Chronic use of topical steroids or cortisones can produce a "steroid Rosacea"
that includes redness, blood vessels, and/or pimples. It is necessary to stop the
application of these steroid creams as soon as the patient can tolerate the change.
Gradual reduction is necessary.
Initial use of topical steroids can reduce redness. However, chronic use for weeks
or longer can produce this paradoxical response that actually worsens the redness
and can produce pimples. It is usually necessary to gradually reduce the frequency
of application and/or the strength of the steroid. Use of oral or topical
antibiotics can assist in tapering off the topical cortisone.
Note: 2 relatively new and very promising non-steroidal topical medications
are available for treatment of steroid rosacea; (Tacrolimus) Protopic .1%
or .03% ointment and (Pimecrolimus) Elidel 1% cream. These two products are
similar and are applied up to twice daily. Since they are relatively new,
cautious monitoring by your dermatologist is advised. Treatment of pimples
(papules and pustules) appears to be the main effect of these two products.
