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Dx Rosacea Treatment:

Medications Used in Treatment:
1. Dicarboxylic Acid: Finacea®/azelaic acid
2. Sulfa Antibiotics: Sumandan®, Sumaxin®, Clenia®, Sumaxin®CP, Prascion®, Rosanil®, Rosaderm®, Topisulf®, Prascion®FC, Rosula®/ sulfacetamide-sulfur
3. Tetracycline Antibiotics: Oracea®/doxycycline
4. Alpha Agonists: Mirvaso®/brimonidine
5. Nitroimidazole Antibiotics: Metrogel® Metrocream® Metrolotion® Rosadan® Noritate®/metronidazole
6. Ivermectin 1%: Sklice®

*Suggested Links:
*N.H.S. Choices (with Video)

*Natural Treatments for Rosacea from the NY Times
*Natural Treatments for Rosacea from WikiHow

*[Editor]The most definitive study to-date was performed in 2011 stating "A range of treatment options are available in rosacea, which include several topical (mainly metronidazole, azelaic acid, other antibiotics, sulfur, retinoids) and oral drugs (mainly tetracyclines, metronidazole, macrolides). In some cases, the first choice is a systemic therapy because patients may have sensitive skin and topical medications can be irritant. Isotretinoin can be used in resistant cases of rosacea. Unfortunately, the majority of studies on rosacea treatments are at high or unclear risk of bias." A recent Cochrane review found that only topical metronidazole, azelaic acid, and oral doxycycline (40 mg) had some evidence to support their effectiveness in moderate to severe rosacea and concluded that further well-designed, adequately-powered randomized controlled trials are required. In our practice, we evaluate our patients for the presence of two possible triggers, Helicobacter pylori infection and small intestinal bacterial overgrowth. When they are present we use adapted antibiotic protocols. If not, we use oral metronidazole or oral tetracycline to treat papulopustolar rosacea. We also look for Demodex folliculorum infestation. When Demodex concentration is higher than 5/cm(2) we use topical crotamiton 10% or metronidazole."

*[Editor]Ten years ago, we were able to clear a stubborn case of Rosacea with an IPL with 10 applications. Treatments have changed. Consult a knowledgeable dermatologist.. Wat reported there was Level 2(some evidence) that IPL could be used for rosacea, capillary malformation, acdtine keratoses, and sebaceous gland hyperplasia.

*[Editor] Once daily 1% ivermectin cleared approximately 40% of patients with Rosacea at 12 weeks and greater than 70% at 40 weeks. A topical form of this antiparasitic medication is F.D.A. approved to treat head lice. [reference Contemporary OB/GYN March 2015]

Copyrighted 2014©; revised April 2, 2015