RosaceaNet Spotlight Article
Advances Changing Face of Rosacea Treatment
Controlling rosacea can be a struggle.
Time-consuming or messy treatments may make it difficult to stick to
a prescribed treatment plan. Concerns about potential side effects
often limit long-term use of medication. Some newer treatment
options may change this. Not only are these newer therapies proving
effective, they tend to have fewer side effects and can fit busy,
Lasers and Other Light Therapies Treat Redness, Visible Blood
More and more dermatologists are treating rosacea with lasers and
other light therapies. Effective at reducing redness, eliminating
visible blood vessels, and diminishing flushing, this treatment
option can be safely combined with other rosacea therapies.
And patients welcome this treatment option. It effectively controls
signs of rosacea, and the risk of side effects is low in the hands
of a physician who has experience using these devices and in-depth
medical knowledge of the skin. Side effects tend to be limited to
temporary bruising, redness, or swelling. The redness and swelling
can last for up to a few days. With some lasers, bruising may
develop and can last as long as 10 to 14 days.
Convenience is another welcomed benefit. Treatment can be performed
in a dermatologist’s office. While the number of treatments varies,
most people require 4 to 8 treatment sessions per year for a few
years to significantly reduce redness and flushing. For most
patients, at least 2 treatments are needed to diminish visible blood
vessels. Once the desired results are seen, patients may not need
treatment again for some time. A few patients have reported that
their redness and flushing did not return for 7 or 8 years.
Treatment also has become more comfortable than it was in the past.
After treatment, many patients say that their skin feels more
The downside of laser and other light therapies is that insurance
usually does not cover the cost because these treatments are
considered cosmetic. Patients can expect to pay from $300 to $700
Non-antibiotic Doxycycline Treats Bumps and Pus-Filled Lesions
Weighing in at only 40 milligrams of doxycycline per capsule, this
dosage of doxycycline is not potent enough to kill bacteria. Since
it cannot kill bacteria, it does not act as an antibiotic. But
research shows that 40 milligrams can effectively stop inflammation.
When inflammation decreases, patients see fewer bumps and pus-filled
This result was seen again and again during clinical trials. In the
phase III clinical trials — the final trials needed to determine
whether or not a drug will receive approval from the U.S. Food and
Drug Administration (FDA) — adults with moderate to severe rosacea
were asked to take one capsule per day for 16 weeks. The capsule
contained either 40 milligrams of doxycycline or a placebo (no
The adults who received the 40 milligrams of doxycycline saw
significantly greater improvement. On average, each person in the
study had about 20 bumps and/or pus-filled lesions and 2 or fewer
nodules. The adults who received the 40 milligrams of doxycycline
saw between 11.8 and 9.5 fewer lesions by week 16. This translates
to a mean reduction of 61% and 46%, respectively. Adults who
received the 40 milligrams of doxycycline also saw a significant
decrease in facial redness.
When the patients were also given 1% metronidazole gel, a medication
approved by the FDA for treating the papules and pustules of
rosacea, the lesions decreased more quickly. The gel was to be used
daily for 12 weeks and then stopped. The patients continued taking
the 40 milligrams of doxycycline for 16 weeks.
While the antibiotic dosage of doxycycline can cause significant
side effects, such side effects were not reported in these clinical
trials. Patients did not say they had an upset stomach or sun
sensitivity. None of the women treated with the non-antibiotic
dosage, also called the anti-inflammatory dosage, experienced a
yeast infection. Since the anti-inflammatory dosage cannot kill
bacteria, a patient would not be expected to develop antibiotic
resistance. When a patient develops antibiotic resistance, the
antibiotic becomes ineffective in killing the targeted bacteria.
Antibiotic resistance is a global health concern.
The results of these studies led the FDA to approve the 40-milligram
capsule of doxycycline for the treatment of the papules (bumps) and
pustules (pus-filled lesions) of rosacea in patients who are 18
years of age and older. This 40-milligram capsule is approved for
once daily use.
Newer Lasers Treat Thickening Skin
Advances also have been made in the treatment of rhinophyma, a sign
of rosacea that causes the skin on the nose to thicken and sometimes
look bumpy. While lasers have been used for years to treat
rhinophyma, the newer lasers can now smooth the nose without
removing a significant amount of skin.
Ask Your Dermatologist
Dermatologists continually tell their patients that it is important
to treat rosacea. Left untreated, rosacea can worsen and become
increasingly difficult to treat. If one of these newer therapies
seems to be a treatment option that could help you control your
rosacea, be sure to ask your dermatologist about it.
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content solely developed by the American Academy of Dermatology