First treatment steps include gentle skin cleansing with a soap-free pH balanced cleanser (to avoid any itching, irritation or exacerbation), photo protection and avoidance of exacerbating factors such as changes in temperature, ultraviolet light, stress, alcohol and some foods (chili and spicy).
For patients with the erythema totelangiectatic form, topical treatments including azelaic acid, metronidazole and brimonidine are options and laser therapies. For the papulopustular form, a combination of topical therapies and oral antibiotics (used for their anti-inflammatory effects).
For severe forms, referring to a dermatologist is advised. The dermatologist may recommend various treatment options including oral isotretinoin, laser therapies or surgery.
The pathogenesis of the disease is not yet fully known. Immunologic reaction, facial vessels, and the Demodex folliculorum mite may play an important role. Currently there is no cure for rosacea, but topical, systemic treatment and laser may suppress its signs and symptoms. Patients should avoid triggering factors, use sun protection and gentle skin-care products. Early diagnosis and management of the disease can also prevent its progression.
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