Rosacea

[Sunshine18]

Hi there,
I suffer from rosacea and have done since my early 30s (I am now 40). It is becoming worse and monthly I get the papules and spots associated with it. I also have thread veins around my nose (with a little rosacea area on the tip) and in the area of rosacea. I have had some laser treatment to this area and also tried metronidazole gel, neither of which have had any effect whatsoever. It is becoming unsightly and I am desperate to find a solution. Can you recommend anything I can try?
Alcohol and sunshine definitely cause a flare as well.
Thank you!

[Dr Emma Wedgeworth]

Hi there,
Sorry to hear you haven't had much success with treatment so far, but rest assured that there are many other treatment options open to you.

You mention lifestyle and it's important to minimise the triggers, so limit alcohol, avoid smoking and eat healthily. Incorporate a broad spectrum sunscreen into your daily routine and limit direct sun exposure where possible. Keep skin care gentle, hydrating and non pore blocking.

In terms of medical treatments for the spots of rosacea, I find azelaic acid cream and the newer topical ivermectin cream very helpful, so have a chat to your GP about prescribing these. If creams alone aren't working, a course of oral tetracyclines (antibiotics) are often very helpful. I try and use these for 3-6 months and then switch back to creams to maintain the improvement. Remember, it may take up to 8-12 weeks of using the creams to see a good improvement.

In terms of redness, I think laser is currently the most effective treatment. However, laser varies enormously according to which machine is used, the settings and the treatment schedule. If one type of laser hasn't worked, you may benefit from another type. I always find seeing a specialist laser dermatologist is extremely helpful.

I hope that helps and good luck!

Best wishes,

Dr Emma

[Sunshine18]

Thank you! That is great advice, I live in Brighton, is there a clinic which is close that you can recommend?