Selecting the Best Treatment for Rosacea

People with rosacea know how it affects their face. There’s flushing, redness, pimples and pustules, and dilated blood vessels. Their eyes may show a thickening. And there’s likely to be swelling, especially of the nose (photo).

Treatments for rosacea aim to control these signs and symptoms. Some are more effective than others; but it’s unclear which is most effective for each individual sufferer.

For example, after reviewing the results from 106 studies in more than 13,000 people, metronidazole (aka Flagel®) and azelaic acid (Azelex® and Finacea®) applied to the skin alone or together appeared to be more effective than placebo (i.e., no active treatment). Topical ivermectin (Soolantra®) is slightly more effective than metronidazole. But that was based on the results of just one study. Brimonidine (Mirvaso®) seems to reduce redness, and some evidence supports cyclosporine eye drops (Restasis®) to treat rosacea affecting the eyes.

Some antibiotics seem to be effective, but which is the best among them isn’t clear. Finally, there’s limited information supporting laser and light-based therapies for treating the redness seen in rosacea.

What about alternative treatments?

Colloidal silver, emu oil, laurelwood, and oregano oil are touted as ways to treat rosacea. But no conclusive evidence supports the idea that any of these are the best for you, let alone better than prescription medicine.

The bottom line.

It’s frustrating that none of these treatments are clearly superior to all the others. The good news, however, is that there are many treatments for rosacea. And in the care of a qualified dermatologist, you can expect the best outcomes for your needs.

You must take that first step. To find the best treatment for your rosacea, find a qualified dermatologist.

At Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D., Dr. Binstock, USCF Fellowship Trained; Dr. Layton; and Stephanie Cullinane, PA-C will answer all your questions. Call our San Francisco office at (415) 956-8686, or in Mill Valley call (415) 383-5475.


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