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Suggest treatment for severe case of rosacea

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Practicing since :1980

Answered : 480 Questions

Posted on Wed, 4 Nov 2015 in Skin Hair and Nails
Question: I have had a severe case of Rosacea this year but it suddenly got better. Three times in the last 2 months I wake up with red, raised patches that itch. Right now my entire face is red except for my forehead but no raised areas. My dermatologist believes I have dermatitis caused by an allergy to something I come into contact with. My dermatologist gave me a shot of steroids earlier this week and for 3 days now I have been soaking my face in Domeboro several times a day and applying either Mometasone Furoate Cream.1% or Desoximetasone Ointment .05%, but it's not helping and my face is so red I've had to cancel business meetings this week. I have been asked to speak for 2 hours at the XXXXXXX Hospital Association's Society for Healthcare Strategy in DC next Tuesday and I'm frantic over how to get rid of this red face because if I cannot I will have to miss the most important opportunity to grow my market research business I have ever had. Could I have developed an allergy to my cat? I'm pretty much at the end of the rope on this thing. It's impacting my business and seriously disrupting my life. Any suggestions would be greatly appreciated.
Answered by Dr. VINAY KUMAR 5 hours later
Brief Answer:
Diagnosis determines the line of action

Detailed Answer:

Welcome to this site!
I am Dr V XXXXXXX I am a XXXXXXX Consultant Dermatologist.

I am concerned with your problem and would do my best to help you out.

First of all, I presume that the diagnosis is not in doubt. Rosacea is a condition with redness and other features of inflammation with tiny pimples and enlarged blood vessels on the central third of face with eye changes in some and brought on by triggers like foods, alcohol, etc.

The underlining theme of treatment should be to control flare ups and soothe the skin if it gets active lesions.This requires patience and hard work and quick solutions like use of steroids need to be kept out of consideration.

The active phase, as seems to be currently present, will resolve best following a strict avoidance of triggers along with following measures:

1 The steroids need to be tapered as their use is not recommended.

2 Frequent washing of face without soaps, face wash, disinfectants, cleansers will be your best help

3 Brimonidine gel is the latest and one of the most effective treatments for blanching redness. Others are Metronidazole and Azelaic Acid.

4 Orally an antibiotic like Minocycline can prove every effective

5 Identification and avoidance of triggers is good not only for the current phase but also for prevention of future episodes

6 In my experience, Isotretinoin is a highly effective drug for long term use in Rosacea and once you are free from current assignments, you might consider its use after proper evaluation.

I hope this helps you in maximizing benefit from suggestions. I want to request you to keep the option of steroids out of the way and use the standard treatments instead. One is tempted by their immediate action but ultimately that too does not measure up to expectations as you have observed.

It would be my pleasure to help you solve the issue at hand.

Best wishes, always!
Above answer was peer-reviewed by : Dr. Yogesh D

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