Copy of Review of the top currently available rosacea treatments – cost vs. effectiveness


Written by Dr. James Macdonald MD, HBSc

March 3, 2024  -  Rosacea is a common, chronic problem, affecting more than 415 million people worldwide. Despite advancements in modern medicine there is currently no cure for rosacea, only treatments.  

References for the information we have provided are available at the bottom of this article and will be updated as new studies are published.

Current treatments on the market are broken down in to two categories based on the individual symptoms:


Treatments for redness and visible blood vessels:


Topical Vasoconstrictors

Trade Names: Brimonidine (Mirvaso), Oxymetazoline (Rhofade)

How they work:

Temporarily reduces facial redness by constricting blood vessels.


Reduces facial redness in 26 out of 100 subjects.

Potential Downsides:

Overuse can worsen flushing, skin irritation, and allergic reactions.

Cost: Mirvaso: $618/30g, Rhofade: $661/30g


Surgical Laser Therapy

Trade Names: Intense Pulsed Light (IPL) therapy

How it works:

Destroys superficial red blood vessels through targeting application of heat.


Considered the primary treatment for visible blood vessels and thickened skin. (rhinophyma)

Potential Downsides:

Temporary pain, redness, blisters, scabs, swelling. Small scars may remain. Cost and accessibility of properly trained physicians.

Cost: $400 to $1200 per session



Trade Names: Off-label prescription

How it works:

Reduces blood flow to the face.


Promising results but not commonly used due to side-effects.

Potential Downsides:

Not approved for rosacea in many places, not suitable for asthma patients, side effects like tiredness and dizziness.

Cost: $14 / 50 tablets @ 10 mg


For Red and Yellow Spots - (Papules and Pustules):


Azelaic Acid (Topical)

 Trade Names: Skinoren, Finacea 


Reduces inflammation


Relieves symptoms in 18 out of 100 users.

Potential Downsides:

Can cause burning, itching, dry skin, rash, may worsen symptoms

Cost: $369 / 50g


Antibiotics (Topical)

Trade Names: MetroCream, MetroGel, MetroLotion, Noritate, Rosadan

How it works:

Topical Antibiotic activity, reduces inflammation.


Comparable to azelaic acid, with some contradictory results.

Potential Downsides:

Skin irritation, contact dermatitis, allergic reactions, increased sun sensitivity.

Cost: $405 / 60g (generic: $145 / 55g)


Antibiotics (Oral)

 Trade Names: Oracea 

How it works:

Topical Antibiotic activity, reduces inflammation.


Systemic Antibiotic activity, reduces inflammation.

Potential Downsides:

Skin irritation, contact dermatitis, allergic reactions, increased sun sensitivity.

Cost: $972 / 30 capsules (generic: $645 / 30 capsules)


Note: Costs listed are in USD and can vary based on insurance coverage and pharmacy location. Always consult with a healthcare provider for personalized advice and to understand the potential risks and benefits of each treatment option.


Leading Rosacea specialist, Dermatologist Dr. Jason Rivers, spent 30 years in clinical practice before devoting 8 years to develop a routine of skincare products for his most deserving patients, those with sensitive, rosacea-prone skin. His approach was to:

  • Eliminate all irritants fragrance, colorants and unnecessary harmful chemicals like parabens, and formaldehyde-releasing agents
  • Ensure all products exist at a pH of 5.5 – eliminating further damage to skin barrier
  • Create moisturizing complexes at every stage of the routine to allow for skin barrier repair, reduce moisture loss, enhance proper moisture movement in the skin and finally allow the skin to restart stimulating the production of its natural moisturizers.
  • Incorporate active ingredients to target the root cause of the symptoms. He has incorporated a proprietary combination of actives with anti-inflammatory, antioxidant, and natural anti-biotic properties. Riversol was the first company to stabilize Beta-thuljaplicin into a skincare formula that met all the other requirements needed for rosacea-prone skin.  
  • Let everyone try the product for free, for enough time to make sure it works for you. A 15-day free sample of Dr. Rivers’ skincare line for rosacea is available here.