Prognosis if left untreated

If left untreated, rosacea tends to be progressive, which means it gets worse over time. However, in most people rosacea is cyclic, which means it may flare up for a period of weeks to months and then signs and symptoms lessen for a while before rosacea flares up again. The rouble is that rosacea may advance to a third stage, in which the spread of excess facial tissue called fibroplasia may develop. It may also distort facial features enough to cause the so-called lionization.
In some cases, the eyes may also be affected by rosacea, resulting in a gritty feeling and bloodshot appearance which can even affect the vision.

Treatment of rosacea

Unfortunately, there is still no way to eliminate rosacea altogether. However, several treatments are available for relieving signs and symptoms of rosacea. The treatment most often this requires a combination of prescription medications and certain self-care measures. The key to successful management of rosacea is early diagnosis. 

Medications

Doctors often prescribe topical antibiotics to treat rosacea. Although this could be confusing because no bacteria are involved, these antibiotics are being used more for their anti-inflammatory properties than to kill bacteria. The most common topical antibiotic prescribed is Metronidazole. It could be also combined with another prescription medication such as azelaic acid.

Oral antibiotics are also prescribed because they tend to work faster than topical ones. 

Some of the most common prescription oral antibiotics include:

• Tetracycline
• Minocycline
• Doxycycline
• Erythromycin

Isotretinoin is a powerful medication sometimes used for more severe cases of inflammatory rosacea. Although it is usually prescribed for cystic acne because it works to inhibit the production of oil by sebaceous glands, it can be really helpful in rosacea treatment. Unfortunately Isotretinoin also has some side effects and is known to cause severe birth defects.

Surgical solutions

Enlarged blood vessels, redness and changes due to rhinophyma often become permanent. In these cases, surgical methods such as laser surgery and electro-surgery, may reduce the symptoms. Dermatological vascular laser or Intense Pulsed Light machines offer one of the best treatments for rosacea. They use light to penetrate the epidermis to target the capillaries in the dermis layer of the skin. 

CO2 lasers can be used to remove excess tissue caused by Phymatous rosacea. 
 
They reduce the visibility of blood vessels, remove tissue buildup around the nose and generally improve appearance.
Self-care
One of the most important things a patient can do if he or she has rosacea is to minimize the exposure to anything that causes a flare-up. 

Suggestions for preventing flare-ups:

• Exercise in a cool environment. Don't overheat
• Use products that are labeled as non-comedogenic. These won't clog your oil and sweat gland openings as much
• When using moisturizer with a topical medication, apply the moisturizer after the medication has dried
• Patients should wear sunscreen with a sun protection factor of 15 or higher to protect face from the sun
• Avoid irritating your facial skin by rubbing or touching it too much
• Avoid facial products that contain alcohol or other skin irritants
• Avoid overheating
• Avoid alcohol
• Avoid hot drinks, spicy foods and caffeine