Rosacea Treatment

• You have not been diagnosed with Rosacea by a doctor in the past
• You are pregnant, planning to become pregnant or breastfeeding
• You require a prescription for a medication that is not listed in our medical application questionnaire. We are not able to provide a prescription for oral retinoids.
• You have other skin conditions that affect your face e.g. acne, lupus
• You have severe rosacea symptoms
• You have Rhinophyma associated with Rosacea (This is excessive thickening of the skin around the nose)
• You have rosacea symptoms that are affecting your eyes or eyelids, now or in the past

Please note: Inflammation/ infection in the front of your eye is a potentially serious, sight-threatening problem. Thankfully, this is uncommon, but you should speak with a doctor URGENTLY if you have rosacea and develop pain in your eye or visual disturbance.

If this service is not suitable for you and you have a flare of your rosacea symptoms you should arrange a face-to-face review with your local doctor or a video consultation with one of our online doctors.

Type and severity of symptoms can vary significantly.

There are different types of Rosacea. This is important to consider as they respond to different treatments.

• Vascular Rosacea: facial flushing, skin redness and prominent blood vessels (telangestica).
  This type of Rosacea does not respond to antibiotic treatment (creams or tablets).
• Inflammatory Rosacea:  This type of Rosacea often responds to antibiotic treatments.
• Ocular Rosacea (affects the eyes)
  There are associated eye symptoms in approximately 50% of patients:
  • Dry eyes
  • Itchy/ burning eyes
  • Gritty sensation
  • Sensitive to light
  • Styes and blepharitis (inflammation of the eyelids)
  • Inflammation or infection of the cornea (clear outer layer) is a rare but potentially sight threatening condition. You should see a doctor URGENTLY if you have Rosacea and you develop eye pain or visual disturbance.
• Rhinophyma: thickening of the skin on the nose; this most commonly affects men.

• The exact cause is not known and a number of factors are believed to play a role: overactive immune system, genetics and environmental factors, or a combination of these.
• Demodex folliculorum may also play a role. This is a tiny mite that normally lives on our skin and does not cause any harm. Higher numbers of this have been found on the skin of those with Rosacea.
• It is not currently believed that Rosacea is caused by bacteria.
• Rosacea triggers cause the blood vessels in the affected skin to enlarge and a flare of symptoms. There are many different triggers and these vary between people. If identified these should be avoided to reduce symptom flares.
• It is not caused  by poor hygiene and it is not contagious.

• If you know what can trigger your symptoms, avoid these things where possible!

Examples of triggers: alcohol, spicy foods, caffeine, cheese

• Wear SPF of at least factor 30 every day (even cloudy days) and avoid exposure to direct sunlight.
• Use a hypoallergenic, non-perfumed and non-greasy moisturising cream if you have dry skin
• Avoid extremes of heat (turn the temperature down in the shower!)
• Camouflage creams and make-up can help to cover and conceal erythema and telangiectasia. Your local make-up counter or pharmacist can advise you on this.

Although Rosacea is a long term skin condition there are effective treatments that can help to control your symptoms when they flare. We can arrange prescriptions for a variety of treatments depending on your symptoms. 

The topical treatments (creams/ gels) can be used alone or in combination with oral antibiotic treatments. 

All of the treatments for Rosacea will take at least 4 weeks, and up to 12 weeks before improvements are seen. If there is no improvement after this time, or your symptoms deteriorate during this time then you should arrange a face-2-face review with a doctor. 

Topical Treatments

These creams and gels will have one of the following:

• Antibiotic medication 
• Anti-mite medication (Demodex folliculorum )
• Anti-inflammatory properties

Oral antibiotics: Tetracyclines 

These oral antibiotics are used in the treatment of Rosacea for their anti-inflammatory effects rather than their anti-bacterial properties, as it is not currently believed that bacteria contribute to this skin condition. They are useful in inflammatory rosacea (spots/ lumps present).

They are not helpful in vascular Rosacea (flushing, redness and telangiectasia).

If clinically appropriate, a prescription for 12 weeks of antibiotic treatment (tablets) may be issued, but current guidance is that this is of limited value in non-inflammatory Rosacea. This should be used along with a non-antibiotic cream/ gel for best results.

The most common side effect of the topical treatments is skin irritation (dry skin, redness, peeling and burning sensation).

It is important to know that these treatments can make your symptoms worse before they improve.

Using these products more frequently than advised will not have any beneficial effect on symptom control, and will significantly increase the risk of problematic skin irritation.

Some patients may develop side effects when using oral antibiotics such as nausea, vomiting, diarrhoea and abdominal pain (‘heartburn’). If you develop a persistent headache with blurred vision/ loss of vision, stop this medication and seek urgent medical advice.

Both the topical AND the oral treatments prescribed will make your skin more photosensitive and therefore more likely to burn. Exposure to sunlight/ sun lamps should be avoided. This can also be a trigger for a flare of rosacea symptoms.

For full details on potential side effects of your medication, please ensure that you read the patient information leaflet that comes with your medication before you start to use it for full details on potential side effects.

If you are concerned that you are developing any side effects, we advise that you stop your medication and seek medical advice.

For further information about Rosacea, including useful skincare tips refer to PCDS.

When completing the questionnaire, please ensure you let us know exactly what medications you are taking and if you have any other medical problems. This will enable us to advise you on appropriate treatments and prescribe them safely for you.

This service is intended for people who have typical flares of their symptoms. We strongly advise that if you notice any changes in your typical symptoms or develop new symptoms that you arrange a face-to-face consultation.