In 2020, new standard management options for rosacea were published in the Journal of the American Academy of Dermatology.¹ Developed by a consensus committee and review panel of 27 rosacea experts worldwide, the updated guidelines are intended to provide a comprehensive summary of treatment options for the respective signs and symptoms identified in the updated standard classification of rosacea.²

The following prescription therapies are approved by the FDA for the treatment of rosacea, in addition to light devices and surgical procedures for certain signs and symptoms. Because rosacea is a disorder with various potential signs and symptoms, each case is unique and what works for one patient may not be appropriate for another. Treatment must therefore be tailored by a physician on an individual basis, and in many cases combination therapy may be necessary for optimal treatment. Talk with your doctor about what treatments are best for you, and be sure to use medication carefully and consistently.

For a complete overview of the National Rosacea Society Expert Committee’s assessment of available treatments to address the disease’s signs and symptoms, also known as phenotypes, the NRS offers the Standard Management Options for Rosacea as a free patient handout.

Azelaic Acid
Azelaic acid is a topical medication used to treat the inflammatory papules and pustules (bumps and pimples) of mild to moderate rosacea. It is available by prescription in foam and gel preparations in a 15% formulation, and is applied twice daily.

Learn more: Azelaic Acid on GoodRx | Finacea Foam

Encapsulated Benzoyl Peroxide Cream
Encapsulated benzoyl peroxide is a topical medication used to treat the inflammatory papules and pustules (bumps and pimples) of mild to moderate rosacea. While benzoyl peroxide acne medications often dry out rosacea skin, encapsulation allows the medicine to penetrate without irritation. It is available by prescription as a cream in a 5% formulation, and is applied once daily.

Learn more: Encapsulated Benzoyl Peroxide on GoodRx | Epsolay

Brimonidine
Brimonidine is a topical alpha-adrenergic agonist medication for the treatment of persistent erythema (redness) in rosacea. It is available by prescription in a gel preparation in a 0.33% formulation, and is applied once daily or as needed. Duration of peak effectiveness is three to six hours.

Learn more: Brimonidine on GoodRx | Mirvaso

Oral Doxycycline
Doxycycline is an oral tetracycline drug prescribed at sub-antimicrobial levels for the treatment of inflammatory papules and pustules (bumps and pimples) of rosacea. It is available in 40mg extended release capsules and is taken once daily.

Learn more: Oral Doxycycline on GoodRx | Oracea

Topical Ivermectin
Topical ivermectin is an anti-inflammatory and antiparasitic medication for the treatment of inflammatory papules and pustules (bumps and pimples) of moderate to severe rosacea. It is available by prescription in a cream preparation in a 1% formulation, and is applied once a day.

Learn more: Topical Ivermectin on GoodRx | Soolantra

Oxymetazoline
Oxymetazoline hydrochloride is a topical alpha-adrenergic agonist medication for the treatment of persistent erythema (redness) in rosacea. It is available by prescription in a cream preparation in a 1% formulation, and is applied once daily or as needed. Duration of sustained effectiveness is 12 hours.

Learn more: Oxymetazoline on GoodRx | Rhofade

Topical Minocycline
Topical minocycline is a medication for the treatment of inflammatory papules and pustules (bumps and pimples) of rosacea. It is available by prescription in a foam preparation in a 1.5% formulation, and is applied once daily.

Learn more: Topical Minocycline on GoodRx

Topical Metronidazole
Topical metronidazole is a medication for the treatment of inflammatory papules and pustules (bumps and pimples) of rosacea. It is available by prescription in gel, cream, and lotion preparations of 0.75% formulations and in gel and cream preparations of 1% formulations, applied once or twice a day as directed by a physician.

Learn more: Topical Metronidazole on GoodRx

Sulfacetamide Sodium / Sulfur
Sulfacetamide sodium / sulfur is a topical medication used to treat rosacea as well as acne and seborrheic dermatitis. It is available in a variety of preparations, including creams, gels and cleansers, and at several dosages, but the most common is 10% sulfacetamide sodium / 5% sulfur. It is applied one to three times daily, as directed by a physician.

Learn more: Sulfacetamide Sodium / Sulfur on GoodRx

 

References:

1. Thiboutot D, Anderson R, Cook-Bolden F, et al. Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2020;82(6):1501–1510. doi:10.1016/j.jaad.2020.01.077

2. Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2018 Jan;78(1):148-155. doi: 10.1016/j.jaad.2017.08.037. Epub 2017 Oct 28.

 

Acknowledgment: This page was reviewed and edited by Dr. Yolanda Helfrich, associate professor of dermatology at the University of Michigan.