Treatments for rosacea include general, topical, systemic and vascular laser. Although there are many ways to treat rosacea, none are curative, and control is the main objective.
General measures focus on staying out of the sun, keeping the skin cool and avoiding known triggers, but you may wish to investigate the cause of your rosacea, for example some rosacea has been associated with small intestinal bacterial overgrowth (SIBO), small mites, and Helicobacter pylori infections.
Topical treatments include:
- antibiotics such as Clindamycin, Erythromycin and Metronidazole
- vasoconstrictor gels which result in temporary improvement in the redness and flushing, though rebound flushing may occur when the preparation wears off
- glycolic acid preparations include glycolic peels
However, the Rosacea will often recur once topical treatments are ceased.
Systemic treatments are taken orally and include antibiotics such as Tetracyclines, Macrolides (Erythromycin, Roxithromycin, Azithromycin, Clarithromycin) or Metronidazole for several months depending on the activity of the rosacea.
Their main effect is to reduce the inflammation and often repeat courses are needed. Isotretinoin (often used in acne) in low dose may be useful if antibiotics have failed but may have significant side effects and will be needed for some time.
Vascular lasers may be very effective in reducing visible blood vessels and generalised redness without the side effects associated with systemic treatment nor the prolonged treatment time associated with creams or gels. Furthermore, recent studies have shown that the damaged blood vessels release chemical mediators which play a large part in rosacea appearing and progressing over many years. Thus treating the vessels treats rosacea at its source and plays a significant part in diminishing the tendency for Rosacea to recur.
Between one and six treatments may be needed depending on the severity of the redness and the laser used.
At ENRICH, we use the Cutera laser with its Excel V and Genesis components. This is one of the best vascular lasers worldwide for treatment of facial redness. It targets visible blood vessels, deeper vessels as well as addressing background redness which, with other lasers, can be difficult to treat.
Repeat treatments may be required every few years and will depend on genetic predisposition, the activity of the rosacea and other factors such as ongoing exposure to triggers like the sun.