The specific treatment of rosacea will depend on many factors. These factors include the subtype of rosacea being considered as well as patient preferences and tolerances. Firstly, there is no point trying to actively treat rosacea if it continues to be fuelled by known triggers. Avoiding the common triggers for rosacea are essential.
As a rule, when it comes to caring for skin affected by rosacea, the KISS principle needs to be adopted. That is, keeping skin care regimes simple and being gentle with the day-to-day care of the skin. Using soap-free cleansers that are pH balanced is important. Hot water should be avoided and only luke-warm water should be used when washing the face. A soft towel should be used to dry the face and only done by dabbing rather than vigorously rubbing. Toners, fragrances, abrasive exfoliators, peels and such treatments should be avoided. Mineral based powder makeup should be used instead of thick concealers. Avoid creams which have botanical ingredients, as while they sound very ‘natural’ and harmless, these ingredients can often irritate the skin. Finding a broad-spectrum sunscreen which is well tolerated is essential. This needs to be applied regularly during the day if out and about.
The dilated blood vessels and fixed redness of rosacea may be improved by specific vascular laser treatments. These treatments need to be performed cautiously by experienced practitioners and tailored to suit the individual patient. If performed incorrectly, lasers can flare rosacea and even cause burning, blistering and scarring of the face. Laser settings must be adjusted according to the skin type, severity and type of rosacea as well as the response to previous treatments. Laser treatments can be ineffective and costly if performed incorrectly.
Flushing can be a more difficult problem to treat, but cream and tablet treatments may suit some individuals, whilst specific laser treatments may also provide some benefit for this as well. Antibiotic tablets and medicated creams can be very useful for the pimples of rosacea. Patients with some forms of rosacea (including early rhinophyma) can benefit from oral retinoid capsules which are restricted to the use by dermatologists. Laser surgery is required to correct rhinophyma in the late stages.
If rosacea continues to be difficult to manage despite trying general measures and seeking advice from a GP, it may be time to see a dermatologist.
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