Rosacea doesn’t have a single, one-size-fits-all treatment. The best option for you depends on the type of rosacea you have and the severity of your symptoms. Here’s an overview of topical and oral medications.
Topical Medications: Applied Directly to the Skin
Topical medications are often used to treat the bumps, pus-filled pimples, and redness of rosacea. They work in various ways. Some reduce inflammation. Others help old skin shed more quickly or make it easier to wash away excess oil and dirt.
Types of Topical Medications
• Topical antibiotics (clindamycin, erythromycin, metronidazole)
• Azelaic acid
• Benzoyl peroxide
• Metronidazole
• Retinoid
• Sulfacetamide
• Sulfur lotions
What to Expect from Topical Treatments
While these treatments can be effective, they usually don’t work as quickly as oral medications. It may take a couple of months before much improvement is seen. Possible side effects include:
- Burning
- Stinging
- Itching
- Skin irritation
- Skin dryness or peeling
- Increased sensitivity to sunlight, cold, or wind
Oral Medications: Taken by Mouth
Oral medications are often prescribed for more severe rosacea. They can be effective at treating bumps and pus-filled pimples.
Types of Oral Medications
Oral antibiotics, including:
- Doxycycline
- Erythromycin
- Minocycline
- Tetracycline
- Azithromycin
- Clarithromycin
- Nonantibiotic orals, including doxycycline (Oracea), which is taken at a dose too low to act as an antibiotic
What to Expect from Oral Medications
After starting these medications, it usually takes about three to four weeks to see improvement. Possible side effects of oral antibiotics include:
• Upset stomach
• Sun sensitivity
• Yeast infections in women
Another concern is that frequent or long-term use of oral antibiotics to treat rosacea may contribute to antibiotic resistance. This is the tendency of bacteria to change over time in a way that reduces the ability of antibiotics to weaken or kill them.
Nonantibiotic doxycycline decreases rosacea’s bumps and pimples by fighting inflammation. But since the dose of antibiotics prescribed in this treatment is so low, it doesn’t have the same side effects or risks as the full-strength dose.
Other Therapies and Procedures to Treat Rosacea
Beyond the commonly prescribed approaches described above, other safe treatments include glycolic acid, eye medication specifically for ocular rosacea, laser and light therapies, electrosurgery, and dermabrasion. These alternatives are shown to be effective for treating specific symptoms of rosacea.
In addition, recognizing your own personal triggers—the weather, certain foods, stress levels— will help you understand and prevent the troubling flare-ups common with rosacea. In the end, no matter which options you choose, one thing holds true for all men and women with rosacea: The better you stick to your treatment plan, the more likely you are to produce the results you want.
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