Reduce triggering factors such as:
- hot drinks like tea and coffee, alcohol etc.
- hot and spicy food
- excessive heat, direct sunshine, hot showers etc.
- topical steroids.
Topical treatment (refer to section 13.6):
For mild papular/pustular rosacea:
- metronidazole (Rozex®) 0·75% cream or gel
- azelaic acid 15% cream.
For moderate to severe persistent redness/erythema:
- brimonidine gel 0·33% can be used (note MHRA advice below).
For moderate rosacea or not responding to topical treatment:
- a tetracycline, eg oxytetracycline or doxycyline
- erythromycin is an alternative
- review treatment in 6 to 8 weeks and if improvement the dose of antibiotics can be reduced, or change to topical.
For severe rosacea or not responding to oral antibiotics refer to Dermatology Department at Raigmore Hospital.
MHRA: Brimonidine gel: advice for health professionals: