Most cases of rosacea can be controlled with oral and long-term topical antibiotics, combined with avoiding lifestyle and environmental factors that may aggravate the disorder in individual cases. In certain patients, however, dermatologists may prescribe additional medication to prevent flushing and reduce severe redness that may not be well-controlled by other means.1
Widely considered a vascular disorder, rosacea seems to appear most frequently in individuals who flush or blush easily, and a telltale sign of rosacea is flushing or blushing that lasts longer than usual.
"The long-lasting redness itself can be unsightly, and the flushing is sometimes difficult to manage with standard therapy," said Dr. Larry Millikan, chairman of dermatology, Tulane University School of Medicine.
He noted, for example, that while some female patients may be able to avoid most lifestyle and environmental factors that trigger redness, some may suffer from severe flushing prompted by menopausal hot flashes or other conditions. In these cases, a centrally-acting alpha-2 agonist such as clonidine or beta-blockers such as propranolol and nadolol may be prescribed.
Dr. Millikan also pointed out that small visible blood vessels that were present all along may suddenly become noticeable once the redness goes away. These can be successfully treated with laser therapy.
Singer MI: Drug therapy of rosacea: A problem-directed approach. Journal of Cutaneous Medical Surgery. 1998;2(suppl 4):20-23.