Prescription Creams for Rosacea
Topical treatments are generally the first line treatment for rosacea, however some patients with more severe rosacea may decide to go for a combination of topical and oral medication to gain control as quickly as possible.
How do metronidazole, azelaic acid, ivermectin work?
- Ivermectin (Soolantra): Has a dual mechanism. It is a potent anti-inflammatory and also targets Demodex mites, which are often found in higher numbers on rosacea-affected skin and are thought to contribute to the inflammatory response. In my experience, it is the most effective topical for inflammatory lesions.
- Azelaic Acid: This reduces inflammation, helps normalise skin cell turnover to prevent clogged pores, and reduces redness.
- Metronidazole: Primarily acts as an anti-inflammatory. It can be effective for papules and pustules but in my experience is less effective than topical ivermectin.
Expected timelines and side effects
Most topical treatments take time to work. You should expect to see initial improvements within 4-8 weeks, with full effects often taking 12 weeks of consistent daily use. Common initial side effects for all can include mild stinging, itching, or dryness, which usually subsides as the skin adapts. It is best to introduce them gradually, perhaps every other night, alongside a good moisturiser.
Related articles
Revessa Health
UK Online Specialist Care
The Online Acne & Rosacea Specialists
Video consultations with specially trained GPs and consultant dermatologists.
Founded by Dr Magnus Lynch, Consultant Dermatologist
GP consultation
£80
Consultant dermatologist
£220
