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Medicine to Ease Rosacea

Dermatologists may prescribe topical treatments including ivermectin to ease rosacea. Light therapy may also help.

Many people suffer with rosacea, a common condition that causes flushing, persistent redness, visible blood vessels and even acne-like bumps on the skin. Usually, dermatologists advise their rosacea patients to avoid triggers such as alcohol, spicy foods or excess sun. However, this strategy may not offer adequate relief. Of course, people with rosacea can take medications. Moreover, one reader reports that light therapy really helps ease rosacea.

Light Therapy to Ease Rosacea:

Q. I have suffered with rosacea for more than 30 years. I have tried all the treatments that I could find. The only thing that has helped me is light therapy.

I am thrilled with the results. which were immediate when I first started using it. I use it for three minutes daily now to maintain control.
The red light kills mites and reduces inflammation and redness better than anything I’ve tried.

A. Rosacea is a skin condition in which chronic inflammation leads to redness, pimples and sometimes lumps and bumps (called phyma). According to a recent review, there is evidence to support vascular lasers and light devices to treat the tiny blood vessels that cause redness (Skin Therapy Letter, July 2021). A recent study shows that pro-yellow laser can reduce the density of Demodex mites, which are linked to rosacea (Journal of Cosmetic Dermatology, March 20, 2021). We could find no controlled trials of red light treatment for rosacea but case reports of LED therapy are promising (Journal of Medical Case Reports, Jan. 28, 2020).

Medicines to Treat Rosacea:

Ivermectin Against Skin Mites:

Q. I keep reading about the ivermectin controversy for treating COVID-19. No one talks about the use of this drug to control rosacea.
I use ivermectin in a compounded gel form for rosacea and it is quite effective.

Most people don’t realize that rosacea has a parasite component. It is unclear whether the parasite causes rosacea or is opportunistic in the presence of rosacea. Either way, this treatment works!

I had an extreme breakout a year ago that finally cleared up with doxycycline and the ivermectin gel. Now I use tiny amounts of both and have had no further flares.

A. Symptoms of rosacea include frequent blushing, persistently red skin and small bumps that look a lot like pimples, although they are not. Dermatologists suspect that some of these symptoms may result from the immune system reacting to the presence of skin mites, Demodex folliculorum. Although these are normal skin inhabitants, people with rosacea appear to host more of them, possibly due to subtle differences in immune response (Journal of Dermatology, Aug. 2021).

The FDA has approved topical 1 percent ivermectin cream under the brand name Soolantra. This treatment is effective for severe rosacea (Expert Opinion on Pharmacotherapy, April 2018).

Other Treatments for Rosacea:

Q. Although I have tried topical metronidazole along with oral antibiotics, they don’t consistently ease rosacea. I have suffered with this condition for many years. Is there anything else that might work to control the redness and bumps?

A. Rosacea is an inflammatory skin condition with flushing, redness and dilated blood vessels on the face. Bumps and pimples may add to the distress.

There are no cures, but there are other treatments. Ask your doctor about the prescription drug Finacea. It is a topical gel containing azelaic acid. One study indicates that it is more effective than metronidazole (Archives of Dermatology, Nov. 2003).

There are some non-standard treatments worth discussing with your doctor. For example, one report from Italy suggested that dietary supplements containing silymarin and MSM (methylsulfonylmethane) may ease redness (Journal of Cosmetic Dermatology, March, 2008). However, hen a person has pustules that resemble acne, topical ivermectin is most effective (Dermatology and Therapy, Feb. 2021).

Moreover, many readers report that using a dandruff shampoo such as Selsun Blue on the face can help ease rosacea as well. Cleansing should be gentle, and dermatologists urge conscientious use of sunscreeen.

Photo by M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara
CC 2.0 This photo has been cropped

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Kang CN-Y et al, "Rosacea: An update in diagnosis, classification and management." Skin Therapy Letter, July 2021.
  • Temiz SA et al, "The effect of 577-nm pro-yellow laser on demodex density in patients with rosacea." Journal of Cosmetic Dermatology, March 20, 2021. DOI: 10.1111/jocd.14085
  • Sorbellini E et al, "Coupled blue and red light-emitting diodes therapy efficacy in patients with rosacea: two case reports." Journal of Medical Case Reports, Jan. 28, 2020. DOI: 10.1186/s13256-019-2339-6
  • Forton FMN & De Maertelaer V, "Which factors influence Demodex proliferation? A retrospective pilot study highlighting a possible role of subtle immune variations and sebaceous gland status." Journal of Dermatology, Aug. 2021. DOI: 10.1111/1346-8138.15910
  • Sahni DR et al, "Ivermectin 1% (CD5024) for the treatment of rosacea." Expert Opinion on Pharmacotherapy, April 2018. DOI: 10.1080/14656566.2018.1447562
  • Zhang H et al, "Rosacea treatment: Review and update." Dermatology and Therapy, Feb. 2021. DOI: 10.1007/s13555-020-00461-0
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