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If you have rosacea, there are many ways to keep the condition under control. Though rosacea can't be cured, treatment can help you control symptoms and prevent them from getting worse. Some things you can do on your own, like avoiding triggers. Other approaches include creams, medication, or surgery.

Avoiding Your Rosacea Triggers

To keep rosacea under control, you need to do your part. Learn what your own personal triggers are. Use a symptom diary to keep track.

When you find a pattern to your rosacea flare-ups, make adjustments to your habits and lifestyle to prevent problems.

Rosacea Medications and Topical Treatments

Your treatment will vary depending on the type of rosacea you have. Most of the ointments and oral medications below are most effective in people with papulopustular rosacea (where symptoms may include small pimples, facial flushing, and tiny red lines on the cheeks).

These treatments may still be used in people with other types of rosacea as well, but often with less success. And even if the approach works and your symptoms go away, you might stay on the treatment to stop further flare-ups. Your doctor may combine a few approaches, using multiple drugs or creams.

Antibiotics are a common rosacea treatment, but that's not necessarily because bacteria causes rosacea. Instead, antibiotics may resolve rosacea symptoms by reducing swelling.

Rosacea Treatment Options

• Creams and Ointments

  Your doctor might start treatment with a prescription cream or ointment you apply to your face once or twice a day.

  Topical metronidazole (MetroCream or MetroGel) is an antibiotic cream and a very common rosacea treatment. Other antibiotic creams include clindamycin (Cleocin and Clinda-Derm) and erythromycin (Emgel and Erygel).

  Your doctor may also recommend antibacterial skin treatments like azelaic acid (Azelex, Finacea) and sodium sulfacetamide and sulfur (Clenia, Plexion).

  Tretinoin (Avita, Retin-A), a retinoid, is used in some hard to treat cases.

  These topical treatments have side effects, like skin irritation. A few are not safe for women who are pregnant or planning to become pregnant. Talk to your doctor about the risks.

• Oral Antibiotics

  If your rosacea is more severe -- or doesn't respond to ointments -- your doctor might suggest antibiotic pills, though you might keep using skin treatments as well.

  Some oral antibiotics your doctor might try are minocycline (Dynacin), erythromycin (ERYC), metronidazole (Flagyl), and doxycycline (Vibramycin.)

  Like any medicine, oral antibiotics can cause side effects. Treatment is typically long-term, often lasting at least six months.

• Other Drugs

  If these rosacea treatments don't work, your doctor may try other medicines, such as isotretinoin (Accutane.) However, because of its serious side effects -- like a risk of birth defects -- its use is not routine.

Other Rosacea Treatments

The dry eyes of ocular rosacea can be treated with liquid tears and daily cleaning of the eyelids with warm water. You may need a referral to an ophthalmologist to prevent problems.

Laser treatments can help get rid of visible blood vessels caused by rosacea.

Surgery or laser therapy may help people with rhinophyma, a rare form of rosacea that causes swelling and deformation of the nose.

The Psychological Effects of Rosacea

Rosacea can be much more than a skin disease. People who have rosacea may become embarrassed about their appearance. Some avoid social situations altogether. And because of its symptoms like a red nose and cheeks -- people with rosacea are sometimes unjustly assumed to be heavy drinkers.

If your symptoms are having a big impact on your mood and self-esteem, do something about it. Of course, treatment for your rosacea symptoms is key. You could also ask your doctor about using cosmetics to camouflage affected patches of skin. If you're anxious or depressed, you might also benefit from counseling or medications. Never ignore signs of anxiety or depression. Get help.

Medically updated by Brunilda Nazario, MD, May 2008.

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