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Chapter 13: Skin
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Management of eczema
Management of psoriasis
Treatment of seborrhoeic dermatitis
Treatment of itching skin (pruritus)
Management of urticaria
Management of acne
Treatment of rosacea
Treatment of actinic keratoses
Management of hyperhidrosis
Management of skin conditions
13.2 Emollient and barrier preparations
13.3 Antipruritics
13.4 Topical corticosteroids
13.5 Preparations for eczema and psoriasis
13.6 Acne and rosacea
13.7 Preparations for warts and calluses
13.8 Sunscreens and camouflagers
13.9 Shampoos and other preparations for scalp and hair conditions
13.10 Anti-infective skin preparations
13.11 Skin cleansers, antiseptics, and desloughing agents
13.12 Antiperspirants
13.13 Miscellaneous skin preparations
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Treatment of rosacea
First Line
Second Line
Specialist
Hospital Only
Rosacea is characterised by recurrent episodes of facial flushing, persistent erythema, telangiectasia, papules and pustules, and eye symptoms. Rule out acne vulgaris before commencing treatment.
Metronidazole gel/cream
- Apply twice daily for 3-4 months
- See section 13.10.1 Antibacterial preparations
Azelaic acid cream 20%
- Apply twice daily (sensitive skin, once daily for first week)
Metronidazole gel/cream
- Apply twice daily for 3-4 months
- See section 13.10.1 Antibacterial preparations
Ivermectin 1% cream
- Apply once daily for 4 months; discontinue after 3 months if no improvement is seen
- See section 13.6.3 Topical preparations for rosacea
- May be used as an alternative to metronidazole in moderate disease
Doxycycline
- Capsules m/r 40mg
- 40mg daily in the morning for 16 weeks; consider discontinuing treatment if no response after 6 weeks
- See section 5.1.3 Tetracyclines
Lymecycline (unlicensed)
- 408mg once daily. Review at 2 months and continue for a total of 3 months if responding well. Repeat 3 monthly course when rosacea flares
- May be taken with food but avoid antacids, iron and zinc at the same time
- See section 5.1.3 Tetracyclines
