What are some of the main medical treatments for rosacea?

Rosacea is a chronic condition, meaning that treatments are not curative but rather help to manage symptoms. Treatment should be managed by a health care practitioner, and tailored to the individual’s current symptoms. Given that symptoms of rosacea can vary between people and even within the same person over time, practitioners will generally focus on addressing the symptoms most bothersome to the individual at that time. Management options include both oral and topical (applied to the skin) medications and laser and light-based therapies.^[1][2]

For managing erythema (facial redness), health care practitioners may prescribe topical medications that constrict superficial blood vessels, such as brimonidine and oxymetazoline. These medications work quickly, often within 30 minutes, with effects lasting for up to 12 hours.^[2][3]

For reducing papules and pustules, health care practitioners may turn to medications with anti-inflammatory and anti-microbial properties. Topical medications like ivermectin, azelaic acid, metronidazole, and minocycline are often tried first. If topical medications fail to control symptoms, health care practitioners may prescribe oral medications such as tetracycline antibiotics or isotretinoin. All of these medications work slowly over time when used consistently.^[2][3]

For eye irritation, health care practitioners may prescribe eye ointments containing cyclosporine or antibiotics, lubricating eye drops, as well as some of the oral therapies previously mentioned.^[2]

Finally, health care practitioners may recommend lasers and intense pulsed light therapy to help reduce visible blood vessels, redness, and skin thickening (phyma), although skin thickening may sometimes require surgical correction.^[1]