What are the specialized treatments for rosacea?

Question

Hello doctor,

I was diagnosed with rosacea (zhala hota), and after trying various treatments, I finally found relief using Episoft moisturizer and Acnedap gel. I have been using them for the past four years, and they have worked well without causing any major issues. Last year, I fell sick two to three times, and each time I developed tiny, textured bumps on my forehead and chin. However, they went away on their own or with my usual skincare routine.

Over the last three to four months, though, these bumps have become persistent and keep reoccurring. They improve with my existing treatment and reduce over time, but they keep coming back. Recently, I visited a new dermatologist who prescribed Minocycline for 20 to24 days. While the bumps have reduced significantly, they have not cleared up completely, even after finishing the course. Currently, my skin looks much better thanks to a new face wash and a hyaluronic acid serum prescribed by the new dermatologist. However, the tiny bumps are still present. This has never happened before. They are only located on my forehead and the sides of my chin. I have not changed my shampoo or made any significant changes to my skincare routine. These bumps just randomly started appearing when winter began, and I am unable to figure out the root cause.

Please help this has been distressing for me, and the fact that the bumps are not clearing up has started to trigger anxiety.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your current forehead and chin texture may be a rosacea flare (papulopustular type) triggered by immune stress from repeated illness and winter-related skin barrier disruption. The persistent bumps despite Minocycline suggest that either inflammation is ongoing, or there is another cause like Malassezia folliculitis (fungal acne), especially after antibiotic use. Since your skin improved with hyaluronic acid, your barrier likely needed hydration, but the bumps suggest more is needed. No changes in shampoo or skincare rule out contact reactions. A topical like Ketoconazole or Azelaic acid may help if fungal or inflammatory. Stick to a minimal routine, avoid scrubs, and wait for blood tests to rule out deficiencies (like B12 or iron) or hormonal triggers. Let me know if you would like a sample routine.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.