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George Woodbury MD 2/23/2023

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Rosacea – sometimes also called Acne Rosacea - can have negative effects upon a person’s mood and self-confidence. Let’s take a look at Rosacea Treatment – my perspective being that of a Memphis Dermatologist with over 30 years of experience with Rosacea treatment. 8018: 1-901-753-0168;, with a focus on what’s new.


First, what is Acne Rosacea?

Rosacea is a type of inflammation generally on the central face below the eyes and on the cheeks which expresses itself as either clogged pores and pus-filled glands called pustules (in which case we call the condition “Papulopustular Rosacea”), or as generalized facial redness with enlarged blood vessels at the skin surface, called “Telangiectases.” Below is first a photo of a person with Papulopustular Rosacea, followed by a person with Telangiectatic Rosacea. And there is a lot of overlap of the two conditions:

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What causes Acne Roacea?

Rosacea is much more common in certain racial groups, particularly Northern Europeans, including the Celtic peoples of the world: Scottish, Irish, Scandinavians, Germans, French, Spanish, Portuguese, and Austrians. But it can occur in all racial groups. Many Dermatologists – including myself - feel that Acne Roacea has genetic causes – because it’s definitely more common in certain families. Hormones also probably are involved – because flares of Acne Rosacea can be associated with times during the menstrual cycle – though it does definitely occur in both men and women. It’s also related to a person’s age – because it’s rare in babies and little kids – and more common in young adults and middle aged people. 


What can be done to treat Acne Rosacea?

Dermatologists now have a growing number of new Rosacea Treatment options, so we can customize management, which does differ for people with dry skin, combination skin, or oily skin. Let take a look at some of these options, my perspective being that of a Board-certified Memphis Dermatologist in Cordova TN since 1993, previously in Rochester, New York from 1991 to 1993.

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What is traditional management of Acne Rosacea?

  Since an important part of Rosacea, also sometimes called Acne Rosacea, is pimples, or infection in pores, with clogged skin glands, many Dermatologists use a combination of courses of oral antibiotics – such as tetracyclines like doxycycline, minocycline, and a new oral drug called sarecycline (Seysara®) – with topical antibiotics (meaning for use “on top of” the skin) – such as Metronidazole Cream or Gel (Metrogel®). Since many patients have an overgrowth of natural skin mites, we often consider a topical prescription cream called 1% Ivermectin Cream (Soolantra® Cream).


For patients with the persistent red variety of Rosacea, another helpful treatment option is a new topical “Adrenergic” medication called Brimonidine Gel (Mirvaso® Gel), applied once or twice a day, to help the blood vessels to close, leading to less facial redness. Mirvaso Gel could potentially affect the blood pressure, so it requires careful monitoring, and it’s available only by prescription. 


What’s new in Acne Rosacea treatment?

  The thinking of Dermatologists on Rosacea strategy changed dramatically in about 2010-2015, with increasing reliance upon what are called Retinoid products (such as Retin A Cream, also called Tretinoin Cream, and Tazorac Gel, Cream, and Foam - Tazarotene), after University of Pennsylvania Department of Dermatology research revealed significant healing in facial skin lesions with use of topical Retinoids (meaning for use “on top of” the skin). Many Dermatologists were initially apprehensive about using Retinoids, because side-effects can include increased redness, but Retinoids are showing much promise when used by patients under careful supervision, with early follow-up visits.


We Dermatologists also work to customize our treatment recommendations to whether the patient has oily skin, combination skin, or dry skin. For people with oily skin, we often pick gel products, or foam products, whereas for people with combination skin or dry skin, lotion or cream preparations tend to be more helpful.


For severe cases of Rosacea, Dermatologists sometimes consider either an oral drug called Spironolactone or else a a five months’ course of oral isotretinoin, previously called Accutane treatment, which dries up the oil glands and which tens to be helpful. Accutane treatment requires strict avoidance of pregnancy while on treatment, and monthly bloodwork, meaning that Accutane therapy requires close supervision with monthly office visits and labwork.


After 25 years of practicing dermatology, in 2016 I decided to establish a skincare products company  - Big River Silk Skincare™ Inc. – of which I am the President -  to manufacture and distribute organic skincare products for people going onto prescription therapies: AmberSoy™ Soap Gel and the GlycoShea™  Creams and Lotions. These products have been used for many years by thousands of acne patients in Tennessee and Arkansas, and they’re now available nationally.  For more on these products, go to


So if you or a family member has complexion issues or Acne Rosacea or Rosacea, consider getting a checkup from a Board-certified Dermatologist. My own Memphis Dermatology practice since 1993 has been with Rheumatology and Dermatology Associates, as a Cordova Dermatologist, in Tennessee ( or (1-901-753-0168). Or you can find a Dermatologist in your own neighborhood by going to the American Academy of Dermatology web site,, then plugging your zip code into the “Find a Dermatologist” tab.


George Woodbury Jr. M.D. (02/23/2023)

Board-certified Dermatologist George Woodbury MD, Cordova TN, on Acne Treatment Strategies, from antibiotics to retinoids to isotretinoin: 1-901-753-0168.  01/24/2023

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