Acne and Rosacea Charity Training Manual
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Treatment of <strong>Rosacea</strong><br />
Most clinical trials in rosacea have concentrated on the inflammatory lesions of rosacea, mainly ignoring the flushing <strong>and</strong><br />
facial redness. The only exceptions are Synchrorose (Rosacure) <strong>and</strong> topical bromonidine (marketed as Mirvaso gel).<br />
Treatment of type I rosacea<br />
The only medications licensed for the treatment of type I rosacea are Synchrorose (Rosacure) <strong>and</strong> topical bromonidine. A number of drugs are effective in<br />
controlling flushing but these are used off license.<br />
adrenergic agonists<br />
Systemic adrenergic agonists are very useful in controlling flushing <strong>and</strong> preventing fixed facial redness. Stimulation of the<br />
causes vasoconstriction.<br />
receptor on blood vessels<br />
Clonidine<br />
Start at 50mcg BD <strong>and</strong> slowly increase to 75mcg TDS. It is impossible to predict what dose an individual will need to control flushing so start at a low dose<br />
<strong>and</strong> slowly increase this. The maximal dose that I will use is 75mcg TDS after which I will add in a adrenergic blocker or other drugs – listed below.<br />
At higher doses, clonidine is used to treat hypertension. It works in rosacea by causing vasoconstriction. I have a high success rate with clonidine with<br />
about 60% of patients responding to it as monotherapy or in combination with other drugs.<br />
It can cause tiredness in some patients <strong>and</strong> may cause problems in patients with concurrent Raynaud’s phenomenon.<br />
Moxonidine<br />
Start at 200mcg OD <strong>and</strong> slowly increase to 200mcg TDS. This is a good alternative to clonidine <strong>and</strong> can be tried if the clonidine is not working or causes<br />
unacceptable side effects.
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