How Do You Clear Up Rosacea?

Rosacea treatment may include sunscreen daily, avoiding triggers, laser treatments, topical medications, oral antibiotics, light treatments, surgical removal, warm compresses, eye drops, and others.

Rosacea is a common and chronic skin condition that causes skin redness and raised, red bumps on the nose, cheeks, chin, forehead, or eyelids. 

There is no cure for rosacea. Treatment to help clear up rosacea involves medications and lifestyle changes to manage symptoms and prevent flare-ups. 

• Lifestyle changes to help manage symptoms of rosacea and prevent flare-ups include:
  • Wear sunscreen daily
  • Avoid triggers that cause or worsen symptoms
  • Use mild, unscented facial cleansers 
  • Avoid using products on the face that contain ingredients that could irritate skin such as alcohol, acid, or fragrance, or other irritants
• Treatments to help clear up skin redness due to rosacea include: 
  • Laser or other light-based treatment
  • Brimonidine gel 
  • Oxymetazoline hydrochloride cream
• Treatments used to help clear up acne-like breakouts caused by rosacea include: 
  • Metronidazole gel or cream
  • Azelaic acid topical 
  • Sodium sulfacetamide and sulfur 
    • Found in over-the-counter (OTC) treatments such as cleansers and topical prescription medications
  • Topical retinoids, a form of vitamin A 
    • Isotretinoin
  • Oral antibiotics
    • Tetracycline
    • Minocycline
    • Doxycycline
    • Erythromycin
    • Low-dose doxycycline: at low doses it can help reduce rosacea breakouts
  • Laser or light therapy
• Treatments used to help clear up thickening skin (phyma) of rosacea include: 
  • Isotretinoin
  • Surgical removal of phyma
• Treatments to help clear up eye symptoms of rosacea include: 
  • Applying warm compresses
  • Using eye drops and eye medications
  • Cleansing with a gentle, eye cleanser
  • Antibiotics if needed

Symptoms of rosacea affect the nose, cheeks, chin, forehead, or eyelids and include:

• Blushing or flushing easily
• Skin redness 
• Raised, red bumps with or without pus in them (may resemble acne, but is not acne)
• Tiny, visible, swollen blood vessels on the skin of the face (also called “spider veins” or telangiectasias)
• Red, swollen, rounded nose (rhinophyma)
• Large pores
• Thickening skin (phyma)
• Burning, irritation, or gritty feeling in the eyes
• Watery eyes

Rosacea can also have a psychological impact. The redness and swelling on the face can affect people’s self-esteem and self-confidence and result in:

• Embarrassment
• Anxiety
• Depression
• Social isolation

It is unknown what causes rosaces, but factors that may be involved include: 

• Genetics: It runs in families
• Immune system reactions: Most people with acne-like rosacea react to a bacterium called Bacillus oleronius
• Demodex skin mites: These mites live on everyone’s skin, and people with rosacea have been found to have large numbers of this mite on their skin
• H. pylori: A common bacterium in people with rosacea but the role it may play is yet unproven
• How the body processes a certain protein (cathelicidin) may cause the characteristic redness and swelling

Factors that may trigger rosacea symptoms and aggravate facial redness include:

• Drinking alcohol
• Exposure to sunlight
• Drinking hot beverages
• Eating hot or spicy foods
• Being too hot or cold
• Stress and other strong emotions

A dermatologist can often diagnose rosacea with a skin examination. Tests may be recommended to rule out other medical conditions that can resemble rosacea, such as:

• Allergic skin reaction testing
• Tests for lupus, which can cause a red "butterfly rash" on the nose and cheeks 

Patients with significant symptoms involving the eyes should see an eye doctor (ophthalmologist) for evaluation.