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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Depending on the severity of this condition, topical or systemic treatment may be necessary. Topical therapy includes the application of topical antibiotics such as metronidazole (MetroCream, MetroGel, MetroLotion, Noritate), sulfacetamide (Novacet, Plexion, Plexion SCT, Plexion TS, Rosanil Cleanser, Rosula, Rosula Cleanser, Sulfacet-R, Zetacet Wash), or perhaps azelaic acid (Azelex, Finacea, Finevin).

If topical therapy is insufficient, oral antibiotics are frequently beneficial. Frequently used oral antibiotics include amoxicillin (Amoxil, Amoxil Pediatric Drops, Moxatag, Trimox) and tetracycline (Ala-Tet, Sumycin) or one of its analogues like doxycycline (Adoxa, Alodox, Avidoxy, Doryx, Monodox, Oracea, Oraxyl, Periostat, Vibramycin, Vibramycin Calcium, Vibramycin Monohydrate, Vibra-Tabs) and minocycline (Dynacin, Minocin, Minocin PAC, Myrac, Solodyn). Systemic treatment with antibiotics may inhibit the development of rhinophyma and is effective in controlling blepharitis (inflammation of the eyelid). Rarely, very severe cases may require isotretinoin (Accutane, Amnesteem, Claravis, Sotret), an oral retinoid. The overall goal of treatment is control the symptoms rather than cure the condition.

Research studies have objectively shown that there is evidence that topical metronidazole and azelaic acid are effective treatments for rosacea. There is evidence that oral metronidazole and tetracycline are effective as well.

Treatment of the telangiectatic component (dilated blood vessels) of rosacea with lasers or intense pulsed light of the appropriate wavelength can diminish the redness. Individual blood vessels can also be treated with electrosurgical destruction. There is also a novel, promising form of medical therapy currently being studied which utilizes a drug similar to that present in long-acting nasal decongestant sprays (like Afrin). Rhinophyma can be improved by "paring down" excess nasal tissues using electrosurgical or microwave devices.

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