Rosacea Treatment: The Complete Guide


According to the National Rosacea Society, as many as 16 million people suffer from some form of rosacea in the United States alone. (NRS)  With so much of the population affected by the condition, it is no wonder that so many researchers, pharmaceutical companies, and doctors are looking for solutions that will not just control rosacea, but cure it completely.  If you have just been diagnosed with the skin condition, or you just want to learn more about rosacea treatment, then you have come to the right place. 

If you are suffering from Rosacea make sure to give Dr. Rivers' 15 day free sample kit a try.  Developed specifically for his patients to reduce redness, flushing and irritation, the free sample kit will last long enough to make sure Riversol works for you.  

For our quick overview on rosacea: click here


Rosacea, by definition, is a disorder that primarily affects the facial skin by way of phases of flare-ups and remissions. Typically, the first signs of rosacea will appear around age 30; they will first show up as redness on the cheeks, chin, nose, and forehead. These symptoms may come and go without worsening for some time. However, if the rosacea is left untreated, it will worsen over time, and eventually lead to:

  • Visible Blood Vessels
  • Bumps or Pimples Appearing in a Red Area
  • Swollen, Bumpy or Excessive Tissue
  • Watery or Bloodshot Eyes

Generally speaking, rosacea can affect anyone, no matter their race, gender, or nationality. However, people who have fair skin and tend to flush easily will be at greatest risk. Additionally, more women are diagnosed with rosacea than men. Find our article on rosacea in people of Asian, African, and Hispanic Heritage. to learn more about how rosacea can affect patients based on ethnic background.

Although there is no known cure for rosacea, most people notice the progression of symptoms can be halted and flare-ups managed through identification and avoidance of triggers combined with gentle rosacea skin care, and medical treatment(s). Awareness, and intervention can improve the quality of life significantly for rosacea patients. It is important to consult your doctor to discuss medical rosacea treatment options, to gain an understanding of your rosacea triggers, and to explore rosacea skin care routines that can help you to lead a full and normal life.

Rosacea Symptoms

Some people who begin to develop rosacea have no idea that they have the condition at all. However, by understanding the symptoms, it is easier to recognize the issue. There are different types of the condition - which we will discuss later - but the basic symptoms include:

  • Flushing – May appear as blushing or unspecified facial redness.
  • Persistent Redness – May look like a chronic sunburn.
  • Bumps and Pimples – May appear pus-filled and will appear along with redness as well as burning or stinging.
  • Visible Blood Vessels – May appear as broken capillaries just under the skin.
  • Eye Irritation – May happen if the rosacea is near the eye.
  • Burning or Stinging – May occur along with itching, tightness, and redness.
  • Dry Skin – Facial skin may be rough and dry to the touch.
  • Plaques – These are raised red patches of skin. Skin thickening from excess tissue may occur too.
  • Facial Swelling – Could appear with other signs or independently.

Rosacea commonly appears on the face, but signs of it can form on the chest, scalp, ears, and neck as well.

As mentioned, there are different types of rosacea. We will discuss the four subtypes individually and discuss the rosacea treatments available for each.

Rosacea Basics

To put it in the most basic terms, rosacea is an inflammation that comes back again and again. Essentially, someone who has this chronic disease will relapse from time to time while going through weeks, months or even years without a single symptom. There is no cure at this time, but this guide sets out to focus on the ways in which each form of rosacea can be treated. More importantly, we set out to provide those living with rosacea different pathways to minimizing the disruptive symptoms associated with this condition.

Types of Rosacea

The four subtypes of rosacea, which we will discuss in detail later, include the following:

Subtype 1: Facial redness (Erythematotelangiectatic Rosacea) – This type is characterized by flushing, redness, and the appearance of visible blood vessels.

Subtype 2: Bumps and Pimples (Papulopustular Rosacea) – This form is characterized by a constant or persistent redness and bumps or pimples forming.

Subtype 3: Enlargement of the Nose (Phymatous Rosacea) – This type is characterized by thickening of the skin and enlargement of the nose.

Subtype 4: Eye Irritation (Ocular Rosacea)  – This type is found around the eye, including dry eyes, excessive tearing, burning eyes, swollen eyelids, vision lost, recurrence of sties, and corneal damage. (NRS)

While these are considered different subtypes of the condition, it is very common for patients to have symptoms of more than one subtype at a time. In other words, you may be suffering from more than one type of rosacea at a time.

General Measures to Avoid Outbreaks

girl looking in mirror

The beginning of rosacea treatment simply starts with knowing how you can avoid outbreaks. While these measures will not take away your risk of outbreak completely, they can minimize it a great deal. So, knowing what causes rosacea to flare up and then avoiding those triggers can go a long way toward not letting the condition rule your life.

In a way, how much rosacea will be a problem for you can depend on what you do. By learning to avoid flare-ups and your own triggers, you will be able to minimize how often you have issues with the condition. That, of course, doesn’t mean you will always be able to avoid flare-ups. Sometimes, they happen for seemingly no reason at all. However, it does mean you can minimize them.


This is, by far, the most common symptom of rosacea. It appears in all subtypes and can be a frustrating problem for rosacea patients. Some experts even believe that the chronic flushing will eventually contribute to other rosacea symptoms. Flushing can be triggered by certain activities, including:

  • Exposure to Extreme Temperatures
  • Exposure to Sunlight
  • Drinking Alcohol
  • Eating Spicy Foods
  • Becoming Very Stressed
  • Exercising
  • Taking Certain Medications
  • Having Hot Flashes Associated with Menopause

Each patient can have different triggers and different levels of these triggers as well. For example, you may flush very badly when exposed to sunlight, but someone else with rosacea may not. It’s a good idea to start logging when you experience flushing, the severity of your symptoms, and what caused it. This will help you create a clearer picture of your own triggers.

Click here for more information on diet in rosacea.

There are certain medications that can help suppress or reduce flushing, including antidepressants, beta-blockers, gabapentin, clonidine, and topical oxymetazoline. However, no one medication therapy is 100% effective. Some experts recommend the use of laser pulsed light and photodynamic therapy, but there is not much data to support this as a method for relieving flushing.


If you are suffering from Rosacea make sure to give Dr. Rivers' 15 day free sample kit a try.  Developed specifically for his patients to reduce redness, flushing and irritation, the free sample kit will last long enough to make sure Riversol works for you.  

It is very important for patients with rosacea to take good care of their skin. A good skin care regimen will help avoid the dry, rough, and scaly symptoms of rosacea. Using gentle skincare measures and avoiding anything harsh that could further aggravate the skin are good fundamental guidelines to follow.

The following tips are critical to creating an effective rosacea skin care system: 

  • Regular Cleansing – It is vital to use only gentle measures to cleanse your skin. This includes using lukewarm water, only the fingertips, and non-soap cleansers such as beauty bars and mild liquid cleansers.
  • Avoiding Harsh Topical Products – A variety of different skin products are simply too harsh for patients with rosacea, including exfoliating agents, toners, and astringents. You should also avoid manual exfoliation with sponges or rough cloths.

Using the right type of skincare will ensure that you do not make the symptoms of your rosacea worse. If formulated correctly, some topical skincare products can even lessen the risk of symptoms and flare-ups.

Rosacea skin is sensitive skin and facial irritation can be caused or exacerbated by skin care products themselves. Thus, gentle hypoallergenic skin care that avoids irritation is an important factor in the management of rosacea. Furthermore, gentle skin care can help to build and maintain the barrier function of the skin, helping to prevent bacterial overgrowth and improving overall skin health.

The barrier function of the skin has two components: the strateum corneum and the acid mantle. The strateum corneum is the outermost layer of cells on the skin. These cells are dead, but form a cohesive barrier that is important in preventing infection and UV damage. The acid mantle is a very fine, slightly acidic (between pH 4.5 and 6.2) film on the surface of the skin secreted by the sebaceous glands, which acts as a barrier to bacteria, viruses, and other potential contaminants.

Gentle, hypoallergenic skin care for rosacea should include a mild cleanser, and gentle serum and a moisturizer. Avoid products containing allergens such as dyes, fragrances, and formaldehyde-releasing agents. Also, chemicals that strip the acid mantle or strateum corneum such as alcohol-based toners, mechanical/chemical exfoliants, and retinols should be avoided.  

Sun Protection

Because exposure to sunlight is a very common trigger for rosacea symptoms, using sun protection is a must. Not only does the warmth of the sunlight cause flushing flares, but the exposure to ultraviolet radiation can cause changes beneath the skin that worsen rosacea.

The best option for anyone with rosacea is to use a broad spectrum sunblock of at least SPF 30 or higher. Additionally, it is a good idea to use sun protective clothing and to avoid midday sun.

The best sunblock to use when you have rosacea will be one that creates a silicone barrier, not those that are alcohol based, because the alcohol can further irritate the skin.

Cosmetic Camouflage

When rosacea symptoms appear, one option is to cover the problem with cosmetics. Red patches and flushing can often be covered well enough that others will not notice.

For women, it is best to start with a green-tinted concealer and finish with a proper flesh-colored foundation.

For men, it is best to use a green-tinted facial powder to reduce the redness.

When choosing makeup, it is best to look for products that do not contain oil and specifically say on the label that they are noncomedogenic. Also, avoid products that contain alcohol, peppermint, menthol, clove oil, eucalyptus oil, salicylic acid, and hazel oil. All of these can irritate the skin and make symptoms much worse.

Now that we have covered the basics of rosacea, and how you can take steps to avoid flare-ups, we will go over each of the subtypes with information on treatment for each as well.

Everything You Need to Know About Subtype 1 Rosacea: Erythematotelangiectatic

Often referred to simply as ETR, this is the most common subtype to show symptoms of rosacea. This type will show:

  • Flushing and redness, especially at the center of the face
  • Broken blood vessels that are visible
  • Skin that becomes swollen
  • Skin that stings and burns
  • Skin that appears dry, rough, and scaly

Remember, you may not see all of the above-mentioned symptoms at once. Some people only develop one or two at a time. However, symptoms typically worsen over time. For example, if you are experiencing redness and flushing and your rosacea is left untreated, you will likely develop the remaining symptoms over time.

Subtype 1 Rosacea Treatment

The core purpose of treatment for this subtype of rosacea is to reduce skin sensitivity and flushing. Usually, people only show mild symptoms, which can be managed well with basic treatment. However, if basic treatment is not effective against more severe forms of this type, then pulsed light, lasers, and medications may be used.


Initially, if you have this subtype of rosacea, you will need to make some changes to your lifestyle and behaviors. That means avoiding triggers that cause flushing, always using good quality gentle skincare methods, and staying out of the direct sun or using sunblock.

If avoiding triggers does not have a noticeable impact on your symptoms, we recommend moving to  second line interventions. This will include light-based treatments and medications.

  • Laser and Intense Pulsed Light – This treatment can be used to treat vascular lesions associated with ETR. This treatment will allow the damaged vessels to be absorbed into the body so that they are no longer visible.
  • Near Infrared Lasers – These are used to treat larger lesions that are affecting more of the face and skin.
  • Medications – It seems that medications have the best chance of actually completely eliminating the symptoms of rosacea.

Again, none of these interventions completely cure rosacea, and they only help fight the symptoms.


If you are suffering from Rosacea make sure to give Dr. Rivers' 15 day free sample kit a try.  Developed specifically for his patients to reduce redness, flushing and irritation, the free sample kit will last long enough to make sure Riversol works for you.  

As mentioned, medications have proven to be most effective at managing the symptoms of rosacea. There are several different types used to manage ETR specifically.

  • Topical Brimonidine – This medication has proven effective at treating ETR rosacea. There have been a few different trials that show this as a very effective treatment. In a gel form, it is well tolerated even by sensitive skin and has proven to remain safe and effective even for long-term use.

Side effects of this treatment include contact dermatitis, flushing, burning sensations, and very rarely, rebound erythema.

If you are taking high blood pressure medication, cardiac medication, depressants of your central nervous system, or monoamine oxidase inhibitors, then you should discuss your options with your doctor before using brimonidine as it can have some adverse side effects with these medications.

  • Topical Retinoids – Some studies have found that these medications, specifically licochacone A, can relieve the redness and flushing associated with ETR.
  • Topical Calcineurin – There have been some reports that these medications can be effective, but at this time, there are no certain studies that prove this.

The main line of defense against rosacea flare-ups of this type are lifestyle factors and changes. Avoiding direct sunlight or using a strong broad-spectrum sunblock is a must. Additionally, using gentle facial cleansers and avoiding harsh chemicals in cosmetics is critical to improving or eliminating the symptoms of rosacea.

If lifestyle changes are not enough to manage the rosacea, then medications or laser light therapy can be used as well. However, your doctor will determine the best course of treatment depending on the severity of your condition and how it has responded to previous treatments.

Everything You Need to Know About Subtype 2 Rosacea: Papulopustular

The next subtype of rosacea is papulopustular, which is often referred to simply as an acne rosacea. Symptoms associated with this type include:

  • Very red skin connected with acne breakouts

  • Excessively oily skin

  • Sensitive skin

  • Visible broken blood vessels

  • Red patches of skin that are raised and irritated

Additionally, patients with this type of rosacea may also flush frequently. This type is so commonly mistaken for acne that many people go for years without knowing that they it.

Subtype 2 Rosacea Treatment

If you have a moderate form of this condition, then there is a good chance it can be successfully managed with topical medications. However, in more severe cases, antibiotics must be used and laser therapy may be considered.

Mild to Moderate Disease

As mentioned, topical medications are used in most cases of mild to moderate forms of rosacea because they are capable of controlling the symptoms to a satisfactory level. Often times, even non-medicated topical skincare is sufficient to control mild / moderate rosacea symptoms. If non-medicated skincare is insufficient, many topical medications can provide relief:

  • Metronidazole – This medication is an antimicrobial, an anti-inflammatory, and an antioxidant. At this time, reviews have not determined how this medication works to improve rosacea. However, it has proven effective time and time again. Metronidazole comes in several forms, including a 0.75% cream or gel, a 1% cream or gel, and a 0.75% lotion. Usually, the topical medications will be used either once or twice a day and it is generally very well tolerated. However, some people may experience stinging, dryness, or irritation.
  • Azelaic Acid – This is a lotion that is used in a 20% form or a gel in a 15% form. Several studies have looked into the use of azelaic acid as a treatment for acne rosacea. As a general rule, it takes about 12 to 15 weeks of use before a patient will see very good results.

There are some side effects that come along with this medication, including itching, burning, and stinging. Usually, the symptoms are mild. However, in about 1% of the patients, the symptoms become chronic.

With that in mind, experts indicate that the three medications are reasonable choices as first line treatments for mild to moderate forms of the disease. Metronidazole is lower in cost, so it is often the first option for patients.

There are other topical medications often used for acne rosacea, but they are not as well studied. These include the following:

  • Ivermectin – Yes, this is the same thing used to treat fleas on dogs, but in a different form. Ivermectin is both anti-inflammatory and anti-parasitic. It can be used in a topical, 1% cream to treat lesions from rosacea.

Two studies have been performed and found that ivermectin shows promise in treating the lesions that come along with acne rosacea. However, total clearing of the lesions was only seen in a very small number of the patients.

Ivermectin is well tolerated and can be applied once daily.

  • Sulfacetamide – Sulfur – This is a topical agent available in many different forms, including lotions, creams, cleansing pads, cleansers and foams. It usually comes in a form of 10% sulfacetamide and 5% sulfure and is even used in sunblocks. At this time, we do not know why this medication works against acne rosacea. However, trials have been completed showing that a sunscreen with these ingredients is superior to any other option.

There are some side effects, including local irritation and an unfavorable smell. Additionally, some patients may have an allergic reaction.

  • Antimicrobials – This includes benzoyl peroxide and clindamycin. These three topical treatments have been studied and found that they can be somewhat effective in treating acne rosacea. However, not enough trials have been completed to determine whether they are as effective as the other treatments mentioned.
  • Retinoids – These anti-inflammatory medications can help to repair cells and will help fight scarring and skin damage associated with rosacea. A 12-week study looked at this treatment and found that the use of retinoids is, in fact, effective at reducing inflammatory lesions.

Retinoids often have adverse effects, including skin irritation, which may make them less preferable.

  • Permathrin – This is a topical anti-parasitic agent that can be used to treat rosacea. It has only been studied in minor trials, but these trials did find that there was some improvement when permathrin was used along with other topical treatments. However, the actual results are questionable and the long-term benefits or dangers are unknown.

Medications that can be used to treat other forms of rosacea do not offer the same benefit in this type. For example, calcineurin inhibitors seem to do little or nothing.

Moderate to Severe Disease

If you have a more severe form of acne rosacea, then topical medications just may not be enough to manage it. As a result, oral antibiotics can be used as well as certain types of laser therapies.


These antibiotics have proven to be the best studied and most effective treatments for more severe acne rosacea. These include tetracycline, doxycycline, and minocycline. They have already been in use for treating rosacea for years. The medications can be helpful due to their anti-inflammatory properties.

Tetracycline is usually given in a dose between 250 and 1000 mg per day. A few small trials have covered the dosage to determine how effective various levels are. One study found that 100 mg per day is plenty to reduce the symptoms of papulopustular rosacea.

In more recent years, there have been concerns over the regular use of antibiotics as the body can build up a resistance. Because of this growing concern, subantimicrobial doses of the medication are being studied. In other words, experts are trying to determine if very small doses of the medications can be beneficial in lessening the effects of the rosacea on a larger scale.

However, most doctors use a short-term treatment of higher doses of these medications. For example, 50 to 100 mg or doxycycline or 250 to 500 mg of tetracycline may be used twice a day for between four and 12 weeks. The purpose of this is to decrease the inflammation quickly and get it under control. Then, after the inflammation has been managed, it is possible to lower the dosage to the subantimicrobial levels for long-term treatment.

Usually, once the severe rosacea can be managed with the antibiotics, you can move over to using topical therapies like azelaic acid or metronidazole.

Patients who are being helped with topical treatments may have breakthrough flare-ups of the lesions and this means the short-term use of higher dosage medications will be needed to handle the flare-ups quickly. Studies have shown that using an oral antibiotic in addition to a topical treatment will do the best to handle severe forms of acne rosacea.

There are a few other oral antibiotics occasionally used to treat this condition, including clarithromycin, azithromycin, erythromycin, and metronidazole. However, these medications have only been studied at a very minor level, so it is unclear how effective they will be in the long run. Oral metronidazole is the most common medication used to treat rosacea in Europe at a level of 200 mg twice a day. If you are using this type of treatment, then you should avoid alcohol altogether as there can be severe reactions between the two.

Refractory Disease

Some people with severe forms of rosacea do not respond to oral antibiotics or topical medications. In those cases, oral isotretinoin is used when nothing else seems to be working. It is used as a last ditch effort simply because it comes along with a variety of different adverse effects as well. Lower doses are used to try and treat the condition without causing any severe effects, so most patients are treated with 0.2 mg/kg per day until the rosacea is managed, which takes five to six months of therapy.

Any higher doses usually come along with adverse effects, so they are not preferred. However, studies continue to show that larger doses are usually not needed. Most people do well by taking a very low dose of this medication.

Laser and Pulsed Light

The treatments with light-based therapy have had some positive results in treating papulopustular rosacea, but those results have been extremely variable. Two studies have looked into intense pulsed light and pulsed dye lasers. There have been some improvements, but they are not sufficient enough to determine if this is an ideal way to treat rosacea of this type.

All of the types of treatments for acne rosacea are simply maintenance. They cannot cure the disease and treatment will be needed for long term management of this disease. This is why subantimicrobial antibiotics are used so commonly for long-term maintenance. Of course, this is something you would want to discuss in detail with your physician before making any decisions for your own treatment.

Everything You Need to Know About Subtype 3 Rosacea: Phymatous

rosacea subtype 3
An Old Man and His Grandson, c. 1490 by Domenico Ghirlandaio. Showing subtype 3 rosacea. 

Phymatous rosacea causes irregular growths on the face, especially the nose. It can also affect the cheeks, ears, and chin. The symptoms of this type include:

  • Thickening skin
  • Skin that looks bumpy and red
  • Thickening nose and nostrils

Because this type of rosacea advances, leading to more and more obvious symptoms, treatment depends on what stage the disease is diagnosed and treated at. Often, the thickening of the skin and tissue on the nose is referred to as “alcoholics’ nose” because it can look very similar to the enlargement, swelling, and broken blood vessels associated with excessive drinking.

Early Cases

There is no quality treatment for early stages of phytemous rosacea. However, some experts feel that the use of isotretinoin can be helpful. It can be administered at 0.3 up to 1 mg/kg per day for a course of 12 to 28 weeks. This may help at initially, but it is uncertain how long the benefits of the treatment will last. Usually, a patient will have to wait until the rosacea and thickening of the skin has gotten worse so that further treatments can be used to deal with the outward signs of the condition.

Advanced Cases

When the disease reaches advanced stages and the skin has become thickened, then surgical intervention is needed. Your doctor may choose to use debulking or recontouring to remove tissue that has been changed or distorted. Infrared lasers or carbon dioxide lasers can be used depending on the actual condition.

Additionally, there are a few different types of debulking surgical methods that can be used, including dermabrasion, scalpel excision, cryosurgery, and electrosurgery. Your doctor will determine the best one based on the extent of your condition.

Of course, laser therapies and surgical intervention for phytemous rosacea do come along with some side effects that you will need to consider, including scarring and hypopigmentation. Some patients report pain and discomfort during the healing period. However, if the rosacea is in the most advanced form, these interventions may be the only option available.

Again, even surgical intervention does not cure the rosacea. It is a way of lessening the effects, though. Additionaly, it can deal with the buildup of excess tissue and skin. As a result, the embarrassing symptoms of this type of rosacea can be managed and removed for a better quality of life.

Everything you need to know about subtype 4 rosacea: Ocular

Ocular Rosacea

As you may have guessed by the name, ocular rosacea affects the eyes, specifically. This chronic skin condition tends to affect the face as well as the eye itself and tends to appear in adults between the ages of 30 and 50. Usually, the first sign of this form as well as other types of rosacea is easy flushing and redness. Symptoms include:

  • Dry eyes

  • Burning and stinging in the eyes

  • Itchy eyes

  • Feeling as if something is in the eye 

  • Sensitivity to light

  • Blurred vision

  • Redness of the skin

  • Dilated blood vessels in the whites of the eyes

  • Red, swollen eyelids

  • Excessive tearing (Mayo Clinic)

Treatment of minor ocular rosacea includes lid scrubs and warm compresses to stimulate the gland so that it will begin functioning properly again. Topical antibiotics may be used to handle any minor inflammation of the eyelid.  In more severe cases of this form of rosacea, a course of tetracyclines is often used. Topical anti-inflammatories will be used to manage any inflammation, as well. The medicines often used include erythromycin, metronidazole, and cyclosporine.

Ocular rosacea can be worsened by certain lifestyle choices and environmental factors, including:

  • Wind

  • Hot and spicy foods

  • Alcohol consumption

  • Sunlight

  • Temperature extremes

  • Anxiety, stress, anger, and embarrassment

  • Hot baths

  • Saunas

  • Cortisone creams

These factors can cause any type of rosacea to worsen. So, it is best to determine triggers for flare-ups and then avoid them when at all possible.

If ocular rosacea is left untreated, it can lead to severe corneal complications, including vision loss, severe infection and inflammation of the eyelid.

Special Cases

In addition to the four subtypes of rosacea outlined above, there are always unique cases that do not appear in the way you would expect. Remember, these cases are very rare and will likely not affect you.

Granulomatous Rosacea

This is a form of rosacea, that varies from the typical symptons and effects. Instead of appearing as pimples or redness, it appears as yellow-brown or red-brown papules over a portion of the face. With this type of condition, you may not see any other symptoms of rosacea, like redness or flushing.

Because this is a rare condition, the actual treatment is not clearly determined, especially since there have been limited studies. Usually, doctors will treat this form in the same way they would treat papulopustular rosacea. However, while this treatment may be effective, it is usually slow and, often, it is not effective at all.

The rosacea treatments that have proven to be most successful include:

  • Oral Isotretinoin
  • Oral Dapsone
  • Topical Pimecrolimus
  • Intense Pulsed Light

Because this is a rare condition, it is usually handled on a case by case basis. That is because there is not enough research to know one single method of treatment that can be used every time a case does arise. If, by chance, you develop this form of rosacea, then your doctor will determine the best way to proceed in managing your condition.

Pediatric Rosacea

As mentioned, rosacea usually develops in people who are over the age of 30. However, there are occasional cases when a child will develop rosacea. Usually, this will be a case of phymatous rosacea specifically. The same types of treatments used with adults will be used on children. In mild to moderate cases, topical medications will be used, including metronidazole, azelaic acid, erythromycin, and sulfacetamide-sulfur.

If the child has developed the acne form of rosacea, then oral antibiotics may be used, including tetracyclines. The two most common forms used are azithromycin and clarithromycin at 30 to 50 mg/kg per day.

Sometimes, when treating children with rosacea, oral metronidazole will be used until the condition goes into remission and them a topical cream will be used to maintain healthy skin.

If ocular rosacea develops in children, then the condition will be managed just as it would be in adults. However, doctors will not use tetracycline on children who are under the age of nine.

Finally, granulomatous rosacea, if it develops in children, can be treated with topical or oral antibiotics. This is a slow reaction illness and the treatment could take several months before any improvement is seen.

Pyoderma Faciale

The final unusual type of rosacea is called pyoderma faciale. This is a condition that is not technically recognized as a variant of rosacea, but it is characterized by the abrupt onset of papules and other nodules on the face. This type of rosacea most commonly affects women.

There is very limited information on how this can be treated, but the usual management of the condition includes prednisone and isotretinoin. Usually, prednisone therapy will be used first and then isotretinoin will be added in later. Once the lesions have been resolved, then the treatment will be stopped.

Some doctors feel that pyoderma faciale can be treated with minocycline, tetracycline, or dapsone.


Rosacea is actually a very common condition that affects millions of people every single day. In some cases, the symptoms are so minor that you do not need to do much else other than use a topical cream from time to time. Sometimes, and for many people, the symptoms are severe enough that further rosacea treatment will be needed.

Whether you are having a rosacea flare-up or not, it is vital that you always use proper skincare to help manage rosacea and mitigate the development and recurrence of flare-ups. Removing harsh or abrasive ingredients into your skin care regimen is of paramount importance. Prioritize skincare products that are safe, mild, and effective at taking care of your face without causing issues.

If you do have rosacea flare-ups, see your physician in order to determine the best treatment method to get your skin back to normal as soon as possible.

Vancouver dermatologist Dr. Jason Rivers has created a range of skincare products to help the patients in his Vancouver clinic manage facial redness. He is offering a free, 15-day supply of his Redness Control line for a limited time.


  1. Introduction
  2. Rosacea Symptoms
  3. Rosacea Basics
  4. Types of Rosacea
  5. General Measures You Can Take to Avoid Outbreaks
  6. Everything You Need to Know About Subtype 1 (Erythematotelangiectatic) Rosacea Treatment
  7. Everything You Need to Know About Subtype 2 (Papulopustular) Rosacea Treatment
  8. Everything You Need to Know About Subtype 3 (Phymatous) Rosacea Treatment
  9. Everything You Need to Know About Subtype 4 (Ocular) Rosacea Treatment
  10. Special Cases
  11. Conclusion