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Rosacea Decision Aid

  • 1. Introduction

    Learn more about rosacea.

  • 2. My Rosacea

    Learn about your rosacea.

  • 3. My Options

    Read about available treatments.

  • 4. My Values

    Express what is important to you.

  • 5. My Trade-offs

    Compare treatments with your values.

  • 6. My Decision

    Your results and next steps.

  • 7. My Resources

    Learn more about rosacea.

My Options

Some treatment options may not be available in certain countries.

You indicated you had the following symptoms. We ordered them based on severity/impact.

  • Abnormal Skin Sensations+
    Gentle skin care and sun protection is routinely recommended by dermatologists. The skin barrier is altered in rosacea and is unable to retain usual amounts of moisture. Gentle cleansers using synthetic detergents instead of regular soap (which can dry and stress the skin) and use of barrier repair moisturizers can improve symptoms of stinging and burning.
  • Ongoing (persistent) Facial Redness+

    Select the options you wish to compare

    x
    No Treatment
    		 x
    Topical Treatments
    		 x
    Light / Laser Treatments
    		 x
    Systemic (Pill) Treatments
    What is it and how does it work?
    No Treatment

    Cover up makeup or foundation may be considered.
    Topical Treatments

    These are applied directly to the skin as gels, creams or lotions.

    Learn More
    Light / Laser Treatments

    These involve applying light or laser devices to affected areas by trained professionals.

    Learn More
    Systemic (Pill) Treatments

    These are taken by mouth.

    Learn More
    What types are there?
    No Treatment

    Cover up makeup or foundation (various manufacturers)
    Topical Treatments

    Alpha adrenergics:

    • Brimonidine
    • Oxymetazoline
    Light / Laser Treatments
    • Intense pulsed light (IPL)
    • Vascular Lasers (PDL, Nd:YAG and KTP 532)
    Systemic (Pill) Treatments

    Beta blockers:

    • Propranolol
    • Carvedilol
    Who is it for?
    No Treatment

    Anyone with rosacea.
    Topical Treatments

    Mild to severe facial redness.

    Learn More
    Light / Laser Treatments

    Mild to severe facial redness, moderate to severe blood vessel lines.

    Learn More
    Systemic (Pill) Treatments

    Severe facial redness and moderate to severe flushing.

    Learn More
    Who is it NOT for?
    No Treatment

    People who want treatment.
    Topical Treatments

    Some may be sensitive to these treatments. Caution must be taken with certain medical conditions. Talk to your health care professional to find out if this is right for you.

    Learn More
    Light / Laser Treatments

    These treatments may not be right for people with certain medical conditions, medications, skin characteristics and pregnancy. Talk to your health care professional to find out if this is right for you.

    Learn More
    Systemic (Pill) Treatments

    These treatments may not be right for people with certain medical conditions or sensitivity. Talk to your health care professional to find out if this is right for you.

    Learn More
    How well does it work?
    No Treatment

    Without treatment rosacea features may get better, worse or stay the same.
    Topical Treatments

    Brimonidine: High certainty evidence

    Oxymetazoline: Moderate certainty evidence

    Learn More
    Light / Laser Treatments

    Low to moderate certainty evidence.

    Learn More
    Systemic (Pill) Treatments

    There is some evidence that these medicines are helpful.

    Learn More
    What are the possible side effects?
    No Treatment

    Rare risk of skin irritation or break outs.
    Topical Treatments

    No risk of serious side effects and some risk of non-serious side effects.

    No evidence of risk during pregnancy.

    Learn More
    Light / Laser Treatments

    Rarely risk of serious side effects and some risk of non-serious side effects.

    Can be considered but with caution during pregnancy.

    Learn More
    Systemic (Pill) Treatments

    Risk of some serious side effects and non serious side effects.

    Risk during pregnancy is unclear.

    Learn More
    Will it inconvenience me?
    No Treatment

    Use of foundation or make up may be inconvenient.
    Topical Treatments

    Reminders for application are required. Time is required for proper application.

    Learn More
    Light / Laser Treatments

    Require visits to a trained professional, time consuming, may require lifestyle changes post treatment, potential for temporary side effects.

    Learn More
    Systemic (Pill) Treatments

    Reminders for taking the pill (s) is required.

    Learn More
    How much does it cost?
    No Treatment

    $ (foundation and makeup)
    Topical Treatments

    $$$$

    Learn More
    Light / Laser Treatments

    $$$$

    Learn More
    Systemic (Pill) Treatments

    $+

    Learn More
  • Flushing+

    Select the options you wish to compare

    x
    No Treatment
    		 x
    Topical Treatments
    		 x
    Light Treatments
    		 x
    Systemic Treatments
    What is it and how does it work?
    No Treatment

    Flushing of rosacea can come and go, decrease, or increase. You can wait and see if features improve or clear.
    Topical Treatments
    Light Treatments
    Systemic Treatments

    These treatments are taken by mouth. They travel through the body causing blood vessels to narrow and reduce blood flow.

    Learn More
    What types are there?
    No Treatment

    NA.

    Monitor for possible triggers and minimize or avoid where possible. Consider coverup makeup or foundation.
    Topical Treatments
    Light Treatments
    Systemic Treatments

    Beta blockers:

    • Propranolol
    • Carvedilol
    Who is it for?
    No Treatment

    Anyone with flushing of rosacea can choose to not receive treatment.
    Topical Treatments
    Light Treatments
    Systemic Treatments

    Severe ongoing facial redness and moderate to severe flushing.

    Learn More
    Who is it NOT for?
    No Treatment

    People who wish to receive treatment.
    Topical Treatments
    Light Treatments
    Systemic Treatments

    These treatments may not be right for people with certain medical conditions or sensitivity to the treatments. Talk to your health care professional to find out if this is right for you.

    Learn More
    How well does it work?
    No Treatment

    Without treatment rosacea features may get better, worse or stay the same.
    Topical Treatments
    Light Treatments
    Systemic Treatments

    There is some evidence that these medicines are helpful.

    Learn More
    What are the possible side effects?
    No Treatment

    Without treatment, flushing of rosacea may go away, stay the same or get worse. Some people with rosacea experience anxiety, embarrassment, depression and lower quality of life.
    Topical Treatments
    Light Treatments
    Systemic Treatments

    Risk of some serious side effects and non serious side effects.

    Risk during pregnancy is unclear.

    Learn More
    Will it inconvenience me?
    No Treatment

    No inconvenience but some people with rosacea experience anxiety, embarrassment, depression and lower quality of life.
    Topical Treatments
    Light Treatments
    Systemic Treatments

    Involves taking pills regularly.

    Learn More
    How much does it cost?
    No Treatment

    $ (Foundation and makeup)
    Topical Treatments
    Light Treatments
    Systemic Treatments

    $+

    Learn More
  • Pimples (Papules/Pustules)+

    Select the options you wish to compare

    x
    No Treatment
    		 x
    Topical Treatments
    		 x
    Light Treatments
    		 x
    Systemic Treatments
    What is it and how does it work?
    No Treatment

    Pimples of rosacea can come and go, decrease, or increase. You can wait and see if these improve or clear.
    Topical Treatments

    These are applied onto the skin as lotions, gels, creams, and foams.

    Learn More
    Light Treatments
    Systemic Treatments

    These are taken by mouth.

    Learn More
    What types are there?
    No Treatment

    Monitor for possible triggers and minimize or avoid where possible. Consider coverup makeup or foundation.
    Topical Treatments

    Treatments include:

    • Ivermectin
    • Azelaic acid
    • Metronidazole
    • Minocycline
    Light Treatments
    Systemic Treatments

    Treatments include:

    • Tetracyclines (e.g. minocycline, doxycycline)
    • Azithromycin
    • Isotretinoin
    Who is it for?
    No Treatment

    Anyone with pimples of rosacea can choose to not receive treatment.
    Topical Treatments

    Mild to severe pimples.

    Learn More
    Light Treatments
    Systemic Treatments

    Moderate to severe pimples.

    Learn More
    Who is it NOT for?
    No Treatment

    People who want treatment for pimples of rosacea.
    Topical Treatments

    Some may be sensitive to these treatments. Caution must be taken with certain medical conditions. Talk to your health care professional to find out if this is right for you.

    Learn More
    Light Treatments
    Systemic Treatments

    Some treatments may not be right for people with certain medical conditions, sensitivity to the treatments, or children/pregnant women. Talk to your health care professional to find out if this is right for you.

    Learn More
    How well does it work?
    No Treatment

    Without treatment rosacea features may get better, worse or stay the same.
    Topical Treatments

    Ivermectin: High certainty evidence

    Metronidazole: Moderate certainty evidence

    Azelaic Acid: High certainty evidence

    Minocycline: Moderate certainty evidence

    Learn More
    Light Treatments
    Systemic Treatments

    Tetracyclines: High certainty evidence

    Azithromycin: Very low certainty evidence

    Isotretinoin: High certainty evidence

    Learn More
    What are the possible side effects?
    No Treatment

    Without treatment your pimples of rosacea may go away, stay the same or get worse. Some people with rosacea experience anxiety, embarrassment, depression, and lower quality of life.
    Topical Treatments

    No risk of serious side effects and some risk of non-serious side effects.

    Some may have risks if taken during pregnancy. Talk to your health care professional for more details.

    Learn More
    Light Treatments
    Systemic Treatments

    Risk of some serious side effects and non-serious side effects in adults and children.

    Some drugs are NOT to be taken during pregnancy. Talk to your health care professional for more details.

    Learn More
    Will it inconvenience me?
    No Treatment

    No treatment-related inconvenience involved.
    Topical Treatments

    Reminders for application are required.

    Time is required for proper application of topical treatments.

    Learn More
    Light Treatments
    Systemic Treatments

    Reminders for taking the pill(s) is required.

    Learn More
    How much does it cost?
    No Treatment

    $ (Foundation and makeup)
    Topical Treatments

    $$$$

    Learn More
    Light Treatments
    Systemic Treatments

    $-$$$

    Learn More
  • Skin Thickening (Phyma)+

    Select the options you wish to compare

    x
    No Treatment
    		 x
    Topical Treatments
    		 x
    Light Treatments
    		 x
    Systemic Treatments
    What is it and how does it work?
    No Treatment

    Phyma is skin thickening and is not likely to improve over time. Inflammation is typical in initial stages but resolved in later stages.
    Topical Treatments
    Light Treatments

    These involve applying special light or laser devices to affected areas by trained professionals.

    Learn More
    Systemic Treatments

    These treatments are taken by mouth.

    Learn More
    What types are there?
    No Treatment

    N/A
    Topical Treatments
    Light Treatments

    Treatments include:

    • Ablative laser surgery (CO2, Er:YAG)
    • Electrosurgery
    Systemic Treatments

    Treatments include:

    • Doxycycline
    • Isotretinoin
    Who is it for?
    No Treatment

    Anyone with features of rosacea can choose to not receive treatment.
    Topical Treatments
    Light Treatments

    Non-inflamed skin thickening.

    Learn More
    Systemic Treatments

    Inflamed skin thickening.

    Learn More
    Who is it NOT for?
    No Treatment

    People who want treatment for phyma.
    Topical Treatments
    Light Treatments

    These treatments may not be right for people with certain medical conditions, skin characteristics, taking certain medications, and in pregnancy. Talk to your health care professional to find out if this is right for you.

    Learn More
    Systemic Treatments

    These treatments may not be right for people with certain medical conditions or sensitivity to the treatments. Talk to your health care professional to find out if this is right for you.

    Learn More
    How well does it work?
    No Treatment

    Without treatment rosacea features may get better, worse or stay the same.
    Topical Treatments
    Light Treatments

    Limited evidence, but supported by clinicians from experience.

    Learn More
    Systemic Treatments

    Case-based evidence shows benefits.

    Learn More
    What are the possible side effects?
    No Treatment

    Phyma does not usually go away by itself. Some people with rosacea experience anxiety, embarrassment, depression, and lower quality of life.
    Topical Treatments
    Light Treatments

    Rare risk of serious side effects and some risk of non-serious side effects.

    Can be considered but with caution during pregnancy.

    Learn More
    Systemic Treatments

    Risk of some serious side effects and non-serious side effects.

    Some drugs are NOT to be taken during pregnancy. Talk to your health care professional for more details.

    Learn More
    Will it inconvenience me?
    No Treatment

    No treatment-related inconvenience involved.
    Topical Treatments
    Light Treatments

    Require visits to a trained professional, time consuming, may require lifestyle changes post treatment, potential for temporary side effects.

    Learn More
    Systemic Treatments

    Reminders for taking the pill(s) is required.

    Learn More
    How much does it cost?
    No Treatment

    $ (Foundation and makeup)
    Topical Treatments
    Light Treatments

    $$$+

    Learn More
    Systemic Treatments

    $+

    Learn More
  • Blood Vessel Lines (Telangiectases)+

    Select the options you wish to compare

    x
    No Treatment
    		 x
    Topical Treatments
    		 x
    Light Treatments
    		 x
    Systemic Treatments
    What is it and how does it work?
    No Treatment

    Cover up makeup or foundation may be considered.

    Prominent blood vessels lines (telangiectases) of rosacea do not usually go away by themselves.
    Topical Treatments
    Light Treatments

    These involve applying special light or laser devices to affected areas by trained professionals.

    Learn More
    Systemic Treatments
    What types are there?
    No Treatment

    Cover up makeup or foundation may be considered.
    Topical Treatments
    Light Treatments
    • Vascular lasers (KTP532, PDL, Nd:YAG)
    • IPL
    • Electrosurgery
    Systemic Treatments
    Who is it for?
    No Treatment

    Anyone with telangiectases of rosacea can choose to not receive treatment.
    Topical Treatments
    Light Treatments

    Moderate and severe blood vessel lines.

    Learn More
    Systemic Treatments
    Who is it NOT for?
    No Treatment

    People who want to treat telangiectases of rosacea.
    Topical Treatments
    Light Treatments

    These treatments may not be right for people with certain medical conditions, medications, skin characteristics and in pregnancy. Talk to your health care professional to find out if this is right for you.

    Learn More
    Systemic Treatments
    How well does it work?
    No Treatment

    Without treatment rosacea features may get better, worse or stay the same.
    Topical Treatments
    Light Treatments

    While these treatments are widely used, current studies are small and evidence is limited.

    Learn More
    Systemic Treatments
    What are the possible side effects?
    No Treatment

    Without treatment, telangiectases of rosacea stay the same or get worse. Some people with rosacea experience anxiety, embarrassment, depression and lower quality of life.
    Topical Treatments
    Light Treatments

    Some risk of non-serious side effects.

    Not recommended during pregnancy.

    Learn More
    Systemic Treatments
    Will it inconvenience me?
    No Treatment

    No treatment related inconvenience involved. Some people with rosacea experience anxiety, embarrassment, depression and lower quality of life.
    Topical Treatments
    Light Treatments

    Requiring visits to a trained professional, time consuming, may require lifestyle changes after treatment, potential for temporary side effects.

    Learn More
    Systemic Treatments
    How much does it cost?
    No Treatment

    No cost or cost of makeup and foundation $
    Topical Treatments
    Light Treatments

    $$$+

    Learn More
    Systemic Treatments
  • Eye or Eyelid Problems (Ocular Rosacea)+

    Select the options you wish to compare

    x
    No Treatment
    		 x
    Topical Treatments
    		 x
    Light Treatments
    		 x
    Systemic Treatments
    What is it and how does it work?
    No Treatment

    Eyelid and eye irritation from rosacea can come and go, decrease or increase. You can wait and see if features clear.
    Topical Treatments

    These treatments are applied onto the eyelids as lotions and gels and eyes as droplets.

    Learn More
    Light Treatments
    Systemic Treatments

    These treatments are taken by mouth.

    Learn More
    What types are there?
    No Treatment

    None.
    Topical Treatments
    • Artificial tears for eyes eyelid hygiene for eyes and eyelids
    • Topical ivermectin and topical metronidazole for eyelids
    • Topical cyclosporine for eyes under care of ocular specialist
    Light Treatments
    Systemic Treatments

    Oral doxycycline and omega-3 fatty acids for eyes.
    Who is it for?
    No Treatment

    Anyone with rosacea can choose to not receive treatment.
    Topical Treatments

    Mild, moderate, and severe eye/eyelid rosacea.

    Learn More
    Light Treatments
    Systemic Treatments

    Oral doxycycline: Mild and moderate eye/eyelid rosacea.

    Omega-3 fatty acids: Mild, moderate, and severe eye rosacea.

    Learn More
    Who is it NOT for?
    No Treatment

    People who do not want to wait for features to go away on their own or those who have eye or eyelid discomfort.
    Topical Treatments

    Some people may be sensitive to these treatments. Caution must be taken with certain medical conditions. Talk to your health care professional to find out if this is right for you.

    Learn More
    Light Treatments
    Systemic Treatments

    Some treatments may not be right for people with certain medical conditions, or sensitivity to the treatments, or children/pregnant women. Talk to your health care professional to find out if this is right for you.

    Learn More
    How well does it work?
    No Treatment

    Without treatment rosacea features may get better, worse or stay the same.
    Topical Treatments
    Learn More
    Light Treatments
    Systemic Treatments
    Learn More
    What are the possible side effects?
    No Treatment

    Without treatment your eye/eyelid features of rosacea may go away, stay the same or get worse. Some people eye involvement can develop visual problems and there is potential for blindness. See ophthalmologist if there is redness in white part of the eye, sudden pain or problems with vision, or eye/eyelid problems in children.
    Topical Treatments

    No risk of serious side effects and some risk of non-serious side effects.

    No evidence of risk during pregnancy.

    Learn More
    Light Treatments
    Systemic Treatments

    Risk of some serious side effects and non-serious side effects in adults and children.

    Some drugs are NOT to be taken during pregnancy. Talk to your health care professional for more details.

    Learn More
    Will it inconvenience me?
    No Treatment

    No treatment related inconvenience involved.
    Topical Treatments

    Topical treatments are applied to the eyes or eyelids once or more per day.

    Learn More
    Light Treatments
    Systemic Treatments

    Requires swallowing a pill once or more each day.

    Learn More
    How much does it cost?
    No Treatment

    None
    Topical Treatments

    $-$$$$

    Learn More
    Light Treatments
    Systemic Treatments

    $+

    Learn More
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