Like sunlight, emotional stress can also trigger rosacea. People who develop infections of the eyelids must practice frequent eyelid hygiene. Managing pretrigger events such as prolonged exposure to cool environments can directly influence warm-room flushing. Medications
Medications with good evidence include topical ivermectin and azelaic acid creams and brimonidine, and doxycycline and isotretinoin by mouth. Lesser evidence supports topical metronidazole cream and tetracycline by mouth.Metronidazole is thought to act through anti-inflammatory mechanisms, while azelaic acid is thought to decrease cathelicidin production. Oral antibiotics of the tetracycline class such as doxycycline, minocycline, and oxytetracycline are also commonly used and thought to reduce papulopustular lesions through anti-inflammatory actions rather than through their antibacterial capabilities.Using alpha-hydroxy acid peels may help relieve redness caused by irritation, and reduce papules and pustules associated with rosacea. Oral antibiotics may help to relieve symptoms of ocular rosacea. If papules and pustules persist, then sometimes isotretinoin can be prescribed. The flushing and blushing that typically accompany rosacea are typically treated with the topical application of alpha agonists such as brimonidine and less commonly oxymetazoline or xylometazoline.A review found that ivermectin was more effective than alternatives for treatment of papulopustular acne rosacea. An ivermectin cream has been approved by the FDA, as well as in Europe, for the treatment of inflammatory lesions of rosacea. The treatment is based upon the hypothesis that parasitic mites of the genus Demodex play a role in rosacea. In a clinical study, ivermectin reduced lesions by 83% over 4 months, as compared to 74% under a metronidazole standard therapy.
Rosacea is a long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels. Often, the nose, cheeks, forehead, and chin are most involved. A red, enlarged nose may occur in severe disease, a condition known as rhinophyma.The cause of rosacea is unknown. Risk factors are believed to include a family history of the condition. Factors that may potentially worsen the condition include heat, exercise, sunlight, cold, spicy food, alcohol, menopause, psychological stress, or steroid cream on the face. Diagnosis is based on symptoms.While not curable, treatment usually improves symptoms. Treatment is typically with metronidazole, doxycycline,  minocycline, or tetracycline. When the eyes are affected, azithromycin eye drops may help. Other treatments with tentative benefit include brimonidine cream, ivermectin cream, and isotretinoin. Dermabrasion or laser surgery may also be used. The use of sunscreen is typically recommended.Rosacea affects between 1% and 10% of people. Those affected are most often 30 to 50 years old and female. People with paler skin or European ancestry are more frequently affected. The condition was described in The Canterbury Tales in the 1300s, and possibly as early as the 200s BC by Theocritus. Signs and symptoms
Rosacea typically begins with reddening of the skin in symmetrical patches near the center of the face. Common signs can depend on age and sex: flushing and red swollen patches are common in the young, small and visible dilated blood vessels in older individuals, and swelling of the nose is common in men.