La rosacea is a chronic disease. Various treatments generally make it possible to improve the appearance of the skin, or at least to slow the progression of symptoms. However, it often takes several weeks to see a result and no treatment can achieve total and lasting remission. Thus, the treatments do not act on telangiectasias (dilated vessels) and the redness present on the cheeks and nose never completely disappears. However, it is essential to consult a dermatologist as soon as symptoms appear, because treatments are more effective when used at the early stage of the disease.

Treatment varies depending on the stage of the disease and the intensity of symptoms. It can be very effective, but be aware that in the majority of cases, rosacea worsens after stopping treatment. Usually, almost continuous treatment is necessary to maintain a satisfactory result.

pharmaceuticals

Antibiotics. The most commonly prescribed treatment for rosacea is an antibiotic cream to be applied to the skin, made from metronidazole (Metrogel®, Rosasol® in Canada, Rozex®, Rozacrème®… in France). Clindamycin creams can also be used. When rosacea is widespread or is associated with eye inflammation, your doctor may order an oral antibiotic (from tetracycline or sometimes minocycline in Canada) for three months. Although rosacea is not directly linked to bacteria, antibiotics help reduce inflammation in the skin.

Azelaic acid. Applied to the skin as a cream or gel, azelaic acid (Finacea®) helps reduce the number of pustules and reduce redness. However, this product is quite irritating to the skin, so a suitable moisturizer must be used as a supplement.

Oral isotrétinoïne. Accutane® in Canada, obtained with a prescription, is sometimes used in low dose to treat severe forms of rosacea (in case of phymatous rosacea or papules, pustules or nodules resistant to other treatments²). As it causes serious side effects, it is prescribed under close medical supervision. Thus, it increases the risk of birth defects if it is used during pregnancy. Women of childbearing potential taking this treatment should have effective contraception and have regular pregnancy tests to make sure they are not pregnant. It is advisable to check with your doctor.

surgery

To reduce redness and decrease the appearance of telangiectasias (small red lines following the dilation of the vessels) or rhinophyma, various surgical treatments exist.

Electrocoagulation. This is an effective technique for telangiectasias (rosacea) which may require several sessions and which has various drawbacks, including: slight bleeding, redness and the formation of small scabs in the days that follow, a risk of scarring or permanent depigmentation of the skin. This treatment cannot be considered during the summer (risk of formation of brown spots).

Laser surgery. More effective and less painful than electrocoagulation, the laser generally leaves less scarring. However, it can cause some bruising or temporary reddening. It takes from one to three sessions per area to be treated.

Dermabrasion. This procedure consists of “wearing away” the surface layer of the skin using a small, rapidly rotating brush.