Rosacea treatment

You can treat rosacea with a range of prescription medications, over-the-counter creams, and lifestyle changes. Most commonly, gels or creams are applied directly to the affected area during a flare-up (when your symptoms worsen) or as a daily long-term treatment, which can help manage and reduce your symptoms. In more severe cases, tablets like antibiotics are used. You can also get light or laser therapy to help treat rosacea.

Prescription rosacea cream is applied directly to the affected areas of your face, either as a short-term treatment during a flare-up or as a long-term treatment. There are a few different types, depending on your symptoms. Common rosacea creams include:

Soolantra 1% cream

A prescription cream that is used for acne rosacea. This is where you get spots or pimples on the face during flare-ups. It contains the active ingredient ivermectin, which reduces inflammation (swelling) and kills skin mites that can make rosacea worse. It’s usually used for at least 3 to 4 months.

Soolantra has been found to improve acne rosacea in over 60% of patients when used daily for 12 weeks or more. It can help to reduce symptoms in around 2 weeks of daily treatment.

Skinoren cream

Skinoren cream is an acne treatment that can be used off-label for treating papulopustular or inflammatory rosacea which causes acne, spots and swelling. It contains the active ingredient azelaic acid and works by reducing the growth of your outer skin cells (keratin cells), which can become blocked and cause the formation of spots. It also works to destroy the bacteria that cause acne.

Skinoren cream is usually prescribed to people with mild to moderate rosacea, and the best results are seen when it’s used long-term. Most people notice an improvement in their skin within 4 weeks. In studies, topical azelaic acid was found to be more effective in reducing redness and inflammation than placebo treatment.

Over-the-counter creams

You can also find over-the-counter creams (moisturisers) designed for rosacea, such as Dermalex. This can ease some symptoms and soften skin. It can be applied morning and evening, instead of your normal moisturiser and can be used alongside makeup. It’s important to use over-the-counter creams every day to help manage your skin.

If you are also using a medicated cream, check with your doctor and in the patient information leaflet, as you may not be able to use both at the same time, or you may need to wait before applying another cream.

Rosacea gel is one of the most common forms of rosacea treatment, and you choose from 3 different prescription rosacea gels with Asda Online Doctor.

Mirvaso gel

Mirvaso gel is a prescription gel applied to the face and can work in as little as 30 minutes. You only need to use a small pea-sized amount for each of the affected areas, such as the nose, cheek, or forehead. It contains the active ingredient brimonidine, which makes the blood vessels in the face smaller, reducing redness.

Mirvaso gel lasts for around 12 hours, meaning it must be applied daily. It is best used in the morning, before applying other products like makeup. In studies on brimonidine 0.5% gel, by hour 3 of the first day, 25.4% of people saw a significant improvement in redness. However, by hour 3 on day 29, this had increased to 71.1%. This shows that Mirvaso gel works best when used consistently for around 1 month.

Finacea gel

Finacea gel contains azelaic acid, which is antibacterial and anti-inflammatory. This makes it effective in treating rosacea if you have inflamed spots called papules and pustules on your face. It works by unclogging your pores and reducing swelling, which can improve papulopustular rosacea. It’s also used in the treatment of acne.

Finacea gel is applied to the affected areas twice a day, morning and evening. You do not need to use much, and around 2.5cm of gel should cover the entire face, so use less if your whole face is not affected. Most people notice an improvement after 4 weeks, and it can be used for several months if it’s working well for you. Studies show it can significantly reduce spots and bumps in 72.7% of people, and also reduces redness in 56%.

Metronidazole gel

Metronidazole gel is a generic medication that contains the antibiotic metronidazole. It can be used for infections and can also help treat mild to moderate papulopustular rosacea during a flare-up. It works by reducing inflammation and infection in the skin that can cause swollen, sore spots and redness. It’s usually used by applying a thin layer to the affected areas twice a day, and takes around 4 weeks to see improvements.

Treatment typically lasts around 2 months, but may be longer in more severe cases. There are few long-term studies into metronidazole gel for rosacea, although it’s an effective and commonly used treatment. In 1 small study where patients used metronidazole gel alongside an antibiotic tablet called tetracycline: 92% had fewer spots and bumps and 73% had less redness. In 59% of people, this combined treatment cleared all spots.

Rosacea tablets are mostly antibiotics and are used for moderate to severe papulopustular rosacea. Specialist treatments such as isotretinoin can be prescribed by a dermatologist for severe rosacea.

Antibiotics

The antibiotic group most commonly used for rosacea treatment are tetracyclines, such as tetracycline, minocycline, doxycycline, and lymecycline. Erythromycin is a second option if tetracyclines are not suitable. Antibiotics work for papulopustular rosacea by reducing swelling and stopping the growth of spot-causing bacteria.

You’ll usually use an antibiotic every day usually for 6 to 12 weeks during a flare-up, and the dosage and frequency will depend on your symptoms and the antibiotic. You may be prescribed an antibiotic tablet with a cream or gel to apply. Sometimes antibiotics can be prescribed long-term in a lower dose for an anti-inflammatory effect. In 1 study comparing doxycycline and minocycline, each treatment had reduced the number of spots and bumps by 13 (doxycycline) and 14 (minocycline) at week 16.

Isotretinoin

Isotretinoin is a generic medication containing isotretinoin, a prescription retinoid which is very strong and only used for severe papulopustular rosacea. It can only be prescribed by a specialist when other treatments have not been effective because it can have severe side effects, and you need to have regular check-ups and blood tests while taking it.

Isotretinoin works by reducing and targeting the glands in your skin that produce oil, making them smaller so that less oil is produced. This reduces the chances of your pores becoming clogged and of spots and bumps forming. It can take anywhere from a few weeks to a few months to notice its full effects, depending on the severity of your symptoms.

Your dosage is worked out by your body weight, and the usual starting dose is 0.5mg per kilogram (kg) of body weight per day. You’ll be prescribed tablets once or twice a day. Treatment with isotretinoin can last anywhere from 4 to 6 months. In studies, isotretinoin improved rosacea symptoms (redness and spots) by more than 90% in 62.5% of people, while 29.2% saw improvements of 50 to 90%.

Rosacea laser therapy is designed for people with rosacea redness who develop thread veins (also known as spider veins). It does not work on papulopustular rosacea as it cannot help with spots. Thread veins are very small blood vessels close to the surface of the skin that can be red, purple, or blue. They can appear after blood vessels become enlarged, such as due to rosacea.

A vascular laser can reduce redness and the appearance of thread veins by shining a small, targeted beam of light to the affected blood vessels. This causes them to seal up and fade away. Rosacea laser therapy is usually only offered privately so you have to pay for treatment, but in severe cases you can apply for NHS funding. You will need a few courses of treatment, usually between 2 and 4, to see the best results.

Studies show that pulsed tunable dye laser (PDL) therapy, a common type of laser therapy for rosacea, reduced:

• visible thread veins by 75%
• flushing by 55%
• redness by 50%

You can get rosacea treatment like gels, creams, and tablets from online doctors like Asda Online Doctor and on the NHS. You can also get specialist treatments from a dermatologist. Rosacea treatment, like laser therapy, can be accessed through private or NHS clinics, but you usually need to pay for treatment.

Can you buy rosacea treatment online?

Yes, rosacea gels, creams, and sometimes antibiotic tablets can be purchased online. At Asda Online Doctor, you can get prescription rosacea gel, with treatment options that suit people with redness and flushing, or for those who have mild spots or bumps. The process does not take long, and we ask for a few photos of the area so that our doctors can make sure you get the best treatment for your symptoms.

To get rosacea treatment online with us:

1. Complete a short, medical questionnaire that asks about your symptoms. You’ll need to attach some photos of the area to help our doctors prescribe the right treatment.
2. Select the treatment you want to try, or the medication you are currently using if it’s working for you. Complete a secure payment through your online account.
3. One of our doctors will review your questionnaire, and if suitable, prescribe your chosen treatment. They may also offer an alternative if needed.
4. Your treatment will be sent to your address, or you can choose to Click & Collect from your most convenient Asda pharmacy.

Is rosacea treatment available over the counter?

Yes, rosacea moisturisers and creams that may slightly reduce redness can be bought over the counter. However, most people need prescription treatment during a flare-up or long-term. Over-the-counter rosacea treatment mainly helps to keep your skin moisturised and healthy and to help reduce symptoms.

Rosacea treatment can have different side effects depending on whether it’s applied to your face, like a cream or a gel, or if it’s a tablet.

Common side effects of rosacea gels and creams

Mostly, rosacea gels and creams cause side effects to the area that you apply it, such as:

• flushing
• a pale appearance (pallor)
• redness
• itching
• rosacea
• a burning sensation
• dry skin (metronidazole gel)

You can manage these side effects by only applying as much cream or gel as needed, only a small amount is required for each affected part of your face. Avoid applying too close to the lips, eyes, and nose. Applying too much can increase the chance of these side effects. For a full list of side effects, check the patient information leaflet that comes with your chosen treatment.

Common side effects get better within a few days to a few weeks, but if any of these side effects are severe after application, wash the cream or gel off and speak to your doctor straight away.

Common side effects of rosacea tablets

Most rosacea tablets are antibiotics, which cause similar side effects, but how often they happen depends on the type. Common rosacea antibiotic side effects include:

• diarrhoea
• feeling sick (nausea)
• being sick (vomiting)
• stomach discomfort
• photosensitivity, a sensitivity to sunlight and UV light
• skin reactions, such as a rash
• pancreatitis, caused by erythromycin

When you take low-dose rosacea antibiotics, these side effects may not be as common. Most antibiotics can cause stomach side effects, so to manage this, make sure you:

• eat a meal with or just before you take your antibiotics – your patient information leaflet may also tell you this
• drink plenty of water to stay hydrated
• eat small, frequent meals, avoiding greasy, fatty, processed, or spicy foods
• avoid alcohol, as this can make these side effects worse and for some antibiotics, can interact with the medication

Speak to a pharmacist or doctor if this is not getting better – they may suggest taking an acid reflux tablet with your antibiotics or lowering the dose. Antibiotics can also make your skin more sensitive to the sun than normal, so avoid sunbeds and too much sun exposure. Make sure to apply suncream if you are going to be outside.

For a full list of side effects, check the patient information leaflet that comes with your chosen treatment.

Common side effects of rosacea laser therapy

Rosacea laser therapy typically affects the area it's treating, with skin symptoms such as:

• tightness
• bruising
• changes in skin colour
• itching
• swelling
• peeling
• a mild rash
• a feeling or look of sunburn

These side effects are typically mild and get better within 2 weeks. To help manage side effects after the procedure, follow these tips:

• apply a wrapped ice pack or a cold compress for no more than 20 minutes at a time, if needed
• avoid exfoliating, scratching, or picking at the skin during the healing process
• avoid applying makeup straight after your treatment, the clinic will let you know how long for
• keep your skin clean and hydrated, using gentle cleansers and products for at least 1 week after
• keep out of the sun, and if you do go out, apply suncream
• use over-the-counter painkillers if the skin feels sore

For a full list of side effects, speak to the laser clinic. This may depend on the type of laser used.

Rosacea is a long-term condition that affects the skin, mainly on the face, but it can also affect other parts of the body. It is most common in women with lighter skin, though symptoms can be worse in men. The cause of rosacea is not known, but it may be triggered by things such as spicy foods and alcohol.

The main symptoms are redness on the face and a stinging sensation, especially when applying skincare products. However, there are different types of rosacea, such as papulopustular rosacea, which also causes spots and bumps, similar to acne

The most common symptom of rosacea is redness in the face, like blushing. This is usually across your cheeks, nose, chin, and forehead. Rosacea comes and goes, but as symptoms get worse, your face may be red all the time. You may also experience a stinging sensation when you wash your face or apply skincare products.

Other symptoms may include:

• yellowish patches on your skin
• dry skin
• swelling
• sore eyelids
• thickened skin after having rosacea for a long time, mainly on your nose
• red or sore eyes
• red bumps or acne (papulopustular rosacea)
• visible blood vessels, known as thread veins

You may need rosacea treatment if you have rosacea symptoms that are affecting your life and are not getting better. However, it’s important not to self-diagnose. Rosacea should be diagnosed by a doctor because the symptoms of rosacea can be similar to other conditions, and you will not be able to get prescribed treatment without a diagnosis.

If you think you have rosacea, place an order with us, and we’ll review your photos to confirm your diagnosis before prescribing. Alternatively, you can make an appointment with your GP. There is no specific test for rosacea, but your doctor may begin by ruling out other conditions. Make sure to keep a diary of your symptoms and any triggers, as this can help with a diagnosis. Your GP may do a physical examination and ask you to take photos of your skin over a period of time.

You cannot always prevent rosacea, as it may be genetic, but there are things you can do to reduce the risk of rosacea and flare-ups. If you get symptoms, speak to your doctor first, as they may want to prescribe treatment. Using a daily rosacea treatment like Mirvaso or Finacea gel can help manage your symptoms. In some cases, antibiotics are also needed.

Other things you can do to reduce rosacea symptoms and the risk of flare-ups include:

• avoiding any triggers that you know affect your skin, for example, alcohol, caffeine, hot drinks, spicy food, and cheese
• checking the patient information leaflet if you take any medication, as some medications can cause rosacea
• managing stress
• using a high SPF suncream or moisturiser every day
• covering your face in cold weather
• using skincare products for rosacea or sensitive skin
• limiting the amount of aerobic exercise you do, such as running

You can also cover rosacea with the help of skincare products, such as foundation or powder that contains a green tint. Green can help block redness caused by rosacea. Concealer can be used to cover blood vessels, spots, and pimples. Before using any product, check with your doctor, especially if you’re using a topical treatment. Try to find skincare products that are for sensitive skin or rosacea specifically.

The actual cause of rosacea is not known, but there may be certain lifestyle choices, medications, and health conditions that increase your chances of getting it. You are more likely to get rosacea if you are a woman with lighter skin, and age increases the chances of developing it.

One study found that genetics increases rosacea risk by around 50%, while other lifestyle factors like being overweight, smoking, and drinking alcohol contribute to the risk of rosacea.

What causes rosacea flare-ups?

A rosacea flare-up happens when your rosacea symptoms get worse. Some common triggers of a rosacea flare-up include:

• hot drinks
• alcohol
• spicy food
• cheese
• caffeine
• exercise

What is the difference between a rosacea gel and a cream?

The main difference between a rosacea gel and a cream is their consistency and how they feel on the skin. Gels are usually more lightweight, meaning they absorb easily, and you typically cannot feel them afterwards. This means gels can be more suited to people with oily, spotty skin. Creams are usually thicker and more hydrating, so better for people with dry skin.

Some medications come as both a gel and a cream, such as metronidazole.

Can I use rosacea treatment with other skincare products?

Yes. You usually can use rosacea treatment with other skincare products, but it’s important to check with your doctor and read the patient information leaflet. You may need to wait to apply them to allow the gel or cream to take effect.

Can I use rosacea creams under makeup?

Yes, rosacea creams can usually be used under makeup, but you may have to wait after applying it until you can apply makeup. Check your patient information leaflet, as it should tell you how long after you can apply other products.

Which moisturiser is best to use with a rosacea treatment?

The best moisturiser to use with a rosacea treatment is one made for sensitive skin or rosacea. For example, Dermalex is an example of a moisturiser developed for rosacea. Avoid using moisturisers that contain harsh chemicals or perfumes.

Should I apply rosacea gel before or after moisturiser?

You should always apply rosacea gel before applying other products like moisturiser. The gel is meant to be applied to clean, fresh skin, so applying it after moisturisers means it cannot work as effectively.

Does rosacea treatment cure the condition permanently?

No, rosacea treatment does not cure the condition permanently, but it can help reduce symptoms and flare-ups. If you take a long-term treatment, you may not have many symptoms, but they can come back when you stop treatment.