Depending on your symptoms, your doctor may prescribe the following:
Antibiotics — Topical metronidazole cream or gel (MetroCream, MetroGel) is the most frequently prescribed first-line therapy. Other topical antibiotics also may be effective. Tetracycline and tetracycline derivatives, such as doxycycline, are prescription drugs taken by mouth once or twice per day. They are sold under several brand names. Improvement is usually noticeable within the first two months after beginning treatment.
Azelaic acid (Finacea) — The U.S. Food and Drug Administration (FDA) approved this drug in January 2003 for topical (applied to the skin) use. It is a gel containing dicarboxylic acid and is used for the inflammatory pimples of mild to moderate rosacea.
Beta-blockers and alpha antagonists — These medications may reduce flushing through their effect on blood vessels. Propranolol (Inderal) and nadolol (Corgard) are beta-blockers, and clonidine (Catapres) is an alpha antagonist. The use of these drugs for rosacea is off-label, meaning that the FDA has not approved their use for rosacea. Beta-blockers usually are used to treat high blood pressure and heart disease. Clonidine was developed to treat high blood pressure, but also is used to decrease hot flashes in menopause.
Estrogen — This female hormone is used when rosacea is aggravated by the hot flashes of menopause. The smallest dose of estrogen that controls menopausal symptoms should be used, then the hormone should be stopped when hot flashes no longer occur.
Laser treatment — This is used to get rid of dilated blood vessels or to remove excess nose tissue.
Surgical procedures — Surgical shave techniques or dermabrasion can also be helpful in removing excess nose tissue in rhinophyma.