Rosacea is a chronic inflammatory skin condition causing persistent facial redness, flushing, visible blood vessels, and sometimes acne-like breakouts. It affects an estimated 16 million Americans and is frequently undertreated. At Belaray Dermatology (Hicksville and Stony Brook, Long Island), our board-certified dermatologists create individualized management plans to control symptoms, reduce flares, and address visible vascular changes.
Types of Rosacea
- Erythematotelangiectatic (ETR) — flushing, persistent redness, visible broken capillaries
- Papulopustular — redness plus inflammatory breakouts resembling acne
- Phymatous — skin thickening, most often on the nose (rhinophyma)
- Ocular rosacea — eye irritation, dryness, and lid inflammation
Treatment Options
Prescription Topicals
- Metronidazole gel/cream — reduces inflammation and redness
- Azelaic acid — anti-inflammatory, mild brightening for post-inflammatory redness
- Ivermectin 1% cream (Soolantra) — targets Demodex mites, a contributing factor in papulopustular rosacea
- Brimonidine (Mirvaso) / Oxymetazoline (Rhofade) — topical vasoconstrictors for transient redness reduction
Oral Medications
- Low-dose doxycycline (Oracea) — anti-inflammatory dosing; reduces papulopustular flares without antibiotic side effects
- Standard oral doxycycline — for more severe papulopustular disease
- Low-dose isotretinoin — used for phymatous and severe refractory rosacea
Laser and Light Treatments
- KTP vascular laser — the most effective treatment for permanently reducing visible telangiectasias and broken capillaries
- IPL/BBL (Sciton Joule) — broad-spectrum light for diffuse facial redness and photodamage in rosacea patients
- Multiple sessions typically needed; results are long-lasting with proper trigger management
Our BBL/IPL photofacial guide explains in more detail how broadband light treats facial redness. Patients whose breakouts turn out to be acne rather than rosacea can review our acne treatment options.
Rosacea Triggers
Identifying and avoiding personal triggers is a key part of long-term rosacea control. Common triggers include:
- Sun exposure — the most consistent trigger; daily broad-spectrum SPF 30+ is essential
- Heat (hot beverages, hot showers, saunas, intense exercise)
- Alcohol, especially red wine
- Spicy foods
- Emotional stress
- Certain skincare ingredients (alcohol, fragrance, harsh exfoliants)
- Cold wind and temperature extremes
Frequently Asked Questions
Can rosacea be cured?
Rosacea cannot be permanently cured, but it can be effectively controlled. Most patients achieve dramatic improvement with prescription therapy and laser treatment, with flares managed through trigger avoidance and ongoing skincare.
Is rosacea covered by insurance?
Office visits and prescription medications for rosacea are covered by most insurance plans. Vascular laser and IPL treatments are typically considered cosmetic and are not covered.
Does rosacea get worse over time if untreated?
In many patients, yes — particularly phymatous rosacea, which causes progressive skin thickening that is harder to treat over time. Early intervention with proven therapies slows progression and prevents permanent vascular changes.
How is rosacea different from acne?
Rosacea lacks comedones (blackheads/whiteheads), predominantly affects the central face and nose, and does not respond to acne-specific treatments like benzoyl peroxide — which can worsen rosacea. A dermatologist can distinguish the two at an office visit.
Schedule at Belaray Dermatology
Hicksville and Stony Brook, Long Island. Most major insurance accepted.
📅 Book Online 💬 Text (516) 822-7546Medical References
Belaray Dermatology education articles are written by our clinical team and medically reviewed by our physicians. This article draws on guidance from the following authoritative sources:
- National Rosacea Society — Rosacea triggers and management.
- American Academy of Dermatology — Rosacea signs and treatment.