Understanding Rosacea · Chapter 9
Topical Treatments for Rosacea
For many people, a prescription cream or gel is the first medical treatment for rosacea. This chapter explains how each works and how they compare.
What is the best cream for rosacea?
For spots and pustules, ivermectin 1% cream (Soolantra) has the strongest evidence and was more effective than metronidazole in a large head-to-head trial. Azelaic acid and metronidazole are well-established alternatives.
How long do rosacea creams take to work?
Most topical treatments take 8 to 12 weeks of consistent use to show their full benefit, so give each one a fair trial before judging it.
Is there a cream for rosacea redness?
Brimonidine gel (Mirvaso) narrows the small blood vessels and reduces redness within about 30 minutes, lasting up to about 12 hours. It treats redness rather than the underlying inflammation, and some people notice rebound redness.
Which rosacea cream is safe in pregnancy?
Azelaic acid is one of the few topical rosacea treatments considered low risk in pregnancy. Always discuss treatment with your doctor if you are pregnant or planning a pregnancy.
Key takeaways
- Ivermectin is the best-supported cream for papulopustular rosacea.
- Most creams need 8 to 12 weeks.
- Brimonidine targets redness but does not modify the disease.
- Good skincare is part of treatment.
This page summarises Chapter 9 of Understanding Rosacea: Your Complete Guide. The full chapter, with references, is in the free PDF.
Download the free 108-page Rosacea Guide (PDF) →
Written and medically reviewed by Professor Vishal Madan, MBBS (Hons), MD, FRCP, MBA, Consultant Dermatologist, Laser and Dermatological Surgeon (GMC 6036936).
Last reviewed:
This page provides general information about rosacea and is not a substitute for personal medical advice. Please discuss your symptoms and treatment with a qualified healthcare professional.