Adult Rosacea Treatment (Rosacea)
MD-only rosacea evaluation and treatment by secure online video visit, $49 flat-fee, no insurance required.
Rosacea is a common chronic inflammatory skin condition that typically affects the central face and can cause persistent redness, flushing, visible small blood vessels, and acne-like bumps. Symptoms often flare with triggers such as heat, alcohol, spicy foods, stress, sun exposure, and harsh skin products. TeleDirectMD physicians evaluate whether your symptoms fit rosacea versus acne or dermatitis, recommend evidence-based topical treatments when appropriate, and provide practical trigger and skincare guidance. If you have eye symptoms, severe swelling, rapidly worsening pain, or concern for another serious facial condition, urgent in-person evaluation is required.
- $49 flat-fee adult visit
- MD-only care (no mid-levels)
- No insurance required
- Secure video visits in 25+ states
- Adults 18+ only, video visits only
Last reviewed on January 21, 2026 by Parth Bhavsar, MD
Online MD-Only Rosacea Care
- Adults 18+ with facial redness, flushing, or rosacea bumps
- Topical therapy options when appropriate
- Trigger identification and skincare guidance
- Clear triage for eye involvement and facial infection concerns
Adults 18+ only. TeleDirectMD does not prescribe controlled substances. Eye pain, eye redness, light sensitivity, vision changes, facial swelling with fever, or rapidly worsening pain requires urgent in-person evaluation.
What Is Rosacea?
Rosacea is a chronic skin condition that tends to flare and improve over time. It most commonly affects the cheeks, nose, chin, and forehead. Some people primarily have flushing and background redness, while others develop acne-like bumps called papules and pustules. Small visible blood vessels may appear over time. Rosacea is not caused by poor hygiene and is not contagious.
TeleDirectMD treats adult rosacea based on symptom pattern and visual exam. If your symptoms suggest another diagnosis or you have eye involvement, in-person evaluation may be needed.
Symptoms and Red Flags
| Symptom or situation | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Central facial flushing and persistent redness | Common rosacea pattern | Yes, often | No |
| Facial bumps that look acne-like without blackheads | Papulopustular rosacea | Yes | No |
| Visible small blood vessels on cheeks or nose | Telangiectasias from rosacea | Yes | No |
| Eye dryness, burning, gritty sensation | Possible ocular rosacea | Telehealth may triage | Urgent evaluation if eye pain or vision changes |
| Eye pain, severe redness, light sensitivity, vision changes | Possible serious eye condition | No | Emergency evaluation same day |
| Rapidly worsening facial swelling with fever | Possible facial infection | No | Urgent evaluation |
| New painful blistering rash in a band on one side of face | Possible shingles | No | Urgent evaluation |
| Diagnosis unclear or new rash not consistent with rosacea | Alternate diagnosis possible | Sometimes, triage | In-person if worsening or uncertain |
Rosacea treatment is focused on reducing flares and improving control over time. Improvement from topical therapies often takes 6 to 8 weeks.
Differential Diagnosis
Several facial conditions can mimic rosacea. TeleDirectMD evaluates distribution, triggers, presence or absence of comedones, and associated symptoms to help distinguish rosacea from other diagnoses.
Common Look-Alikes
- Acne vulgaris
- Seborrheic dermatitis
- Perioral dermatitis
- Contact dermatitis or irritation from products
- Lupus rash or photosensitive dermatitis
Clues Supporting Rosacea
- Central facial redness with flushing triggers
- Papules and pustules without blackheads
- Burning or stinging with certain products
- Visible blood vessels over time
- Flare pattern with heat, alcohol, spicy foods, or sun exposure
Telehealth Eligibility
When a Video Visit Is Appropriate
- Adult 18+ with typical facial redness or rosacea bumps
- No eye pain, vision changes, or severe eye redness
- No fever or rapidly spreading facial swelling
- Able to show facial skin clearly on video or provide photos
- Willing to follow gentle skincare and trigger reduction plan
Red Flags Requiring In-Person or ER Care
- Eye pain, light sensitivity, or vision changes
- Severe eye redness or worsening eye symptoms
- Facial swelling with fever or severe pain
- New blistering rash, especially one-sided
- Diagnosis uncertain or concern for another serious condition
If any red-flag symptoms are present, seek urgent in-person or emergency care. TeleDirectMD is not an emergency service.
Treatment Options
Rosacea management combines trigger reduction, gentle skincare, and medication when appropriate. Because rosacea is chronic, the goal is control rather than a permanent cure. Many adults improve with consistent topical therapy and daily sunscreen use.
Trigger and Skincare Guidance
- Use a gentle cleanser and avoid harsh scrubs, astringents, and alcohol-based toners
- Apply a bland moisturizer to reduce skin barrier irritation
- Use daily broad-spectrum sunscreen and minimize heat exposure when possible
- Track and reduce triggers such as alcohol, spicy foods, hot beverages, and stress when relevant
Medication Options
- Topical metronidazole, azelaic acid, or ivermectin can help reduce bumps and inflammation
- For persistent redness and flushing, some adults benefit from targeted topical options depending on skin type and symptoms
- Oral antibiotics are not the first-line telehealth default and are reserved for select cases when appropriate
TeleDirectMD focuses on safe, guideline-based care. If you have significant ocular symptoms, in-person ophthalmology evaluation may be needed.
Medication Options
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Metronidazole 0.75% cream or gel | Apply 2 times daily | 42–56 days | Common first-line topical for inflammatory rosacea bumps |
| Azelaic acid 15% gel or foam | Apply 2 times daily | 42–56 days | Alternative topical option for redness and bumps, may cause mild stinging initially |
| Ivermectin 1% cream | Apply 1 time daily | 42–56 days | Topical option for papulopustular rosacea in select adults |
| Brimonidine 0.33% gel | Apply 1 time daily | As directed | Targeted option for persistent facial redness in select adults, may not be suitable for everyone |
These are example regimens only. Your treatment plan depends on rosacea subtype, severity, skin sensitivity, and medical history. Improvement may take 6 to 8 weeks with consistent use.
Home Care and What to Expect
- Expect gradual improvement. Early irritation or dryness can occur with topical therapy.
- Use a fragrance-free moisturizer to reduce irritation.
- Daily sunscreen is one of the highest-impact steps for long-term control.
- Seek urgent care for eye pain, vision changes, or rapidly worsening swelling with fever.
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual care for adults using secure video visits to evaluate rosacea and prescribe treatment when clinically appropriate. Visits are $49 flat-fee with no insurance required and are available in 25+ states. TeleDirectMD is not an emergency service. Eye pain, vision changes, severe facial swelling with fever, or rapidly worsening symptoms require urgent in-person evaluation.
Adult Rosacea FAQs
Can TeleDirectMD treat rosacea online?
Yes, for many adults 18+ with typical rosacea symptoms and no red flags. Your MD evaluates your facial pattern and recommends skincare changes and topical therapy when appropriate.
How is rosacea different from acne?
Rosacea often causes central facial redness and flushing and may produce bumps that look acne-like, usually without blackheads. Acne more commonly includes comedones and may involve the jawline, chest, or back.
How long does topical treatment take to work?
Many adults need 6 to 8 weeks of consistent use to see meaningful improvement. Some irritation early on can be normal depending on the medication.
What triggers rosacea flares?
Common triggers include heat, sun exposure, alcohol, spicy foods, hot beverages, stress, and harsh skincare products. Triggers vary by person.
Do I need sunscreen?
Yes. Daily broad-spectrum sunscreen is one of the most helpful steps for reducing flares and preventing worsening redness over time.
What is ocular rosacea?
Ocular rosacea can cause dry, irritated, burning, or gritty eyes. Eye pain, light sensitivity, or vision changes requires urgent same-day evaluation.
Can rosacea be cured?
Rosacea is chronic, but many adults achieve good control with trigger management, gentle skincare, and consistent topical therapy when needed.
When do I need in-person care instead of telehealth?
Seek in-person care for eye pain, vision changes, severe swelling with fever, rapidly worsening facial pain, blistering rash, or if the diagnosis is uncertain.
Can TeleDirectMD prescribe oral antibiotics for rosacea?
Some adults with more significant inflammatory rosacea may need oral therapy, but TeleDirectMD focuses on safe and appropriate care. Oral antibiotic decisions depend on severity, contraindications, and follow-up planning.
What makes TeleDirectMD different for rosacea care?
TeleDirectMD provides MD-only video visits for adults at a $49 flat fee in 25+ states. We focus on accurate diagnosis, trigger guidance, and evidence-based topical therapy with clear escalation for ocular symptoms.
Dealing with persistent facial redness or bumps?
$49 flat fee. Adult-only video visits. MD-only care. Evidence-based rosacea treatment options and practical trigger guidance.