredients have been effective in the past, but they are now second-line treatments because of the newer agents on the market.
Also, the FDA approved their use before the standards for approval became more rigorous.
It is important to note that anyone with a sulfa allergy should not try this type of rinse. Also, many people find the odor unpleasant, and some experience localized irritation.
Metronidazole and azelaic acid can reduce skin discoloration, they have little effect on color changes caused by permanently dilated blood vessels. Brimonidine, however, constricts blood vessels on the surface of the skin, which can help with persistent rosacea.
Mirvaso contains brimonidine 0.33%. Some possible side effects include:
- dry skin
In 2014, the FDA approved the use of ivermectin for papulopustular rosacea. Ivermectin may be more effective for this type of rosacea than metronidazole.
Doctors believe that ivermectin treats rosacea by easing inflammation, combating microbes, and particularly targeting the demodex mites that have increased populations in the skin of people with rosacea.
Soolantra cream contains 1% ivermectin, and may reduce the appearance of bumps and blemishes associated with rosacea. However, it can cause burning and irritation.
People with rosacea should cleanse and moisturize their skin daily. These habits help reduce the appearance of symptoms and may keep them from flaring up.
Prosacea is an over-the-counter product that may help treat and control the color changes, pimples, bumps, and irritation associated with rosacea. It contains a 10-fold dilution of sulfur and natural aloe, which may help soothe sensitive skin.
This is a homeopathic product, and although it contains only 1% sulfur, people with allergies or hypersensitivities to sulfur should not use it.
Cetaphil Gentle Skin Cleanser
Non-irritating cleansers are best for people with rosacea, which increases the skin’s sensitivity.
In one study, researchers assessed the effectiveness of Cetaphil Gentle Skin Cleanser in people with rosacea. During the 2-week trial, no significant increase in transepidermal water loss occurred, indicating that the product did not damage the skin’s barrier.
The researchers found that the product also reduced symptoms on the cheeks, forehead, nose, and chin. No increases in rosacea symptoms occurred during the study.
The cleanser contains:
- cetyl alcohol
- propylene glycol
- sodium lauryl sulfate
- stearyl alcohol
Soothe Natural Redness Relief Cream
Era Organics market their product as an anti-inflammatory cream for people with rosacea but say that it can also help with eczema, acne, dry skin, and sensitive skin.
This moisturizer contains aloe vera, methylsulfonylmethane, and other natural ingredients. The company say that the ingredients soothe redness and irritation without causing side effects.
They also report that this cream can:
- reduce inflammation and irritation
- reduce itchiness
- reduce the appearance of scars and blemishes
- promote healing and recovery
Some types of rosacea require treatment that goes beyond facial creams and ointments.
People with papulopustular rosacea may need tetracycline antibiotics, such as doxycycline. Another oral medication that may be effective is isotretinoin (Accutane). Limited studies have demonstrated that it works better than doxycycline.
Doctors may recommend laser or light-based therapies, particularly for people with phymatous rosacea.
These therapies may include pulsed dye laser, intense pulsed light, and near-infrared laser therapy to reduce the appearance of discoloration. People with papulopustular lesions may not benefit from these treatments, however.
When rosacea affects the eyelids, dermatologists recommend increased lid hygiene, topical cyclosporine, and topical or systemic antibiotics.
If symptoms do not respond to over-the counter treatments, discuss other options with a doctor or dermatologist.
People with rosacea may require medicated creams or ointments, laser or light therapies, or oral antibiotics. In any case, having a good skin care routine, limiting sun exposure and avoiding other triggers is key.