Treating Rosacea: The Board-Certified Guide

February 28, 2023

Treating Rosacea: The Board-Certified Guide

More than 14 million Americans have rosacea, a common skin condition that causes redness in the face among a variety of many other symptoms. Rosacea can affect anyone—men and women both and in all skin colors and types. However, it is most common in those with fair skin, and fair skin itself can make the redness and other symptoms look more pronounced. 

As rosacea is a chronic skin disease, it can have multiple long-term effects on quality of life. It’s common for those with rosacea to feel frustration or embarrassment, have low self-esteem, or suffer other mental effects.

But despite the challenges that rosacea may add to your life, there are both medical and cosmetic treatments that can help individuals manage their symptoms and get their confidence back! Learn about the different subtypes of rosacea below, and then read on for information from our Board-Certified providers and the AAD on how to treat rosacea.

Distinguishing the Subtypes of Rosacea

Because of the wide range of symptoms possible with rosacea, there are four official subtypes of the disease according to the American Academy of Dermatology.

Subtype 1: Erythematotelangiectatic Rosacea (ETR)

In addition to redness and flushing, those with ETR have visible blood vessels, swollen and/or sensitive skin, dryness and/or scaliness.

Subtype 2: Papulopustular Rosacea

In papulopustular rosacea, symptoms include acne-like breakouts, oily and/or sensitive skin, visible broken blood vessels, and raised patches of skin.

Subtype 3: Phymatous Rosacea

Phymatous rosacea is a rare and more severe type. In addition to thickening skin (known medically as phyma), symptoms include bumpy skin, oiliness, visible broken blood vessels, and large pores. The sooner thickening skin is noticed, the better success you will have in treating it, whether you choose a medical or cosmetic method.

Subtype 4: Ocular Rosacea

Ocular rosacea occurs in the eyes. Those with this subtype may have watery or bloodshot eyes, dry eyes, burning and stinging sensations, sensitivity to light, blurry vision, visible broken blood vessels on the eyelid, and more.

The Power of Prescription Treatments: Medical Solutions

There are multiple prescription medications available for treating rosacea symptoms, from topical to oral options. For many patients, it’s normal to try a few different medications or a combination of medications in order to find the right treatment for you and your specific case of rosacea.

Topical prescriptions reliably offer promising results for multiple types of symptoms. Brimonidine gel and oxymetazoline hydrochloride cream are both popular options for flushing, as they constrict blood vessels thereby reducing redness 12 hours after application. Because the effects on the blood vessels are temporary, these particular topical medications have to be applied regularly. 

When it comes to rosacea pimples, other topical treatments like azelaic acid and metronidazole can be effective solutions in controlling breakouts. Ivermectin is another option to treat rosacea pimples, and although it can take longer to see improvements, it results in longer remission than azelaic acid and metronidazole. An oral antibiotic, such as doxycycline, can also be prescribed in moderate to severe rosacea with pimples.

In severe cases of rosacea that don’t respond to other treatments, isotretinoin (also known as Accutane®) may be the solution. When used early, isotretinoin can be used when skin thickening (phyma) is starting to occur, as it can prevent phyma from worsening. Isotretinoin can be very effective in treating severe rosacea as well as other severe acne conditions, but it is not a safe medication for everyone, especially pregnant women. It’s important to disclose to your provider if you are pregnant or planning to become pregnant so an alternative treatment plan can be determined.

Laser-Focused on High-Quality Results: Cosmetic Solutions

If you’re more eager to try the cosmetic route for rosacea treatment, there are plenty of possibilities. Among cosmetic treatments, lasers are rosacea’s biggest enemy, as they address redness and visible blood vessels. The laser’s heat collapses the visible blood vessels, therefore making them less noticeable. After 1-3 treatments with laser services spaced 3-4 weeks apart, most patients see a 50-75% reduction in visible blood vessels according to the AAD. Results can last 3-5 years as well! 

We offer treatments using the Excel® V laser, a powerful and precise laser perfect for treating visible blood vessels in rosacea. Typically, only 1-2 treatments are needed to see desired results and downtime is minimal! 

For treating phymatous rosacea, laser resurfacing can help. As your skin heals from laser resurfacing, you will notice it becoming softer, brighter, and more even. Results continue on through the next 3-6 months, as deeper layers of skin fill in with collagen. To help prevent phyma from coming back, a medication may be prescribed. 

Our brand-new DEKA SmartXide Tetra CO2 laser is the most advanced skin resurfacing technology on the market now—come try it out at Paradise Dermatology and see how it can improve your rosacea!

See Our Team for Help Managing Your Rosacea!

Whether you’re interested in treating your rosacea from a medical angle or a cosmetic one, Paradise Dermatology can help! Rosacea can be challenging, but treatment is possible and our expert team is ready and equipped with the best knowledge and technology to help you feel your best and glow your brightest. Book your appointment with us here.