Oral and Topical Medications

Oral Medications for Rosacea Treatment

Oral medications are often used to control the pimples that occur with rosacea, and are the same ones used to treat acne. The most commonly used antibiotics for acne and rosacea are the tetracyclines including: doxycycline, tetracycline and minocycline. These antibiotics have anti-inflammatory affects in addition to their anti-bacterial action, so they suppress the inflammation associated with rosacea. Other antibiotics are also used less commonly to treat rosacea.

How Effective are Medications?

Antibiotics are effective at controlling rosacea symptoms, but the mainstay of rosacea treatment is removing the excess facial vessels with laser treatment, together with sun-protection to prevent more from coming.

Topical Medications

Numerous topical medications are used to treat rosacea, some are also used to treat acne, and some are unique. One of the interesting features of rosacea is that some of the medicines that work to improve it work in ways we are not sure of. Others, like topical or oral antibiotics reduce inflammation and can attack the Demodex mites that are found in greater amounts in the pimples of rosacea, than in unaffected skin.  Topical treatments aimed at treating the mites are topical metronidazole gel (MetroGel®), cream or lotion, and ivermectin cream (Soolantra® cream). Other antibiotics commonly used to treat the acne-like rash of rosacea are topical sodium sulfacetamide creams, gels, and lotions or sulfur-containing topicals and washes. In addition, azelaic acid-containing cream or gel (Finacea® or Azelix®) have also been shown to treat the acne component of rosacea.

There is a relatively recently-approved medication, Mirvaso® or brimonidine, that actually prevents dilation and flushing of blood vessels in the skin and can dramatically reduce the redness of rosacea almost immediately after application. The problem is that once this medicine wears off, the flushing returns, often flaring unless the medication is re-applied. This treatment is best when a big event is looming and one needs to reduce the redness and flushing for the big day. Application can be tricky, as skipped areas can look quite red in contrast to treated areas.