No specific test is used to diagnosis rosacea. Instead, your doctor relies on the history of your symptoms and an examination of your skin. You may have tests to rule out other conditions, such as psoriasis or lupus. Studies show that in people of color, rosacea can be missed or misdiagnosed as an allergic reaction or seborrheic dermatitis.
If your symptoms involve your eyes, your doctor may refer you to an eye specialist (ophthalmologist) for evaluation.
Treatment for rosacea focuses on controlling signs and symptoms. Most often this requires a combination of good skin care and prescription drugs.
The duration of your treatment depends on the type and severity of your signs and symptoms. Recurrence is common.
Medications
New rosacea medications have been developed in recent years. The type of medication your doctor prescribes depends on which signs and symptoms you're experiencing. You may need to try different options or a combination of drugs to find a treatment that works for you.
Prescription drugs for rosacea include:
Topical drugs that reduce flushing. For mild to moderate rosacea, your doctor may prescribe a cream or gel that you apply to the affected skin. Brimonidine (Mirvaso) and oxymetazoline (Rhofade) reduce flushing by constricting blood vessels. You may see results within 12 hours after use. The effect on the blood vessels is temporary, so the medication needs to be applied regularly to maintain improvements.
Other topical products help control the pimples of mild rosacea. These drugs include azelaic acid (Azelex, Finacea), metronidazole (Metrogel, Noritate, others) and ivermectin (Soolantra). With azelaic acid and metronidazole, noticeable improvements generally don't appear for two to six weeks. Ivermectin may take even longer to improve skin, but it results in a longer remission than does metronidazole.
Oral antibiotics. Your doctor may prescribe an oral antibiotic such as doxycycline (Oracea, others) for moderate to severe rosacea with bumps and pimples.
Oral acne drug. If you have severe rosacea that doesn't respond to other therapies, your doctor may suggest isotretinoin (Amnesteem, Claravis, others). It's a powerful oral acne drug that also helps clear up acnelike lesions of rosacea. Don't use this drug during pregnancy as it can cause serious birth defects.
