You've been following your doctor's orders for prescribed medical therapy and have made lifestyle changes to avoid trigger factors -- and you look terrific. Then you stop using the therapy and go back to a carefree lifestyle. And your rosacea returns with a vengeance.

"Rosacea is often characterized by remissions and flare-ups," said Dr. Diane Thiboutot, professor of dermatology, Pennsylvania State University. "Patients must remember that the key to successfully managing their condition is to comply with medical therapy and lifestyle changes on a long-term basis, even when the signs and symptoms seem to have cleared up."

Studies have found that patients who continued to use medical therapy were substantially less likely to experience a recurrence of symptoms. In a clinical study of rosacea patients over a six-month period, 77 percent of those who maintained long-term topical therapy remained in remission, compared with only 58 percent of those who stopped therapy during the same period.¹

The importance of maintaining medical therapy was also underscored by the results of a National Rosacea Society (NRS) survey of more than 1,000 patients, in which 74 percent of the respondents said their condition worsened if they failed to use medication as prescribed by their doctor. Of those using medication as directed, more than 90 percent reported it had reduced their symptoms.

Many patients find that including topical therapy in a daily facial care routine not only helps to prevent flare-ups but also provides a refuge of calm during a hectic or busy day.

A soothing regimen to avoid the irritation of sensitive facial skin starts with a gentle soap or water-based cleanser that is not grainy or abrasive. It should be spread with the fingertips rather than a rough washcloth. Rinse with lukewarm water, and use a thick, soft towel to blot the face dry.

Let your face thoroughly air dry and rest for a few minutes before applying medication. Although it is preferable not to apply anything after medication, if it is essential, wait at least 20 minutes before applying a moisturizer or makeup.

In addition to complying with medical treatment on a long-term basis, rosacea patients are advised to identify and then avoid environmental and lifestyle factors that may aggravate their individual conditions. According to an NRS survey, the most common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, heavy exercise, alcohol consumption, spicy foods, humidity, certain skin-care products and indoor heat.

In NRS surveys of rosacea patients who identified and avoided their personal rosacea triggers, more than 90 percent reported that their condition had improved.

"Rosacea is a chronic condition that requires special care regardless of whether signs and symptoms may be present at the moment," Dr. Thiboutot said. "Preventive measures, including maintenance therapy and lifestyle changes, play a central role in the successful management of this condition."

Associated Reference

1. Dahl MV, Katz HI, Krueger GG, et al. Topical metronidazole maintains remission of rosacea. Archives of Dermatology. 1998;134:679-683.