Acne Rosacea

Last modified date

Mild to moderate [few papules or pustules and mild to moderate persistent erythema]

Metronidazole gel 0.75% OD or Metronidazole cream 1% OD – [Apply DAILY as directed – Come for review in 2 months]

Intolerant/not responding Azelaic acid 15% gel BD [Apply DAILY as directed – May cause a mild burning or stinging sensation, but will improve in 1-2weeks – come for review in 2 months]

Severe or or no response to above

Oxytetracycline 500mg BD (112, 250mg) [Take two tablets twice a day – Come for review in 2 months] or (if pregnant, reaction to sunlight…) Erythromycin 500mg BD (112, 250mg) [Take two tablets twice a day – Come for a review in 2 months]

Review ever 2m

Full 1-3m full dose

Wean off over 2-6m

1/2 dose – 1/4 dose reduction every month

Topical on alternate days

Occular symptoms

Mild – [Eyelid hygine] [Lubricants] [Oxytetracycline]

Urgent – Keratitis

Routine – Resistant to maximal Rx

Referral

Opthalmology – Keritits [urgent] Resistant ocular symptoms [routine]

Dermatology – [psychosocial distres] [no response over 12w papulopustular] [Uncertain diagnosis]

Plastics – [severe rhinophyma]

Patient information sheet

http://www.patient.co.uk/health/Rosacea.htm