#AskDermLetter: Rosacea and Acne

We’ve had more than a few questions come in from our DermLetter readers over the last few months as well as on our Facebook page. We thought we would answer some of the most common questions.

What are the best treatments for pimples and pustules due to rosacea? Antibiotic treatments haven’t given me the results that I had hoped for or expected. What about laser treatment?

I apologize in advance for what some might call a “non-answer” but it’s very difficult (and often irresponsible) to provide specific medical advice online. With that said, there is some relevant information that we can guide you to.

The “bumpy” subtype, also known as papulopustular rosacea, is characterized by pimples and pustules, and is one of the four main subtypes of rosacea, and a very common one. Various laser treatments like IPL, KTP do seem to have some good success in controlling the symptoms of papulopustular rosacea. It’s a bit old, but still very relevant, this article explains from a dermatologist’s standpoint, many of the treatment options that are tried and tested for this form of rosacea. There is also a rosacea app (We have no connection or commercial interest, but this app is supported with the help of pharmaceutical companies) that may help you with the lifestyle and trigger avoidance.

At the end of the day, however, you will need to visit your dermatologist, or another one if you feel this is the best, and explain the symptoms, the outcome you desire, and discuss the best treatment plan that works for you.


I’ve had acne for 2 years. I’ve been using acne products, but haven’t seen any positive results. I have oily skin on my face, and I hate the feeling of oiliness.

Unfortunately, the information we have about your situation is limited but we’ll do our best to answer your concern. You mentioned that you’ve tried medication, but it doesn’t help. Is this a prescription medication? The first advice is to see a dermatologist. Depending on where you live in the world, it may not be the easiest to see a specialist, but if at all possible, you should always start by seeing a doctor. This ensures that you have a proper diagnosis and medical advice about your skin condition.

If you have a doctor prescribed or recommended medication, it’s important that you follow the directions given by your doctor and continue to comply with the treatment even if it doesn’t seem to be immediately working. Acne treatment is notorious for being slow, even when the treatment would ultimately be effective. It’s also common to see acne temporarily worsen after treatment is applied. Unfortunately, many patients lose patience with their treatment regimen and give up before giving the medication a chance to work. Your doctor should remind you that many acne treatments can take 12 weeks or longer to see results, and that the improvement is often gradual. Patients in turn, must be patient while the medication does its thing.

Oily skin is a common concern with acne patients. Acne can occur in any skin type, but in people with oily skin, it seems to be more common, and tends to gravitates toward the more severe cases of acne. Oiliness is largely a genetic factor. Your sebaceous glands which produce skin oil are more active than most people. To control oiliness, proper use of cleansers are important. Use a cleanser, preferably a medicated cleanser (usually with benzoyl peroxide) daily. It’s important not to overdo this, however. Once a day of gentle cleansing should suffice. The skin is intelligent; cleansing strips the oil away from the skin, and if it’s over-cleansed, the skin will respond by producing even more oil. If you have long hair, it’s a good idea to tie it back or cut it short, as hair is very oily, and if it’s consistently coming into contact with the face, it could trigger worsening of acne.


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