Although flushing may be the most difficult component of rosacea to treat, it can be controlled with a variety of options that must be tailored to each individual -- including medications for severe cases -- according to physicians now developing standard disease management options as part of a consensus committee organized by the National Rosacea Society (NRS).

Rosacea often casts a negative spell on quality of life and emotional well-being that is in direct proportion to its physical effects, according to a new survey by the National Rosacea Society. Fortunately, most rosacea patients reported they are able to overcome these drawbacks through effective medical therapy and coping techniques.

Q. If I take long-term medication consistently, will it lose its effectiveness?

A. Topical therapy is commonly prescribed to control rosacea on a long-term basis, and no evidence has suggested that it loses effectiveness. A long-term controlled clinical study found that 77 percent of rosacea patients consistently using topical metronidazole remained in remission, while 42 percent of patients using no therapy had relapsed within six months.

Most cases of rosacea can be controlled with oral and long-term topical antibiotics, combined with avoiding lifestyle and environmental factors that may aggravate the disorder in individual cases. In certain patients, however, dermatologists may prescribe additional medication to prevent flushing and reduce severe redness that may not be well-controlled by other means.¹

At a symposium during a recent meeting of the American Academy of Dermatology, Dr. Mark V. Dahl, chairman of Dermatology, University of Minnesota, noted that to ensure the effectiveness of topical antibiotic therapy for rosacea, patients must spread the medication over the entire face.

"Some patients may apply topical therapy to individual papules and pustules, much as they may have treated acne when they were younger," said Dr. Dahl. "It is important to use this medication over the entire face as a preventive measure for it to be useful."

Q. I am using a topical antibiotic to control my rosacea with great success. Should I suspend treatment for a couple of weeks to prevent developing a resistance to the medication?

When dealing with rosacea, experts agree that a strong offense is usually a patient's best defense. According to research, rosacea sufferers who diligently follow long-term medical therapy substantially reduce their chances of a relapse.

To treat rosacea, dermatologists often initially prescribe oral antibiotic tablets to bring the condition under immediate control. However, taking more than one oral medication for different conditions may produce an adverse reaction, according to Dr. H. Irving Katz, professor of dermatology at the University of Minnesota, speaking at a recent meeting of the American Academy of Dermatology.

Complying with long-term medical therapy may appear to be a demanding commitment. However, many rosacea patients have found that incorporating topical therapy into a twice-daily facial care routine is a painless and efficient way to comply with doctor's orders.¹ In fact, the soothing regimen necessary to avoid irritating the facial skin or causing flushing can be a refuge of calm during a busy day.

In a recent National Rosacea Society survey of more than 1,022 rosacea sufferers on compliance with medical therapy, 74 percent said their condition worsened if they failed to take their medication as directed by their physicians.

More than half of the respondents said a flare-up eventually occurred if they did not use medication as prescribed, and 28 percent said their symptoms became more severe. Only 4 percent said their symptoms stayed under control without proper use of medical therapy.