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Acne rosaceaDermatology

Acne Rosacea

Updated: 30th Oct 2023

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

·   Ophthalmology – Keratitis [urgent] Resistant ocular symptoms [routine]

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

·   Plastics – [severe rhinophyma]

Patient information sheet

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