Treatments For Rosacea – Combine Modalities to Deliver Exponential Correction
Treatments for Rosacea that are making waves in the medical + spa skincare industry.
Rosacea is a chronic inflammatory skin condition that predominantly affects the face, resulting in redness, visible blood vessels, and, in some cases, acne-like breakouts. It typically affects adults, particularly individuals with fair skin, and is more common in women than men. Though the exact cause of rosacea is still unclear, it is believed to be multifactorial, involving genetic predisposition, immune system dysregulation, environmental triggers, and vascular abnormalities. Traditionally, rosacea treatment has centered on topical medications, oral antibiotics, and lifestyle modifications. However, with the increasing demand for non-invasive and innovative treatments, new modalities have emerged, including mesotherapy, chemical peels, and other advanced therapies.
October 2025 L+A Report
How Long-Term Treatment Plans Produce Advanced Skincare Correction
It’s no longer about booking a single facial or even committing to a series of treatments. Clients and patients are partnering with skincare professionals for lifetime skin health strategies. Professionals aren’t just service providers; they’re trusted guides who help their clients navigate the biological changes, environmental stressors, and lifestyle shifts that impact skin health across decades.
Think of it as a shift from one-off fixes to skincare mentorship. The role of the esthetician or medical skincare professional now extends beyond the treatment room, providing holistic planning, seasonal adjustments, and support through hormonal and life stage changes.
The psychosocial impact of rosacea is substantial, with patients experiencing reduced quality of life and higher rates of anxiety and depression compared to unaffected individuals. Even when it is a medical problem, there is an important esthetic and cosmetic burden that can be attacked by combining treatment modalities to not only improve health but also appearance.
Contribution by Dr. Alberto Leguina-Ruzzi MD, Ph.D.
Biologist, Doctor of Medical Sciences, Physician, and Dermatology Specialist, with over 10 years of experience in biomedical research, university teaching, clinical practice, and the pharmaceutical industry, serving in positions of strategic and managerial responsibility.
My academic training and interdisciplinary experience allow me to integrate clinical knowledge with a solid scientific foundation to develop medical strategies aimed at rational drug prescribing, supported by clinical, molecular, and epidemiological evidence. I have led processes of collection, analysis, and interpretation of scientific data in regulatory and product development contexts, contributing to the creation of technical content with high scientific rigor.
My research and application focus has been on immunologically based systemic inflammatory pathologies, with an emphasis on the impact of aging and lifestyle on the integumentary system and other target organs. This has allowed me to develop comprehensive diagnostic and therapeutic approaches aligned with trends in personalized and translational medicine.
Additionally, I have led continuing medical education initiatives, provided scientific and technical support to sales teams, and provided medical validation of promotional materials, ensuring the ethical, accurate, and clinically relevant communication of pharmaceutical products to professional audiences and patients.
I am currently active in the fields of research, medical education, and the pharmaceutical industry, coordinating science, clinical practice, and innovation to contribute to the advancement of national and international public health.
Pathophysiology of Rosacea
Rosacea manifests as a spectrum of symptoms, ranging from mild redness to severe pustules and thickened skin. It is typically divided into four subtypes:
- Erythematotelangiectatic Rosacea (ETR): Characterized by persistent redness and visible blood vessels (telangiectasias).
- Papulopustular Rosacea: Involves red, acne-like breakouts, often mistaken for acne vulgaris.
- Phymatous Rosacea: Characterized by thickened skin, particularly around the nose (rhinophyma).
- Ocular Rosacea: Affects the eyes, causing dryness, irritation, and in some cases, vision problems.
The pathophysiology of rosacea involves abnormal blood vessel dilation, inflammation, and immune system activation. The release of inflammatory mediators such as cytokines and matrix metalloproteinases leads to tissue damage and the characteristic redness. Triggers such as sun exposure, stress, hot beverages, spicy foods, and alcohol exacerbate these symptoms.
Traditional Approaches to Treatments For Rosacea
Conventional treatments for rosacea have included:
- Topical therapies: Metronidazole, azelaic acid, and ivermectin creams are often used to reduce inflammation and control breakouts.
- Oral antibiotics: Tetracycline derivatives like doxycycline are prescribed for moderate to severe cases to manage inflammation and control bacterial overgrowth.
- Laser and light therapies: Pulsed dye lasers (PDL) and intense pulsed light (IPL) have been used to target visible blood vessels and reduce erythema.
Although these treatments are effective to an extent, they do not address all aspects of the condition, such as the underlying vascular abnormalities, immune dysfunction, or the cosmetic concerns of thickened skin. As a result, newer and more targeted treatment modalities are gaining popularity.
Newer Treatments For Rosacea
Mesotherapy Treatments for Rosacea
Mesotherapy is a minimally invasive technique that involves injecting small amounts of various substances (including vitamins, enzymes, hormones, and plant extracts) directly into the mesoderm, or middle layer of the skin. This treatment for Rosacea has gained traction due to its ability to reduce inflammation, improve skin texture, and reduce redness.
In rosacea, mesotherapy can be used to deliver a combination of anti-inflammatory agents such as hyaluronic acid, succinic acid, and vitamins (such as vitamin C and E), which help improve the skin’s barrier function and reduce swelling. The injections also promote circulation, which may reduce the appearance of visible blood vessels over time. Furthermore, mesotherapy can aid in reducing the thickening of the skin often seen in the more severe subtypes of rosacea, such as phymatous rosacea.
One study demonstrated that mesotherapy could significantly reduce erythema and skin thickness in patients with rosacea, offering a promising non-surgical alternative to traditional treatments. However, it is important to note that mesotherapy is not a one-size-fits-all solution, and results can vary depending on the individual’s response to treatment.
Recently, our research group studied the use of high molecular weight hyaluronic acid plus succinic acid mesotherapy to improve the skin in rosacea. We demonstrated that using this acid combination in mesotherapy is an efficient, safe, and cost-effective adjunct therapy for patients already using a particular topical treatment. In terms of skin improvement, it is observed a reduction of erythema, increase in hydration, reduction in closed comedones, papules, telangiectasias, increase in skin elasticity, and improvement in symptoms of soreness, burning, itching, and tingling. The full study can be found in https://onlinelibrary.wiley.com/doi/10.1111/jocd.70484 (A. Leguina-Ruzzi, A. Navarro, and M. Zambrano, “ Efficacy and Effectiveness of High Molecular Weight Non-Cross-Linked Hyaluronic Acid Plus Succinic Acid Mesotherapy in Rosacea as Adjunct Therapy,” Journal of Cosmetic Dermatology 24, no. 10 (2025): e70484, https://doi.org/10.1111/jocd.70484)
Chemical Peel Treatments for Rosacea
Chemical peels are another innovative treatment modality for rosacea, particularly beneficial for patients with mild to moderate cases who experience persistent redness and minor pustules. Chemical peels involve the application of a chemical solution to the skin, which exfoliates the outer layers and stimulates skin regeneration.
For rosacea, superficial chemical peels using glycolic acid, lactic acid, or salicylic acid are typically employed. These peels work by promoting the removal of dead skin cells, unclogging pores, and improving skin texture. They can also help reduce inflammation and redness, making them an effective treatment for erythematotelangiectatic rosacea.
In particular, salicylic acid peels are often recommended for rosacea patients due to their anti-inflammatory and antibacterial properties. This type of peel can address both the redness and the pustules associated with papulopustular rosacea. Moreover, chemical peels stimulate collagen production, which may help improve the skin’s overall appearance and reduce the thickening that can occur in phymatous rosacea.
The benefits of chemical peels for rosacea are numerous, including improved skin tone, a reduction in visible blood vessels, and a smoother skin surface. However, chemical peels should be used with caution in sensitive individuals, as they may cause irritation or exacerbate symptoms if not performed properly. It is important for patients to consult a dermatologist experienced in rosacea management before undergoing chemical peel treatments.
Other Emerging Treatments
In addition to mesotherapy and chemical peels, several other treatment modalities have shown promise in the management of rosacea:
- Laser Treatments: As mentioned, laser therapies like PDL and IPL are highly effective in treating the visible blood vessels and redness associated with rosacea. These therapies work by targeting the hemoglobin in blood vessels, causing them to collapse and eventually be absorbed by the body.
- Topical Retinoids: Retinoids, although traditionally used for acne, are now being explored for their anti-inflammatory properties in rosacea. They help reduce the thickening of the skin, especially in patients with phymatous rosacea.
- Bitter Orange Extract: Some studies suggest that bitter orange extract, known for its anti-inflammatory effects, can reduce erythema and improve skin condition in rosacea patients.
- Probiotics and Oral Supplements: A growing body of research suggests that gut health may play a role in rosacea, and oral probiotics or anti-inflammatory supplements like omega-3 fatty acids are being explored as adjunctive treatments.
Rosacea is a chronic and often frustrating condition, but advancements in treatment options offer hope for patients seeking relief from its symptoms. While traditional therapies such as oral antibiotics, topical treatments, and laser therapies remain effective, newer modalities like mesotherapy, chemical peels, and other advanced options provide additional benefits. These treatments target not only the visible symptoms of rosacea but also the underlying inflammation, vascular abnormalities, and skin texture changes.
Mesotherapy’s ability to reduce inflammation and promote circulation, combined with the exfoliating and anti-inflammatory properties of chemical peels, makes them viable options for improving rosacea symptoms and providing cosmetic benefits. As research continues and new treatments are developed, rosacea management will likely become more personalized, offering patients a wider range of therapeutic choices to improve their skin health and overall well-being.