Follow-up

• the patient should be followed-up if the condition deteriorates despite lifestyle changes or drug treatment (1)
• patient should be reviewed every 2-3 months
  • if treatment effective, it may be stopped
    • patient should be advised that their rosacea may relapse, and the same treatment may need to be started again. following options are available:
      • maintenance treatment:
        • continuous (e.g. a reduced dose of oral treatment for 2-6 months followed by a 'drug holiday')
        • intermittent (e.g. using a topical treatment on alternate days or twice a week)
        • 'stepping down' from oral to topical treatment
  • if treatment has been unsatisfactory:
    • for people receiving topical treatment, consider switching to an alternative topical treatment, or prescribing an oral antibiotic
    • for people receiving an oral antibiotic, consider adding a topical treatment, or seek specialist advice. An alternative oral antibiotic is unlikely to be of benefit
• the aim of treatment is to suppress rosacea completely
• once the rosacea has been successfully treated then treatment can be slowly withdrawn over several months - antibiotic treatment should not be suddenly stopped as this can cause a recurrence of the rosacea

Reference:

1. Rivero A. An update on the treatment of rosacea. Aust Prescr. 2018 Feb; 41(1): 20–24.