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What treatments would you recommend for rosacea patients with persistent, soft/non-fibrotic cysts on the dorsal nose recalcitrant to chronic doxycycline and topical therapies?

3 Answers
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Dermatology · Stanford University
Answered on

Can consider a trial of a different oral antibiotic (such as a macrolide), or intralesional triamcinolone if lesions are discrete. However, I would likely proceed with a course of oral isotretinoin if there are no contraindications, given the recalcitrant nature of the disease. Doses usually range b...

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Dermatology · University of Pennsylvania
Answered on

I have seen several similar patients. A central aspect of chronic inflammation on the nose in rosacea is sebaceous gland hyperplasia-most likely due to chronic UVA photodamage. My approach has been isotretinoin 0.5mg/kg till maximal improvement. The inflammation and thickness and coarseness of the n...

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Dermatology · Karhade MD Dermatology
Answered on

While the diagnosis may certainly be cysts, it may be worth biopsying one as papular keloidal scars are very common on the nose after acne or rosacea. I see them frequently on the nose. Injection with very precise tiny aliquots of intralesional kenalog, and following with subsequent resurfacing lase...

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