Rosacea is a long term skin condition that causes facial redness, thread veins and spider veins (known medically as telangiectasias), and in some cases, papules and pustules. These symptoms can be very troublesome psychologically, and lead to social withdrawal and isolation in some people who are severely affected. However, treatments are available that will help get rid of the redness, thread veins and papules.
Which Rosacea cream is the most effective?
The answer requires a strict scientific approach where groups of comparable patients are given different treatments and compared in a standardised way. Fortunately, this has been done for patients with rosacea.
The results of these clinical comparisons has shown that Azelaic acid cream is one of the most effective topical treatments (that is, a cream that can be rubbed into the skin rather than a medication that has to be taken orally) that reduces nearly all the symptoms of rosacea in the majority of patients who are prescribed it. The only thing that it doesn’t help is established spider or thread veins (telangiectasia). These can be treated with Intense Pulsed Light (IPL) or the Veinwave technique, which is based on microwave energy for thermo-coagulation of small veins.
In the United Kingdom Azelaic acid is available as Skinoren cream. In rosacea it is thought to work by reducing the quantity of free oxygen radicals. It also has an exfoliative and anti-comedonic affect that works well for people who also have acne vulgaris, the common form of acne. Metronidazole antibiotic gel is an alternative treatment but it doesn’t work as well as Azelaic acid. Both are well-tolerated by most people, though some do have to stop treatment with Azelaic acid due to excessive dryness or irritation.
Azelaic acid has other advantages in terms of it being probably non-teratogenic, unlike the Vitamin A preparations like Tretinoin (although all medications should be avoided during pregnancy where safe and practical).
What other treatments are available for Rosacea?
In addition to the creams that are available for rosacea, some of the symptoms can also be effectively controlled with Intense Pulsed Light and laser treatments. This is especially true for the facial redness and spider veins that are often seen in this condition. This treatment requires skill and experience to be effective and yet avoid side effects such as burns, but the results can be very good.
A new topical gel treatment called Mirvaso is now available for the facial redness that you often get with rosacea. The active ingredient is called Brimonidine. It isn’t a cure, but will temporarily reduce the redness for up to several hours.