A Review of Prescription Rosacea Therapies
Although we still do not have a cure for rosacea and are still learning more about this common inflammatory skin disease, there are now a number of prescription therapies that can help to reduce and control its symptoms. Because there are several subtypes of rosacea and symptoms can vary depending on which type or types you have, the right prescription treatment for you will depend on your specific situation.
Of course, you should always talk with your doctor about your treatment options, but you can use this as a guide to help you understand more about the rosacea therapies that are now available.
Finacea (15% azelaic acid)
Finacea is a topical gel used to treat inflammatory papules and pustules (raised bumps) that form on the skin as a result of a type of rosacea called papulopustular or acne-like rosacea. Its active ingredient, azelaic acid, has been shown to possess strong anti-inflammatory properties and may also offer protection against free radicals. Recent studies have found that azelaic acid may also work by decreasing the expression of an enzyme called kallikrein 5 (KLK5) and a peptide called cathelicidin.
Azelaic acid tends to be well-tolerated and can be an effective solution for many people with rosacea.
Rhofade (1% oxymetazoline)
Rhofade is a vasoconstrictor, meaning it constricts the blood vessels that otherwise become dilated and “leaky,” causing redness. It is a vasoconstrictor for both alpha 1 and alpha 2 adrenergic agonist receptors, which helps to prevent a rebound or vasodilation.
This once-daily prescription cream helps to reduce redness caused by rosacea for up to 12 hours, but it does not address papules and pustules. Your doctor can help you decide if Rhofade might be a suitable option for you. If you tend to get red when exercising, your doctor might recommend applying Rhofade prior to your workout to help control redness.
Mirvaso (0.33% brimonidine)
Similar to Rhofade, Mirvaso is a topical gel that is applied directly to the skin to help reduce redness. It works as a vasoconstrictor for alpha 2 adrenergic agonist receptors, but may result in rebound or vasodilation because it does not affect alpha 1 receptors.
Other formulations of brimonidine, the active ingredient in Mirvaso, are used to treat glaucoma and ocular hypertension.
MetroGel (1% metronidazole)
MetroGel contains the a topical antibiotic metronidazole, which also has anti-inflammatory properties. It is used to help control red, inflamed bumps associated with rosacea.
Soolantra (1% ivermectin)
A topical anti-parasitic, Soolantra is used to kill Demodex mites on the skin that are believed to contribute to rosacea symptoms. Its active ingredient, ivermectin, is the same ingredient used to kill certain parasites in pets. Never use medications that are formulated for animals, however, because the concentration of active ingredients and dosage can widely vary, and formulations intended for animals are not tested on humans.
We continue to learn more and more about what causes and contributes to rosacea and how to treat it. While we still do not have a cure, there are many more treatment options now available than in years past. Work with your doctor to determine which prescription therapy would be best for you and to develop a rosacea-friendly skin care routine with your unique skin type in mind.
Wishing you great skin!
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