Key takeaways:
Rosacea is a common skin condition that causes redness, burning, and pimple-like spots on your face.
Rosacea treatment is based on the type of symptoms you have. Options include different medications (like pills and rosacea creams) and laser therapy.
Over-the-counter medications like creams and gels can be a great and cost-effective option for treating rosacea symptoms.
Rosacea is a common skin condition that usually starts with facial flushing or blushing. It can lead to permanent skin redness, burning, and pimple-like spots. It’s more common in women and those with fair skin, but it can affect people of all ages and skin types and tones.
The best medication and treatment for rosacea depends on what type of symptoms you have. Creams, pills, and lasers are all effective at treating certain symptoms, from redness and flushing to rosacea pimples. Rosacea creams and gels are usually used as the first treatment, and, for most people, they’re enough to keep symptoms under control. You can find some topical treatments over the counter (OTC), while others are available by prescription only.
For other people, combining topical treatments with oral antibiotics or lasers may be needed (more on those below).
OTC treatments: Rosacea creams and gels
Some OTC creams can also treat different rosacea symptoms and improve overall skin health. No matter what products you use, it’s important to avoid ones that will irritate your skin and worsen rosacea symptoms.
Here are some ingredients to look for in your OTC rosacea creams and products:
Ceramides: Lipids (fat molecules) that help your skin stay moisturized and healthy
Hyaluronic acid: A sugar found naturally in your skin that helps it stay hydrated
Niacinamide: A form of vitamin B3 that helps lower inflammation and redness
Mineral sunscreens: Sunscreens that contain only zinc oxide or titanium dioxide (or both)
Azelaic acid: Topical antiseptic found in both prescription and OTC options
Sodium sulfacetamide / sulfur: Antibiotic found in both prescription and OTC options
Prescription rosacea creams and gels
There are several prescription creams and gels that are FDA approved to treat rosacea symptoms. These can help reduce redness and flushing, or treat pimples associated with rosacea. Some people may benefit from using a combination of different prescription creams and gels.
Metronidazole (Metrogel): This is an antibiotic that helps reduce skin inflammation. Metrogel is available in a cream, gel, or lotion. It’s often a first-choice medication for rosacea because it tends to cost less than other treatments.
Sodium sulfacetamide / sulfur: This is an antibiotic that helps lower skin inflammation. Sodium sulfacetamide / sulfur comes in different strength creams, gels, and cleansers. Some insurances may cover this.
Minocycline (Zilxi): This is an antibiotic foam that helps reduce skin inflammation. Insurance companies may be less likely to cover Zilxi.
Brimonidine (Mirvaso) and oxymetazoline (Rhofade): These medications reduce redness and flushing by narrowing (constricting) small blood vessels and lowering blood flow. They work well, but access can be an issue. Your prescriber may need to submit a coverage appeal to your insurer to get coverage for brimonidine and Rhofade.
Azelaic acid (Azelex and Finacea): Azelex and Finacea (both azelaic acid) also help lower skin inflammation and the number of rosacea pimples, but they’re often not covered by insurance.
Ivermectin (Soolantra): This is an antiparasite medication that, when used as a cream, helps lower inflammation and kills demodex mites. Soolantra is also rarely covered by insurance.
Benzoyl peroxide (Epsolay): Unlike other benzoyl peroxide creams, Epsolay is formulated not to cause skin irritation. It works by killing bacteria and gently exfoliating the skin. Some insurances may cover this.
Oral treatments for rosacea
Some people with rosacea pimples need more than rosacea creams and other topical treatments to treat their symptoms. Adding a short course of low-dose antibiotic pills can help improve symptoms quickly. Commonly used antibiotics include:
Doxycycline (Oracea)
Minocycline (Minocin)
Tetracycline (Sumycin)
Dealing with rosacea: Read about how three women managed their rosacea symptoms and reduced their facial redness.
Facial flushing: From rosacea to menopause, learn the top reasons your face gets red.
Acne vs. rosacea: Learn how to tell the difference between these two common skin conditions.
Laser treatment for rosacea
Laser treatments can be an effective treatment for certain symptoms caused by rosacea, like visible blood vessels or thickened skin. Lasers are usually combined with other types of treatment. Here are some common types of lasers used for rosacea:
Vascular laser (pulsed-dye laser): This targets small blood vessels in the skin, and helps reduce redness and broken capillaries. Because it’s so effective, the vascular laser is usually the first-choice laser treatment for rosacea.
Intense pulsed light (IPL): This isn’t technically a laser, but rather it uses multiple wavelengths of light to reduce background skin redness caused by rosacea.
Nd:YAG: This laser can also treat blood vessels and redness, but it has a higher risk of scarring.
Carbon dioxide (CO2): This laser is used to resurface bumps or thickened skin caused by rosacea.
While they’re worth pursuing, laser treatments can be expensive since they’re not covered by insurance, and multiple sessions may be needed.
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How to get rid of rosacea permanently
There’s no way to get rid of rosacea permanently. However, using the right treatment regimen can make your skin look and feel better, and keep flares under control. It’s also important to practice good skin care, wear sunscreen daily, and avoid your known triggers.
Frequently asked questions
There are many different rosacea triggers, and they vary from person to person. Some common ones include:
Hot environments
Spicy foods
Stress and anxiety
This list of rosacea triggers can help you identify what may be affecting your rosacea.
Some small studies suggest that vitamin B deficiency may be linked to rosacea. However, in some people, certain types of vitamin B can also trigger rosacea (see below). So, more research needs to be done. Taking too many supplements can be harmful, so talk with a healthcare professional before starting anything new.
While no medication causes rosacea, several can worsen or trigger rosacea symptoms. Here are some common ones to watch out for:
Vasodilators, like hydralazine
Niacin (also called nicotinic acid or vitamin B3)
Most insurance companies cover at least some prescription rosacea medications. However, they don’t usually cover laser treatments. Your healthcare team can help you find a cost-effective treatment that works for you.
Yes, laser treatment for rosacea is generally FSA eligible if your doctor says it’s a medically necessary treatment. You’ll need to get a Letter of Medical Necessity from your healthcare team and check with your specific FSA plan.
There are many different rosacea triggers, and they vary from person to person. Some common ones include:
Hot environments
Spicy foods
Stress and anxiety
This list of rosacea triggers can help you identify what may be affecting your rosacea.
Some small studies suggest that vitamin B deficiency may be linked to rosacea. However, in some people, certain types of vitamin B can also trigger rosacea (see below). So, more research needs to be done. Taking too many supplements can be harmful, so talk with a healthcare professional before starting anything new.
While no medication causes rosacea, several can worsen or trigger rosacea symptoms. Here are some common ones to watch out for:
Vasodilators, like hydralazine
Niacin (also called nicotinic acid or vitamin B3)
Most insurance companies cover at least some prescription rosacea medications. However, they don’t usually cover laser treatments. Your healthcare team can help you find a cost-effective treatment that works for you.
Yes, laser treatment for rosacea is generally FSA eligible if your doctor says it’s a medically necessary treatment. You’ll need to get a Letter of Medical Necessity from your healthcare team and check with your specific FSA plan.
The bottom line
Rosacea is a chronic skin condition that causes redness, burning, and pimple-like spots on your face. There are many different rosacea treatments, and the best one depends on the type of symptoms you have. For most people, rosacea creams and gels are all that’s needed to manage symptoms. These are available OTC or by prescription. Other people may need combination therapy, with oral antibiotics or lasers in addition to topical treatments.
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References
Algarin, Y. A., et al. (2024). The role of vitamins and nutrients in rosacea. Archives of Dermatological Research.
Alia, E., et al. (2022). Rosacea pathogenesis, common triggers, and dietary role: The cause, the trigger, and the positive effects of different foods. Clinics in Dermatology.
American Academy of Dermatology Association. (2023). People with darker skin tones can get rosacea.
American Academy of Dermatology Association. (n.d.). Lasers and lights: How well do they treat rosacea?
Baldwin, H., et al. (2021). Evidence of barrier deficiency in rosacea and the importance of integrating OTC skincare products into treatment regimens. Journal of Drugs in Dermatology.
Baylor College of Medicine. (n.d.). Laser treatment with pulsed dye laser.
LaRosa, C., et al. (2017). Laser treatment of medical skin disease in women. International Journal of Women's Dermatology.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2024). Rosacea: Diagnosis, treatment, and steps to take. National Institutes of Health.
National Rosacea Society. (2023). Survey shows insurance covers rosacea medication, but not laser treatments.
National Rosacea Society. (n.d.). Factors that may trigger rosacea flare-ups.
National Rosacea Society. (n.d.). FDA approved treatments for rosacea.
Sharma, A., et al. (2022). Rosacea management: A comprehensive review. Journal of Cosmetic Dermatology.
