Erythema —– the medical term for redness –in rosacea is associated with just about every subtype of rosacea. In erythematotelangiectatic (what’s called “subtype 1”) the primary symptom of the disease is persistent facial redness and visible blood vessels (telangiectasia). There are a few treatments for this subtype depending on the severity of the disease. In milder cases, the main treatment may be to manage triggers and use covering make-ups (like those with a green tint) to mask the redness. In more severe forms, prescription medications may be an option. The table below discusses the different treatment options your dermatologist might discuss with you.

This is the most common subtype of rosacea, and the one most studied. There are various topical prescription products available to treat this subtype of rosacea. Prescription topical products include metronidazole, azaleic acid and sodium sulfacetamide 10%/sulfur 5%. Although not indicated for treating rosacea, oral antibiotic products (typically doxycyclines or other tetracyclines) are often prescribed in more severe forms of this subtype; however, because rosacea does not appear to be caused by bacteria and due to concerns about increased cases of bacterial resistance, the utility of antibiotics to treat this disease is being re-evaluated. One form of low-dose doxycycline (a dose below that needed to kill bacteria) is approved to treat this form of rosacea and does not induce resistance. It is thought that both topical and oral products work on the inflammatory process of rosacea and decrease the bumps and blemishes. Other products and how they are used to treat this type of rosacea are discussed in the table below.

This is probably the most easily but incorrectly identified form of rosacea, manifesting as thickened skin, typically around the nose. Many times this type of rosacea is mistakenly identified as “alcoholics’ nose” due to the thick, red skin around the nostrils. WC Fields is the most often referenced sufferer of this condition. By the time rosacea reaches this stage, it is very difficult to treat by the more conventional therapies used for treating papulopustual (subtype 2) rosacea, and in many cases requires laser or other dermatologic surgery or intervention to reverse the effects of this stage of the disease.

This subtype is often misdiagnosed and is very difficult to treat. There are currently no treatments approved by the FDA to treat this type of rosacea. Treatment options range from oral antibiotics to artificial tears. A discussion of treatment options is in the table below.

All drug products (including those you get over the counter) may cause side effects. The most important information to remember is to speak to your doctor about your treatment options and thoroughly understand your choices.

As a general rule of thumb however, topical prescription products used to treat rosacea (metronidazole, azaleic acid and sulfacetamides) may cause your skin to feel dry, sting, burn or cause other effects when you apply them. Oral products – particularly antibiotic doses of doxycylcines and tetracyclines – can cause mild to severe gastrointestinal upsets such as diarrhea and nausea, and vaginal candidiasis is a typical side effect when using these products.