There are 2 main medical treatments:
1. A topical treatment for facial redness
2. Lasers and light-based treatments for visible blood vessels, redness and flushing
In some cases, metronidazole, azelaic acid or oral doxycycline may also help reduce facial redness. (See detailed information about these treatments under Type 2 – Facial redness and pimples.)
For flushing (when this is the predominant symptom), treatment options include medications that affect blood vessel dilation such as beta blockers.
A topical treatment for facial redness
Brimonidine is a topical (for use on the skin) treatment applied in the morning that significantly reduces persistent redness on the face for up to 12 hours.
Approved by Health Canada in 2014, this gel helps to temporarily reduce facial skin redness. It can be used daily in combination with other rosacea treatments.
How it works
Brimonidine is a vasoconstrictor that temporarily reduces the size of very small blood vessels to reduce skin redness. This treatment has no effect on spider veins.
Drug reactions including redness, itching, flushing and skin burning sensation were reported in up to 3.3% of patients over a course of 1 month. These reactions were usually temporary, mild to moderate in severity and generally did not require stopping treatment. *See package insert for full information.
For best results, apply a pea-sized amount to 5 main areas of the face – each cheek, the nose, chin and forehead. Spread evenly. Apply in the morning only.
Visible improvement usually starts 30 minutes after application with maximum clearing of skin redness seen 3 hours later and lasting up to 12 hours.
Lasers and light-based treatments for visible blood vessels, redness and flushing
Laser and light-based therapies have been successfully used for many years to treat the visible, tiny blood vessels, facial redness and flushing of rosacea. The cost of these treatments is not covered by provincial health plans, although some private plans may cover treatment.
Several treatment sessions (3 – 6) are often needed. Results may last for years, although 1 – 2 treatments a year may be needed for maintenance as rosacea is a chronic condition.
How it works:
Vascular lasers, such as pulsed dye lasers or long pulse Nd:YAG, and light-based devices, such as Intense Pulsed Light (IPL) or Broad Band Light (BBL), emit energy that is specifically absorbed by tiny, visible blood vessels just below the surface of the skin. This energy is then converted into heat that causes these small vessels to seal and be naturally removed.
Laser energy feels like an elastic band snapping against the skin. Most people tolerate treatment well. Redness, heat and swelling of the skin are common in the first few days. Blistering and scarring are rare.
Treatments with light-based devices also feel like an elastic band snapping against the skin. With IPL or BBL, there are minimal side effects such as temporary, mild skin reddening.
Dos & don’t’s
Never undergo treatment when you have tanned skin as you risk getting colour change to the skin, burns and scarring. Do consider having your treatments performed at a medical clinic supervised by a physician. Avoid Triggers and maintain good skincare.
Benefits are often seen after 1 – 2 treatments and typically continue to improve with ongoing sessions. Treatments are usually spaced 1 month apart.