Rosacea

NHSL Medicines Guidance
NHS Lanarkshire

General Notes: Rosacea

Mild to moderate

  • Metronidazole cream/gel or azelaic acid gel/cream (cream may be more suitable for sensitive skin)

Moderate to severe

  • Topical preparation – other
  • Oral antibiotic treatment

Further information, including presentation, management and referral criteria available at The Dermatology Patient Pathways - Rosacea.

Topical Preparations for Rosacea

Preferred list (P)

METRONIDAZOLE 0.75% cream/gel (Rozex®)

AZELAIC ACID 15% gel (Finacea®)

Total list (T)

IVERMECTIN 10mg/g cream (Soolantra®)

  • SMC restriction: the treatment of moderate to severe inflammatory lesions of rosacea where a topical treatment is considered appropriate.

BRIMONIDINE 3mg/g gel (Mirvaso®)

Oral Antibiotics for Rosacea

Preferred list (P)

OXYTETRACYCLINE

  • Avoid in renal disease.

DOXYCYCLINE capsules

  • Restriction: reserve 40mg modified release once daily for papulopustular facial rosacea without ocular involvement. Discontinue if no improvement after 6 weeks.

Total list (T)

LYMECYCLINE

  • Avoid in renal disease.

ERYTHROMYCIN

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.