From the Guidelines
Treatment for rosacea should prioritize topical metronidazole (0.75% or 1% gel or cream applied once or twice daily) as first-line therapy, given its efficacy in reducing inflammatory lesions and perilesional erythema, as demonstrated in studies such as 1.
Overview of Treatment Options
Treatment options for rosacea include both topical and oral medications, as well as lifestyle modifications. Topical treatments are typically first-line therapy and may include:
- Metronidazole (0.75% or 1% gel or cream applied once or twice daily) 1
- Azelaic acid (15-20% applied twice daily) 1
- Ivermectin (1% cream applied once daily) 1
- Brimonidine (0.33% gel for temporary reduction of redness) For moderate to severe rosacea, oral antibiotics may be prescribed, particularly:
- Doxycycline (40-100mg daily for 8-12 weeks) 1
- Minocycline (50-100mg daily)
Lifestyle Modifications
Lifestyle modifications are crucial and include:
- Avoiding triggers such as spicy foods, alcohol, extreme temperatures, sun exposure, and stress
- Daily use of gentle cleansers, fragrance-free moisturizers, and broad-spectrum sunscreen (SPF 30+) 1
Additional Therapies
Additional therapies that may be considered include laser and light therapies to reduce persistent redness and visible blood vessels. Treatment effectiveness varies by individual and rosacea subtype, so a personalized approach under dermatological guidance is recommended, often combining multiple therapies for optimal control 1.
From the FDA Drug Label
To use AZELEX® Cream for the full prescribed treatment period. If sensitivity or severe irritation develop with the use of AZELEX® Cream, treatment should be discontinued and appropriate therapy instituted.
The treatment options for rosacea include the use of azelaic acid cream, such as AZELEX® Cream, as prescribed by a physician.
- Patients should use the cream for the full prescribed treatment period.
- If sensitivity or severe irritation develop, treatment should be discontinued and appropriate therapy instituted 2.
From the Research
Treatment Options for Rosacea
The treatment options for rosacea include:
- Topical medications such as metronidazole, azelaic acid, and sodium sulfacetamide-sulfur 3, 4, 5, 6
- Oral antibiotics such as tetracyclines, metronidazole, and doxycycline 3, 7, 6
- Laser and light-based therapies, including intense pulsed light and pulsed dye laser 5
- Surgical procedures, such as those used to treat rhinophyma 5
Topical Treatments
Topical treatments are often used as a first-line treatment for rosacea, and include:
- Metronidazole, which has been shown to be effective in reducing inflammatory lesions and erythema 3, 7, 6
- Azelaic acid, which has been shown to be effective in reducing papules and pustules 4, 5, 6
- Sodium sulfacetamide-sulfur, which has been shown to be effective in reducing inflammatory lesions and erythema 4, 5
Oral Treatments
Oral treatments are often used in combination with topical treatments, and include:
- Doxycycline, which has been shown to be effective in reducing inflammatory lesions and erythema 3, 7, 6
- Tetracyclines, which have been shown to be effective in reducing papules and pustules 7, 6
- Isotretinoin, which may be used in resistant cases of rosacea 7, 6
Combination Therapy
Combination therapy, such as the use of topical metronidazole and oral doxycycline, may be effective in treating rosacea 3, 6