Rosacea is a chronic medical condition of the skin that causes redness of the face. There are four main components of rosacea that often require different treatments to achieve control. Anue offers a range of evidence-based treatment options to help reduce redness and limit irritation.
On this page we mostly focus on the treatment of rosacea. Please see our Definitive Guide to Rosacea to learn more about the condition.
What is rosacea?
Rosacea is a common condition affecting about 5% to 10% of the population. On the skin, it presents with different phenotypes (symptoms and signs):
- Erythema (redness) of the face
- Papules and pustules (similar to acne)
- Phymatous change: thickening skin with irregular surface
- Intermittent flushing
- Telangiectasia: enlarged blood vessels in the superficial skin
- Burning and/or stinging sensation
- Appearance of dry skin: feeling rough and scaly
It is important to note that not everyone with the condition will exhibit all symptoms. Nonetheless, the redness can have a significant impact on confidence and self-esteem. This can lead to people avoiding activities and enjoying life to the full.
Rosacea treatment options
Unfortunately, there is no unifying rosacea treatment that resolves all components of the condition. Essentially, each treatment needs to be targeted for each specific symptom.
This emphasises the importance of customising treatment to the individual. The most important part of your treatment is listening to what your concerns are so that we can tailor treatment to your individual needs.
Rosacea treatment with skin care
Moisturiser
Applying moisturiser twice a day has been proven to reduce the symptoms of skin sensitivity, discomfort, dryness, and roughness.1Del Rosso JQ. The use of moisturizers as an integral component of topical therapy for rosacea: clinical results based on the Assessment of Skin Characteristics Study. Cutis. 2009 Aug;84(2):72-6,2Laquieze S, Czernielewski J, Baltas E. Beneficial use of Cetaphil moisturizing cream as part of a daily skin care regimen for individuals with rosacea. J Dermatolog Treat. 2007;18(3):158-62. doi: 10.1080/09546630601121078
Cleanser
Cleansing the face at least once daily with lukewarm water and soap-free cleansers is recommended. Aim for a cleaner with a pH level of around 4.0–6.5. 3Wilkin JK. Use of topical products for maintaining remission in rosacea. Arch Dermatol. 1999 Jan;135(1):79-80. doi: 10.1001/archderm.135.1.79.,4Draelos ZD. Cosmetics in acne and rosacea. Semin Cutan Med Surg. 2001 Sep;20(3):209-14. doi: 10.1053/sder.2001.27556
Sunscreen
Sunscreen with the highest SPF available is recommended (at least SPF50+, aim for SPF100). Ideal sunscreens contain protective silicones (e.g., dimethicone, cyclomethicone) rather than alcohol-based vehicles, which generally cause irritation.5Pelle MT, Crawford GH, James WD. Rosacea: II. Therapy. J Am Acad Dermatol. 2004 Oct;51(4):499-512; quiz 513-4. doi: 10.1016/j.jaad.2004.03.033,6Nichols K, Desai N, Lebwohl MG. Effective sunscreen ingredients and cutaneous irritation in patients with rosacea. Cutis. 1998 Jun;61(6):344-6
Others
Toners, irritants, and chemical exfoliants such as salicylic acid and alpha-hydroxy acids should be avoided. Mechanical exfoliants such as rough cloths or scrubs should be avoided as well. Ideally, avoid alcohol-based products such as gels and lotions. Creams and foams are generally less irritating.7Draelos ZD. Cosmetics in acne and rosacea. Semin Cutan Med Surg. 2001 Sep;20(3):209-14. doi: 10.1053/sder.2001.27556,8Draelos ZD. Facial hygiene and comprehensive management of rosacea. Cutis. 2004 Mar;73(3):183-7.
Vascular rosacea treatment
Topical brimonidine (Mirvaso) can be an effective rosacea treatment by reducing erythema in about 25% of people.9Fowler J Jr, Jackson M, Moore A, Jarratt M, Jones T, Meadows K, Steinhoff M, Rudisill D, Leoni M. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. 2013 Jun 1;12(6):650-6,10Fowler J, Jarratt M, Moore A, Meadows K, Pollack A, Steinhoff M, Liu Y, Leoni M; Brimonidine Phase II Study Group. Once-daily topical brimonidine tartrate gel 0·5% is a novel treatment for moderate to severe facial erythema of rosacea: results of two multicentre, randomized and vehicle-controlled studies. Br J Dermatol. 2012 Mar;166(3):633-41. doi: 10.1111/j.1365-2133.2011.10716.x,11van Zuuren EJ, Fedorowicz Z, Tan J, van der Linden MMD, Arents BWM, Carter B, Charland L. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol. 2019 Jul;181(1):65-79. doi: 10.1111/bjd.17590 However, it is expensive and needs to be applied every day as the results wear off after several hours.
Laser and IPL (Intense Pulsed Light)
Vascular lasers and IPL provide more durable results and have been used extensively for the vascular components of rosacea. Their efficacy for telangiectasias, erythema, and flushing is well established.12Neuhaus IM, Zane LT, Tope WD. Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea. Dermatol Surg. 2009 Jun;35(6):920-8. doi: 10.1111/j.1524-4725.2009.01156.x,13Taub AF, Devita EC. Successful treatment of erythematotelangiectatic rosacea with pulsed light and radiofrequency. J Clin Aesthet Dermatol. 2008 May;1(1):37-40,14Kassir R, Kolluru A, Kassir M. Intense pulsed light for the treatment of rosacea and telangiectasias. J Cosmet Laser Ther. 2011 Oct;13(5):216-22. doi: 10.3109/14764172.2011.613480,15Bernstein EF, Kligman A. Rosacea treatment using the new-generation, high-energy, 595 nm, long pulse-duration pulsed-dye laser. Lasers Surg Med. 2008 Apr;40(4):233-9. doi: 10.1002/lsm.20621 Due to their superior efficacy, they should be considered a first-line treatment for the vascular components of rosacea.
See our page on laser and IPL treatments to learn why our lasers result in less burning, fewer adverse effects and shorter recovery times than traditional devices.
Papules and pustules
Numerous treatments are available for this component of rosacea. Fortunately, good control is normally relatively straightforward to achieve when the correct treatment is used.
Treatment options include:
Topical agents
Metronidazole (Rozex) has historically been the main topical treatment. However, newer treatments have shown improved effectiveness.16van Zuuren EJ, Fedorowicz Z, Tan J, van der Linden MMD, Arents BWM, Carter B, Charland L. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol. 2019 Jul;181(1):65-79. doi: 10.1111/bjd.17590
Oral medication
Tetracycline antibiotics and retinoids are the main oral medications used. Both medications are very effective at clearing papules and pustules.17Sneddon IB. A clinical trial of tetracycline in rosacea. Br J Dermatol. 1966 Dec;78(12):649-52. doi: 10.1111/j.1365-2133.1966.tb12168.x,18Webster GF. An open-label, community-based, 12-week assessment of the effectiveness and safety of monotherapy with doxycycline 40 mg (30-mg immediate-release and 10-mg delayed-release beads). Cutis. 2010 Nov;86(5 Suppl):7-15,19Ertl GA, Levine N, Kligman AM. A comparison of the efficacy of topical tretinoin and low-dose oral isotretinoin in rosacea. Arch Dermatol. 1994 Mar;130(3):319-24,20Hoting E, Paul E, Plewig G. Treatment of rosacea with isotretinoin. Int J Dermatol. 1986 Dec;25(10):660-3. doi: 10.1111/j.1365-4362.1986.tb04533.x,21Erdogan FG, Yurtsever P, Aksoy D, Eskioglu F. Efficacy of low-dose isotretinoin in patients with treatment-resistant rosacea. Arch Dermatol. 1998 Jul;134(7):884-5. doi: 10.1001/archderm.134.7.884,22Gollnick H, Blume-Peytavi U, Szabó EL, Meyer KG, Hauptmann P, Popp G, Sebastian M, Zwingers T, Willers C, von der Weth R. Systemic isotretinoin in the treatment of rosacea – doxycycline- and placebo-controlled, randomized clinical study. J Dtsch Dermatol Ges. 2010 Jul;8(7):505-15. English, German. doi: 10.1111/j.1610-0387.2010.07345.x
Phymatous change
Surgery and ablative laser treatments are typically used to quickly remove phyma tissue. Retinoids can be used to induce some improvement in phyma as well as for maintenance or preventative treatment.23Gollnick H, Blume-Peytavi U, Szabó EL, Meyer KG, et al. Systemic isotretinoin in the treatment of rosacea – doxycycline- and placebo-controlled, randomised clinical study. J Dtsch Dermatol Ges. 2010 Jul;8(7):505-15. doi: 10.1111/j.1610-0387.2010.07345.x,24Plewig G, Nikolowski J, Wolff HH. Action of isotretinoin in acne rosacea and gram-negative folliculitis. J Am Acad Dermatol. 1982 Apr;6(4 Pt 2 Suppl):766-85. doi: 10.1016/s0190-9622(82)70067-2
What are the benefits of rosacea treatment?
Being a dermatologist-led clinic allows us to achieve good long-term results. We are able to offer the best evidence-based treatments available particularly when this requires a prescription cream or tablet. We can often settle the papules and pustules into a longer-term remission. Our laser treatments can have a long-lasting effect, but they may need to be maintenance treatments up after a few years.
What to expect
An experienced healthcare provider will conduct your first appointment as a consultation. The first thing they will ascertain is what your skin concerns are and what your desired outcome is. Next, they will undertake a comprehensive assessment of your skin and provide their expert recommendations regarding treatment. Then they will develop a treatment plan tailored to your skin.
Our optimal goal is to help you achieve long-term results and not have to keep coming back for appointments.
Rosacea Treatment with Anue
We believe our clients deserve access to expert, evidence-based rosacea treatments. That is why we offer our services by our trusted team, supervised by renowned specialist dermatologist, Dr. David Lim.
By using refined techniques, qualified professionals, and high-quality products, we aim to make you look and feel your best. Our rosacea treatments are safe and effective at helping you achieve your goals.