What is the best prescription cream for rosacea?

The “best“ prescription cream for rosacea would be effective in reducing symptoms, causing minimal side effects and result in a long-lasting or permanent improvement in symptoms. Unfortunately, no cream meets all these criteria and the best cream for any individual will vary depending on a combination of factors including clinical response and how well the medication is tolerated.

Prescription and non-prescription topical creams and ointments are an important part of rosacea treatment.

The most effective treatment for getting rid of veins on the face and persistent redness is laser or IPL treatment but other rosacea symptoms such as pimples and dry, sensitive skin respond well to topical treatments (i.e. creams and ointments).

Topical treatments commonly used in the treatment of rosacea include:

• Metronidazole: This is a topical antibiotic that can help reduce inflammation and kill bacteria on the skin. It is available in gel, cream, and lotion formulations. Metronidazole is typically used to treat mild to moderate rosacea and is effective in reducing redness and bumps. Metronidazole is generally well-tolerated, and side effects are minimal. It can be used long-term, and it does not cause resistance to develop.
• Ivermectin: This is a cream that works by reducing inflammation and killing mites on the skin. It is available in cream form and is often used to treat papulopustular (inflamed, pimple-like) rosacea. Ivermectin is effective in reducing bumps and inflammation. It can also improve the overall appearance of the skin. It is generally well-tolerated, although it may cause more irritation than metronidazole.
• Brimonidine: This is a topical vasoconstrictor that works by constricting blood vessels on the skin, which reduces redness. It is available in gel form and is often used to treat erythematotelangiectatic (red with spider veins) rosacea. Brimonidine is effective in reducing redness quickly and can provide almost immediate relief from symptoms. Effects usually last for a few hours only.
• Azelaic acid: This cream works by reducing inflammation and killing bacteria on the skin. It is available in gel or cream form and is often used to treat papulopustular rosacea. In Australia, it is available without a prescription

While these creams can be effective in treating rosacea, they may not work for everyone. It’s not unusual to have to try more than one product to get the best result – which takes weeks or months to achieve. Rosacea creams can irritate the skin and in some cases need to be discontinued. In these cases, rosacea and perioral dermatitis, a closely related condition, can also be treated with oral antibiotics.