The treatment of Rosacea

The full medical name of Rosacea is Acne Rosacea. Rosacea affects two components of the skin, hair follicles and blood vessels. Especially hair follicles that have large oil glands attached are afffected. These hair follicles are found on the face, chest and back. No one knows exactly what causes Rosacea. One theory suggest that a certain organism, called Demodex, is the cause of the hair follicle problems. Another theory suggests that the blood vessel problem is related to sun damage of the tissue around blood vessels. Middle aged people are the most commonly affected age group. Rosacea goes through different phases of development and the treatment of Rosacea in each phase is different.

Phase 1: Intermittent flushing

The intermittent flushing phase tends to be triggered by sun exposure or other factors like warm drinks, warm food, alcohol or spicy food. The treatment of this phase involves avoiding the trigger factors and applying sunblock.

Phase 2: Persistent redness and broken capillaries

The redness and broken capillaries are best treated with a laser or intense pulsed light device.

Phase 3: Pimples

The pimple phase is treated with topical medication (creams, gels and ointments) or systemic medication (tablets or capsules). Topical medications include Metronidazole gel (Rozex gel) and Azeleic acid (Skinoren). Oral medications include Tetracycline derived antibiotics (Minocycline, Lymecycline, Doxycyline) and Vitamin A derived medication called Isotretinoin (Roaccutane, Oratane, Acnetane). Patients have to take these medications for weeks to months to control the Rosacea.

Phase 4: Permanent swelling of the nose and occasionally other areas

Rosacea can cause permanent enlargement of the oil glands. This enlargment of the oil glands leads to swelling. Swelling of the nose is called Rhinophyma. Rhinophyma can be treated with Vitamin A derived medication called Isotretinoin, surgically, with laser or with a process called Dermabrasion.

In addition to the skin symptoms, Rosacea can also cause red itchy eyes.

 

7 thoughts on “The treatment of Rosacea

  1. Hi there doctor louw . I was previously a patient of yours . I used isotretinoin for 5 months . after i went overseas and lay in the sun , without protecting face . Now i flush all the time on cheeks and nose with alot of redness and telangiectasia . I also have flaky/dry looking skin particularly in the Morning . Had alot of blood tests to rule out sinister causes all normal beside elevated IGE – Allergies. What would you suggest as treatment for the redness/flushing and dry/flaky skin – Thanks

    1. Hi Je. It will depend on the cause of the flushing…… So, first we need to make a diagnosis. Come and show me when you can.

  2. Hello,
    Please can you assist me. I have rosacea and have been treating it with the rozex gel. I have seen some improvement (more so on the one side of my face) but I dont think the improvement is good enough!
    I have been using the gel for almost a year and have not been back to the skin specialist since my first visit. (I live in the country). I am scared to go onto tablets as I also suffer from thrush if take any antibiotics but as beginning to think it is my only option. I dont eat spicy food and the redness doesnt seem to be related to alcohol as I get it anyway.
    What would you suggest? Should I go back to the specialist or just my own doctor? I am getting desperate but I dont want to waste money!
    thank you

    1. Dear Joy. If the diagnosis of Rosacea is correct and after a year of Rozex there are still very little improvement, I think you should considering oral medication in addition to the Rozex. There are non-antibiotic options, like low dose Oratane/Roaccutane. There are also different aspects to Rosacea. If it is mostly redness that bother you, then laser therapy will be your only viable option. If it is mostly the acne-type element of Rosacea that bothers you, then medication is the route to take.

  3. Hello,
    Please can you assist me. I have rosacea and have been treating it with the rozex gel. I have seen some improvement (more so on the one side of my face) but I dont think the improvement is good enough!
    I have been using the gel for almost a year and have not been back to the skin specialist since my first visit. (I live in the country). I am scared to go onto tablets as I also suffer from thrush if take any antibiotics but as beginning to think it is my only option. I dont eat spicy food and the redness doesnt seem to be related to alcohol as I get it anyway.
    What would you suggest? Should I go back to the specialist or just my own doctor? I am getting desperate but I dont want to waste money!
    thank you

    1. Dear Joy. If the diagnosis of Rosacea is correct and after a year of Rozex there are still very little improvement, I think you should considering oral medication in addition to the Rozex. There are non-antibiotic options, like low dose Oratane/Roaccutane. There are also different aspects to Rosacea. If it is mostly redness that bother you, then laser therapy will be your only viable option. If it is mostly the acne-type element of Rosacea that bothers you, then medication is the route to take.

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