Rosacea Treatment Online

About rosacea

Rosacea is a chronic skin condition that causes redness, flushing, and sometimes bumps or pustules on the face, most often the cheeks, nose, chin, and forehead. It can also affect the eyes (ocular rosacea). Rosacea tends to flare and settle over time.

While the exact cause is not fully understood, triggers and skincare approaches are key parts of management. Treatment options include topical and oral medications.

How a telehealth GP can help

A NewDoc GP can assess your skin via video, discuss triggers and skincare, prescribe topical or oral treatments where appropriate, and refer you to a dermatologist for complex or persistent rosacea.

Risk factors for rosacea

Rosacea most commonly affects adults between 30 and 60 and is more frequently seen in people with fair skin, although it can affect any skin type. A family history of rosacea may increase your likelihood of developing it. Women are more often affected, although men can experience more severe forms, particularly thickening of the nose (phymatous rosacea).

Environmental and lifestyle factors can influence flares. Chronic sun exposure, spicy foods, hot drinks, alcohol (particularly red wine), extreme temperatures, and stress are commonly reported triggers. Certain skincare products and topical steroids can also worsen symptoms.

Rosacea medications: topical and oral treatments

Treatment is tailored to the rosacea subtype (erythematotelangiectatic, papulopustular, phymatous, ocular) and severity. Australian Therapeutic Guidelines (eTG) and the Australasian College of Dermatologists recommend a stepped approach with topical therapy first-line and oral antibiotics added for moderate-to-severe inflammatory rosacea.

Topical treatments — first-line for papulopustular rosacea

• Ivermectin 1% cream (Soolantra) — first-line topical for papulopustular rosacea; works against Demodex mites and inflammation; once-daily; PBS-listed
• Metronidazole 0.75% gel or cream (Rozex, Metrogel) — established anti-inflammatory topical; can be used long-term as maintenance
• Azelaic acid 15% gel (Skinoren) — alternative for inflammatory lesions and post-inflammatory pigmentation; twice-daily
• Brimonidine 0.33% gel (Mirvaso) — alpha-2 adrenergic for persistent redness; 12-hour effect; some patients experience rebound erythema, so a test patch is sensible

Oral antibiotics — for moderate-to-severe papulopustular rosacea

• Doxycycline 50 mg daily (Doryx, Vibramycin) — the low-dose anti-inflammatory regimen used in Australia; preferred for long courses (a dedicated 40 mg sub-antimicrobial modified-release formulation has no widely-available branded equivalent in Australia, so the standard 50 mg capsule once daily is typically used as the equivalent low-dose option)
• Doxycycline 100 mg daily — used short-term where higher anti-inflammatory effect is needed, then stepped down
• Erythromycin 250–500 mg daily — alternative oral antibiotic in pregnancy (where doxycycline is contraindicated) or in doxycycline intolerance

Oral antibiotics are usually combined with a topical, then continued for 8–12 weeks before review. A topical alone is typically continued as maintenance once the oral course is finished.

Refractory rosacea and dermatologist-led options

• Low-dose oral isotretinoin — specialist-prescribed by a dermatologist for refractory papulopustular rosacea; requires pregnancy precautions and monitoring
• Vascular laser or intense pulsed light (IPL) — for persistent erythema and visible blood vessels (telangiectasia); typically 2–4 treatment sessions
• Laser or surgical reduction for rhinophyma (phymatous rosacea)

For more severe or phymatous rosacea, or for ocular rosacea not responding to initial care, your GP can arrange a dermatologist referral.

Gentle skincare is a cornerstone of management. Use fragrance-free, non-soap cleansers (such as CeraVe or Cetaphil), a ceramide-based moisturiser to support the skin barrier, and broad-spectrum SPF50+ sunscreen daily — mineral filters (zinc oxide, titanium dioxide) are often better tolerated than chemical filters.

When to see a specialist about rosacea

A GP can manage most mild to moderate rosacea. A dermatologist referral is usually appropriate for persistent or severe rosacea, for phymatous changes (particularly of the nose), or where the diagnosis is uncertain. Dermatologists can also consider specialist treatments such as laser therapy for persistent redness or visible vessels.

Ocular rosacea, which may cause gritty, itchy, or inflamed eyes, may warrant review by an ophthalmologist if symptoms are persistent or affecting vision. Your GP can issue the referral and coordinate shared care.

Tips for managing rosacea

Keeping a short trigger diary for two to four weeks can help you identify which factors worsen your symptoms. Noting foods, drinks, weather, stress levels, and skincare products alongside flare-ups may reveal patterns that can be addressed.

Sun protection is particularly important. Wearing a broad-brimmed hat outdoors, using broad-spectrum SPF50+ daily, and seeking shade during peak UV hours may help reduce flares. Choose mineral sunscreens if chemical filters cause irritation.

Simplify your skincare routine to minimise irritation. Avoid abrasive scrubs, astringents, and products containing alcohol or menthol. If makeup is irritating your skin, a gentle primer and mineral-based foundation may be better tolerated. Your GP can review your routine and provide guidance.