Author: Dr Roy Palmer
In rosacea, there is redness of the face, with visible small blood vessels (‘broken veins’), and there is a tendency to acne. Due to the latter, the condition is often known as acne rosacea. In addition, the skin of the face becomes easily irritated, for example by the use of some cosmetics.
The acne can be treated with creams or tablets and often responds very well to such treatment. The creams used include ones containing metronidazole, ivermectin or azelaic acid. The patient should avoid anything that they notice makes their skin redder, such as contact with soap or perfumed moisturisers. If necessary, oral antibiotics are used. Patients are often concerned about taking an antibiotic for a prolonged period, but it is possible to use one that is safe for long-term use, and that is used little in general medicine so that the issue of bacterial resistance is less important. Occasionally a medication called Roaccutane (which is derived from vitamin A) is used, and it can be very effective.
The redness of rosacea can be treated using a cream called Mirvaso, but unfortunately results of that are often unsatisfactory. The redness and ‘broken veins’ can be treated with intense pulsed light or laser therapies (I do not offer these treatments but can advise on where to get them).