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How to Treat Rosacea

Rosacea | Schweiger Dermatology Group
April is Rosacea Awareness Month. Many people are not aware of how to treat rosacea and often confuse it with redness or acne breakouts. But there’s a real difference. “It is very important to determine if you have rosacea or acne, because the treatments can be very different,” says Dr. Jeremy Fenton from Schweiger Dermatology Group “Treatments that may be helpful for acne, which promote exfoliation and may dry the skin, can easily make rosacea much worse.”  Additionally, when left untreated, rosacea can potentially cause damage to the eyes(in a condition called ocular rosacea). For this reason, as well as the cosmetic annoyance of redness and bumps on the skin, rosacea should be diagnosed as early as possible. Here, Dr. Fenton answers some of the most common questions on how to treat rosacea.

What are the latest and most effective treatments for rosacea
There are some new topical medications that have come out in recent years including:

  • MirvasoOne of the most frustrating components of rosacea is the persistent redness and flushing that many patients deal with.  Most of the topical and oral medications target the papules and pustules, but are minimally effective for this redness.  Mirvaso is a new medication that was released in the last 2 years.  For some patients, Mirvaso can significantly decrease the redness for about 12 hours.  It constricts the blood vessels and produces a temporary effect that lasts most of the day.  Unfortunately, some people report increased “rebound” redness when it wears off.  Although this is still temporary, you should test it out for a week or two before any important events.
  • Soolantra: a once-a-day topical cream that targets the papules and pustules.  It reduces the amount of natural mites that live in the skin and can cause inflammation.  It is believed that people with rosacea have higher levels of these mites living on the skin. 
  • Finacea: This is the brand name of a medication with the active ingredient azelaic acid, is a topical medication that has been around for quite some time.  They recently released this medication in a new vehicle, a foam, that some believe may be more soothing and more effective.
  • KTP Laser Treatment: The most effective and long-term solution for the redness in rosacea are in-office laser treatments.  These lasers target the blood vessels at the surface of the skin which are responsible for the redness.  Originally, most of these lasers required significant downtime with bruising.  However, I now prefer to use the KTP laser which does not leave behind any bruising.  This procedure has little downtime, usually just some increased redness for about 24 hours.  After 3-4 treatments, patients usually see a significant reduction in the redness that can last for 3-4 years.
  • Antibiotics: Some of the most effective treatment options for the papules and pustule of rosacea continue to be antibiotics such as doxycycline and minocycline.  Much of the benefit of these drugs comes from the anti-inflammatory properties of the drug.  Fortunately, there is a low-dose form of doxycycline at 40mg, brand name Oracea, that has been shown to provide effective anti-inflammatory benefits without the antibacterial component.  This is a much safer option to be on long-term than the traditional doses we gave many years ago.

Should those with rosacea try and tackle it alone or always seek the help of a dermatologist?
It is a good idea to get the help of a dermatologist if you think you suffer from rosacea.  Many of the most effective treatment options are only available by prescription.  It is also important to determine if you have rosacea or acne, because the treatments can be very different.  Treatments that may be helpful for acne which promote exfoliation and may dry the skin, can easily make rosacea much worse.  Rosacea can also affect the eyes, called ocular rosacea.  This left untreated can potentially cause damage to the eyes and should be diagnosed as early as possible.

What are the best lifestyle choices for those with rosacea to help keep it under control?
The redness and flushing that comes with rosacea can be worsened by certain factors that patients can control.  Rosacea patients should get to know their triggers and avoid them.  Common triggers include spicy foods, alcohol, hot drinks, and large changes in temperature.  Patients should always use a sunscreen as well, because chronic sun exposure will increase that persistent redness and make prominent blood vessels more visible. Patients with rosacea should use gentle cleansers and avoid anything that may irritate the skin, which can bring out more inflammation.  For basic moisturizers and facial washes, I recommend products designed for sensitive skin such as Cetaphil or Cerave.  Clinique also has a daily moisturizer that is made for rosacea patients, Redness Solutions Daily Relief Cream. 

I would also recommend a quality zinc oxide-based daily sunscreen.  My favorite sunscreen is Elta MD UV Clear SPF 46.  This sunscreen works well for acne and rosacea patient, containing niacinamide to help calm inflammation.  Elta MD products are sold in select Schweiger Dermatology Group office locations. 

Dr. Jeremy Fenton Schweiger Dermatology GroupDr. Jeremy Fenton treats patients in the Midtown Manhattan location at Schweiger Dermatology Group. To book an appointment with Dr. Fenton, call (212) 283-3000.

 
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