Q My rosacea has progressed to the stage of papules and pus. What treatment should I undergo at this stage?
A Stage 2 rosacea (papulopustular type) requires inflammation control as its core. Standard treatments include low-dose doxycycline or azelaic acid; if Demodex overgrowth is involved, ivermectin cream is added. Korean medicine uses blood-clearing and heat-clearing formulas to control internal heat, helping reduce antibiotic dependence.
Detailed Answer
Standard treatments for Stage 2 rosacea: ①oral antibiotics (doxycycline 40mg modified-release; long-term use carries resistance risk), ②topical antibiotics (metronidazole gel), ③azelaic acid 15–20% gel, ④ivermectin 1% cream (when Demodex overgrowth is present). If papules and pustules persist for several months, revisit your treatment plan with a dermatologist.
Korean Medicine Clinic Perspective
At Dongjedang, Stage 2 rosacea with papules and pustules is interpreted as Spleen-Stomach Dampness-Heat (脾胃濕熱) manifesting on the skin. Formulas in the Cheongheol-samul-tang or Hwangnyeon-haedok-tang family resolve heat-toxin (熱毒). External washing with a decoction of Phellodendron (黃柏), Forsythia (連翹), and Honeysuckle (金銀花) suppresses the Demodex environment.
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