Treatment Options for Acne Rosacea

Rosacea is a common chronic, and sometimes progressive, dermatosis. It is characterized, alone or in combination, by central facial erythema, symmetric flushing, stinging sensation, inflammatory lesions (papules and pustules), telangiectasias, and phymatous changes (tissue hyperplasia and nodules). Rosacea can occur in adults of any ethnicity, and adversely affects patients' quality of life. The condition can be effectively controlled with therapy tailored to the specific subtype of rosacea that is affecting the patient. Topical metronidazole, sulfacetamide/sulfur, and azelaic acid are generally effective for patients with mild rosacea. For moderate papulopustular rosacea, combination therapy with oral tetracyclines and topical agents is the first-line choice. Treatment with a topical agent, such as metronidazole, may help maintain remission. Patients with ocular involvement may benefit from long-term oral antibiotics and metronidazole gel. Referral to a subspecialist is necessary for patients who have ocular rosacea with ophthalmic complications, severe or recalcitrant rosacea, or phymatous changes. (Am Fain Physician. 2009;80(5):461-468, 505. Copyright (C) 2009 American Academy of Family Physicians.)