How Rosacea Is Treated

Rosacea is not curable, but it can be managed and treated with lifestyle modification, skin care, oral and topical prescription medications, and procedures such as laser therapy.

Your condition may improve with some of the available interventions and not with others. In time, you and your healthcare providers will be able to track your response to treatment and create a treatment plan that works best for you. 

Home Remedies and Lifestyle 

Managing your rosacea means taking care of your skin every single day. You will need to develop routines and habits to avoid exacerbating your condition.

This begins with learning what your triggers are and making sure to avoid them completely. You can start by observing your skin for about a week after exposure to know if any triggers worsen your rosacea. 

Environmental factors to avoid when you have rosacea include:

• Cigarette smoke
• Alcohol
• Spicy food
• Strong sunlight
• Excessively cold or hot temperatures
• Anxiety and emotional stress
• Coffee

You can also develop increasing skin redness or inflammation due to other factors that might not be commonly recognized as rosacea triggers. These can include specific foods, drinks, medications, lotions, soaps, cosmetics, detergents, or fabrics.

Be attentive to the pattern of your symptoms because you may discover a trend in your skin condition that's related to dietary habits or something in your environment.

Ocular Rosacea

If you have ocular rosacea—with swelling, redness, or cysts on your eyes or eyelids— it’s important to be extra careful about making sure your contact lenses are clean and well cared for. And don’t share makeup with anyone—especially eye makeup like eyeliner or mascara. 

Skin Care

Be sure to cleanse your face if you get hot or sweaty and take off your makeup before going to bed. Dry your face thoroughly and gently after washing.

If possible, avoid masks or other items, like scarves or turtlenecks, that irritate your skin.

Over-the-Counter Therapies

When you have rosacea, it’s important that you protect your skin. This often entails using over-the-counter (OTC) cleansers, moisturizers, sunscreen, and creams and lotions to soothe your skin. 

In general, the sunscreens and skin care products that you use should not contain perfumes or other additives that could cause skin inflammation. It’s not always easy to know whether a product will irritate your skin before you use it.

Products and moisturizers that are marketed to sooth the skin may be helpful. According to a report published by The National Rosacea Society Expert Committee, skin care products containing chamomile, licorice root extracts, willowbark, and aloe vera may reduce skin symptoms for some people with rosacea.

Prescriptions

A number of prescription medications can help control your rosacea. Depending on the severity and persistence of your symptoms, your healthcare provider may recommend that you use some medication every day and others only as needed when your symptoms flare-up. 

Topical prescriptions are applied on the skin or the eyes as directed, and oral medications are taken by mouth. Oral and topical prescription options include anti-inflammatory treatments and antibiotics (medications that destroy or inhibit bacteria). Some of these medications come in both an oral and a topical form—you and your doctor can discuss which of these choices is best for you.

Topical therapies commonly used in the treatment of rosacea include:

• Metronidazole 
• Clindamycin
• Brimonidine
• Minocycline
• Oxymetazoline
• Ivermectin
• Azelaic acid
• Sulfacetamide sodium

In April 2022, the Food and Drug Administration (FDA) approved Epsolay (benzoyl peroxide) 5% cream for the treatment of adults with inflammatory lesions, including papules and pustules caused by rosacea. Epsolay is slowly released, requiring a once-daily application.  

Oral medications commonly used in the treatment of rosacea include those for treating symptoms of papules, erythema, or flushing.

For treating papules or erythema:

• Doxycycline
• Azithromycin
• Minocycline
• Isotretinoin
• Trimethoprim/sulfamethoxazole
• Tetracycline
• Clindamycin

For the treatment of flushing:

• Carvedilol
• Clonidine
• Propranolol 

Ocular rosacea can be treated with many of the same oral prescriptions used to manage papules and erythema. Topical treatments used in the management of ocular rosacea include azithromycin and cyclosporine.

Surgeries and Specialist-Driven Procedures

Several interventional procedures can help alleviate some of the effects of rosacea. These treatments need to be administered by a healthcare provider who is experienced in laser therapy. You may need more than one session before you begin to notice an improvement of your symptoms. 

• Laser therapy: This process utilizes intense pulsed light (IPL) and it can be used for managing erythema (skin redness) as well as ocular rosacea. 
• Ablative lasers: This option is also described as surgical shaving and it is used to remove thickened tissue, especially if you have rhinophyma (thickened skin on the nose). 

Before having an interventional procedure using laser therapy, you may need to discontinue taking some of your medications for a few days ahead of your procedure.

Keep in mind that not everyone who has rosacea is a candidate for these interventions. But you can talk to your healthcare provider about these options or ask for a referral, especially if topical or oral medication isn’t controlling your symptoms or if you haven’t been able to tolerate the side effects. 

Complementary and Alternative Medicine (CAM)

While there are some natural plant-based ingredients in oral and topical OTC products, there is no evidence that these products are effective for treating this condition. The National Rosacea Society Expert Committee does not endorse CAM treatments for rosacea.

Emotional stress is recognized as a cause of rosacea flare-ups, but stress management techniques like mediation and mindfulness have not been widely evaluated as strategies for controlling the skin condition.

Acupuncture, an interventional alternative therapy, has shown some promise in the treatment of rosacea, although the effects have not been studied in large numbers of people with rosacea.

A Word From Verywell

Rosacea is not curable, but it can be managed with a combination of lifestyle modifications, medication, and possibly interventional procedures as well. If you have rosacea, you need to incorporate a well-planned skin care routine into your daily life so that you can minimize the effects of the condition.

Over the years, your response to treatment may change and you can develop new triggers. Because rosacea is a chronic disease, you need to manage it over the long term—and your management strategy may need to be adjusted at times.