Is rosacea triggered by sunlight?
Rosacea: treating the skin with medication
For many rosacea patients it is sufficient to only treat the skin externally (topical rosacea therapy). However, if the skin disease is more severe, doctors use additional drugs that work throughout the body (systemic treatment).
The following rosacea drugs are approved for the treatment of the skin in Germany:
- Metronidazole: This active ingredient is an antibiotic that normally fights bacteria in a targeted manner. Metronidazole is currently the most commonly prescribed antibiotic for rosacea. It reduces skin redness, pustules (rosacea pustulosa) and papules (rosacea papulosa). How exactly the antibiotic works for rosacea is not yet known. Presumably, the drug slows inflammation and dampens the activity of the immune system. Metronidazole is available in two different dosages (0.75 and 1 percent) as a cream, gel, emulsion or ointment for rosacea
- Azelaic acid: The active ingredient azelaic acid in rosacea treatment probably also dampens inflammation and normalizes the keratinization process of the skin - the growth of the horny cells (keratinocytes) slows down. Overall, the drug is just as effective as metronidazole in the treatment of rosacea. However, research suggests that azelaic acid fights the papules and pustules a little better than metronidazole. Azelaic acid is available as a gel (15 percent)
- Brimonidine (actually a means for lowering intraocular pressure) has been approved in Europe for the treatment of rosacea since 2014. Brimonidine reduces skin redness and is available as a gel.
Other means of treating rosacea:
- Permethrin actually works against parasites such as mites or lice (antiparasitic). The cream with the active ingredient reduces papules and pustules in rosacea.
- Clindamycin: The antibiotic for rosacea reduces the number of papules, puffs, and lumps on the skin.
- Retinoids are descendants of vitamin A. These include the active ingredients adapalene, which slows down skin inflammation; Retinaldehyde, on the other hand, has a beneficial effect on the reddening of the skin and dilated blood vessels.
- Calcineurin inhibitors dampen the immune system. The active ingredients tacrolimus and pimecrolimus seem to work particularly well in the form of rosacea in which patients have taken glucocorticoids (cortisone) for too long (steroid-induced rosacea)
- Benzoyl peroxide is one of the most important remedies for acne. Benzoyl peroxide improves the complexion of rosacea patients with insensitive skin. However, the opposite is true for those with sensitive skin.
Although some active ingredients are not approved for the clinical picture of rosacea, doctors still use them in some cases ("off-label use"). One example is isotretinoin, a chemical derivative of vitamin A acid.
In addition to the active ingredients used, the preparation of the drugs (gel, ointment, cream, emulsion) also plays an important role in tolerability and effectiveness. Typically, people with rosacea have particularly sensitive skin. The condition of the skin determines which means doctors choose to treat rosacea.
One problem with rosacea is that in many cases it will flare up again when you stop treatment. That is why dermatologists recommend long-term therapy (maintenance therapy) in order to permanently improve the complexion. Mostly they use the active ingredient metronidazole for this.
Rosacea: treatment that works throughout the body
In severe forms of rosacea, local treatment of the skin is often not enough. The same applies to mild forms of rosacea, for which proven drugs are no longer sufficiently successful. Then doctors put pills that work throughout the body. Examples are:
- Tetracyclines - The active ingredients doxycycline and minocycline are found in antibiotics that dermatologists use most often for rosacea. Antibiotics are usually very effective at fighting bacteria of all kinds. In rosacea, however, antibiotics probably work differently: They slow down inflammation and dampen the immune system. Doxycycline appears to do better than minocycline for rosacea treatment in terms of effects and side effects. For the treatment of rosacea, in which papules and puffs have formed (papulopustular rosacea), doxycycline is the only approved drug (as capsules)
- Macrolides are also antibiotics and an alternative to tetracyclines if a patient cannot tolerate them, is pregnant or the agents no longer work adequately
- Isotretinoin works in severe forms of rosacea, but is not approved for them. The effect also sets in later than with treatment with antibiotics. Isotretinoin noticeably reduces papules, pustules, reddened skin and visible veins. Patients should not use the drug at the same time as tetracyclines. Pregnant women are also not allowed to take it because it can damage the unborn child.
- Glucocorticoids (e.g. cortisone) are only allowed for a short time in case of rosacea fulminans. In this form of rosacea, the clinical picture develops rapidly. Otherwise, glucocorticoids are not suitable for the treatment of rosacea because they can worsen the skin disease
If the rosacea is severe, doctors always combine drugs that work locally on the skin with drugs that work throughout the body.
Rosacea treatment with laser
Dermatologists also use laser treatment for rosacea therapy. It relieves reddening of the skin, makes enlarged veins disappear and refines the entire complexion. There are different laser techniques for the skin.
For example, the is effective against rosacea IPL laser. The abbreviation "IPL" stands for "Intense Pulsed Light". The laser emits controlled light pulses, welds the blood vessels together and obliterates them - this reduces the reddening of the skin. According to dermatologists, good cosmetic results can be achieved with IPL lasers, but also with other types of laser (color laser, diode laser).
A treatment only takes a few minutes and is almost painless. Patients report that the laser treatments felt like tiny needle pricks on the skin. Most are several sessions needed and there is a risk that the skin symptoms will return after a while.
Those who have rosacea treated with laser usually have to bear the costs themselves. Statutory health insurance companies usually do not pay for aesthetic therapies. Private health insurance companies have a better chance of assuming the costs. In any case, ask your insurance company beforehand. However, many see cosmetic treatments as a good investment in their wellbeing. Also discuss with your dermatologist how many sessions - depending on the severity - are necessary and how expensive the treatment will be overall.
Home remedies and homeopathy for rosacea
Dermatologists know some triggers that can promote rosacea. Sometimes they succeed in tracking these down in a patient individually. Avoiding risk factors is considered the best home remedy for rosacea. Spicy food, hot drinks or alcohol can "trigger" the skin disease. The rosacea also increases with stress. That is why everyday relaxation exercises are also a good home remedy for rosacea.
Because the skin is so sensitive in people with rosacea, proper skin care is very important. However, not every home remedy cares for the skin of every patient. So try out what is good for your skin. It is important that you do not irritate your already stressed skin any more. And: Home remedies alone are not a suitable meansto fight rosacea, but rather a good supplement!
More home remedies for rosacea
- Many swear by it Aloe vera in rosacea. The plant has calming and anti-inflammatory properties, moisturizes and promotes healing processes. Aloe vera soothes skin redness and irritation. For example, you can apply aloe vera to the skin as a cooling gel or take it as a juice
- Also chamomile has anti-inflammatory and soothing effects on the skin. Either apply chamomile as a cool compress on the skin or drink chamomile tea
- Apple Cider Vinegar slows inflammation and has a disinfectant effect. For rosacea, apply diluted apple cider vinegar to the skin or drink an apple cider vinegar solution diluted with water
Rosacea: Does Homeopathy Help?
Some also try to treat their rosacea with homeopathy. However, there is no specific homeopathic remedy for rosacea. Homeopaths know some globules that are supposed to improve the appearance of the skin and refine the complexion.
Even if the rosacea cannot be cured: There are many treatment options that can make your skin look significantly more beautiful!
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