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    Suggest treatment for adult acne with rosacea

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Posted on Wed, 2 Jul 2014 in Skin Hair and Nails
Question: I have mild to moderate, adult acne on the chin and cheeks (some cystic, some not), coupled with rosacea. Visited a doctor last August. He prescribed doxycycline, which I did not tolerate well. I have since used bezoyl-peroxide 5% on the acne (but not the rosacea), with limited success. I have had a recent acne flare-up, and I will see a dematologist here in Canada but wanted your opinion about non-oral antibiotic treatment options.

My questions: what specific retinoids and / or topical antibiotics should I try? What other topical medications would you recommend? Does phototherapy with blue light work? Thank you.
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Answered by Dr. Kakkar S. 5 hours later
Brief Answer:
Acne Rosacea

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your concern and I have understood it.

Available medical treatment options for rosacea include:

-Topical antibacterial and antiinflammatory gels (clindamycin phosphate 1% gel, clarithromycin gel, benzoyl peroxide 2.5% gel),
-Topical retinoids like Azaleic acid, Adapalene, Tretinoin etc
-Antibiotic pills (Doxycycline, Azithromycin, Roxithromycin),
-Lasers ( 584 nm Pulse XXXXXXX Laser)
-Oral isotretinoin
-Pulsed light therapies (Intense pulsed light 585 nm)
-photodynamic therapy.

I would suggest Oral Retinoids e.g Isotretinoin for you in a dose of 20 mg once daily for 6-8 months.

Topically you could use either Benzoyl peroxide gel or Clindamycin phosphate gel. Benzoyl peroxide can cause some irritation, since you also have rosacea. Therefore I would suggest topical clindamycin phosphate gel 1% in your case for active acne.

Orally you could take either Roxithroimycin 150 mg twice daily OR Azithromycin 500mg three days consecutively in a week. They can be continued for a few weeks.

Doxycycline cannot be given along with Oral retinoids (Isotretinoin) because when given together they can cause Pseudotumor cerebri.

Rosacea is complex condition and for Vascular rosacea, IPL(Intense pulsed light) works best.

Blue light phototherapy using a narrowband LED light source is a safe and effective additional therapy for mild to moderate acne. It can be safely combined with other topical and oral therapies.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8967 Questions

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