• Alopecia
• Acniform eruptions
• Benign tumors
• Bullous diseases
• Dermoscopy
• Nevi, melanoma
• Nonmelanoma cancer
• Psoriasis and others
• Stds
• Vascular tumors
• Vulvar disease

• Acne
• Acne Psychology and Approach to Patient
• Acne Cause and Pathophysiology
• Acne Lesions and Classification
• Blackhead and Whitehead Comedone Acne
• Acne Pimples - Papules and Pustules
• Acne Pimples - Papules and Pustules
• Cystic Acne Information
• Cystic Acne Cases and Acne Scars
• Acne Treatment - How Acne Medicine Works
• Acne Treatment with Topical Antibiotics
• Acne Treatment with Topical Retinoids Retin-A
• Acne Treatment with Oral Antibiotics Doxycycline
• Acne Treatment Antiandrogens and Birth Control Pills
• Acne Treatment with Accutane Isotretinoin Part 1
• Acne Treatment with Accutane Isotretinoin Part 2
• Perioral Dermatitis
• Perioral Dermatitis Information
• Perioral Dermatitis cases
• Perioral Dermatitis Treatment
• Rosacea
• Acne Rosacea Information
• Acne Rosacea Erythema Telangiectatic
• Acne Rosacea Papulopustular
• Acne Rosacea Nose Phymatous
• Acne Rosacea Eye Ocular
• Acne Rosacea Treatment
• Hidradenitis
• Hidradenitis Suppurativa Information
• Hidradenitis Suppurativa Cases
• Hidradenitis Suppurativa Treatment

Acne Rosacea Treatment

Treatment of rosacea

Rosacea may be treated with both topical and oral medications.

Topical therapy

Rosacea may respond to treatment with topical antibiotics. Topical

antibiotic are not as effective as oral antibiotics but may be used for

initial treatment for mild to moderate cases and for maintenance after

stopping oral antibiotics.

Metronidazole

Metronidazole Tris commonly prescribed. MetroGel, MetroCream and

MetroLotion are available in a 0.75% concentration and are applied

twice each day. Noritate cream is 1% metronidazole and it is effective

when applied once each day. Bedtime application is usually the most

convenient. Clindamycin in a lotion or gel base is used to treat acne.

It is sometimes effective for rosacea.

Sulfacetamide/sulfur

Sulfacetamide/sulfur lotions are effective as monotherapy. Sulfacet-R

is flesh colored and hides redness. It is also available in a tint free

base. Plexion is available as a lotion and wash. AVAR Green has a green

base and attenuates erythema. Rosac is a cream based form of

sulfacetamide and sulfur that contains sunscreens. Sunlight makes

rosacea worse. Cream based medications are best for patients with dry

skin. There are many other formulations.

Azelaic acid

Azelaic acid 15% gel or Finacea is effective and well tolerated in the

treatment of papulo-pustular rosacea. Both pustules and erythema

respond.

Oral antibiotics

Oral antibiotics are effective and reliable treatment for rosacea. Both

the skin and eye manifestations respond. They are more effective than

topical preparations and used as first line therapy for moderate to

severe rosacea. Low doses of medication may be effective. The starting

dose for doxycycline is 20, 50, 75 or 100 mg once or twice each day.

Tetracycline or erythromycin are started at 500 mg twice each day.

Resistant cases can be treated with minocycline 50, 75 or 100 mg twice

daily.

Medication is stopped when the pustules have cleared. The response

after treatment is unpredictable. Some patients clear in 2 to 4 weeks

and stay in remission for weeks or months. Others flare and require

long-term suppression with oral antibiotics. Treatment should be

tapered to the minimum dosage that provides adequate control. Patients

who remain clear should periodically be given a trial without

medication.

Nicomide

Patients who are reluctant to take oral antibiotics may improve with a

preparation of nicotinamide and vitamins called Nicomide. This product

has antiinflammatory properties.

Isotretinoin

Isotretinoin, 0.5 mg/kg/day for 20 weeks is effective in treating

severe, refractory rosacea. Much lower doses may be effective.

Patients resistant to conventional treatment were treated with oral

isotretinoin, 10 mg/d, for 16 weeks. Papular and pustular lesions,

telangiectasia and erythema were significantly reduced at the end of 16

weeks.

Rhinophyma

Patients with rhinophyma may benefit from specialized procedures

performed by plastic or dermatologic surgeons. These include

electrosurgery, carbon dioxide laser, and surgery. Unsightly

telangiectatic vessels can be eliminated with careful electrocautery.