Acne Rosacea is a long term skin condition that causes facial redness, thread veins and spider veins (known medically as telangiectasias), and in some cases, papules and pustules. These symptoms can be very troublesome psychologically, and lead to social withdrawal and isolation in some people who are severely affected. However, treatments are available that will help get rid of the redness, thread veins and papules. The question is which treatment is the most effective? The answer requires a strict scientific approach where groups of comparable patients are given different treatments and compared in a standardised way. Fortunately, this has been done for patients with rosacea.
The results of these clinical comparisons has shown that Azelaic acid cream is an effective topical treatment (that is, a cream that can be rubbed into the skin rather than a medication that has to be taken orally) that reduces nearly all the symptoms of rosacea in the majority of patients who are prescribed it. The only thing that it doesn’t help is established spider or thread veins (telangiectasia). These can be treated with Vein wave technique, a recently developed and very safe way of treating thread veins.
In the United Kingdom Azelaic acid is available as Skinoren cream. In rosacea it is thought to work by reducing the quantity of free oxygen radicals. It also has an exfoliative and anti-comedonic affect that works well for people who also have acne vulagaris, the common form of acne. Metronidazole antibiotic gel is an alternative treatment but it doesn’t work as well as Azelaic acid. Both are well-tolerated with only minor problems with skin irritation.
Azelaic acid has other advantages in terms of it being known to be teratogenic (although all medications should be avoided during pregnancy where safe and practical), and is not associated with systemic adverse events or photodynamic reactions.
