Doctors infrequently prescribe isotretinoin for severe and resistant rosacea. Often physicians prescribe it after multiple other therapies have been tried for some time and have failed. Patients take a daily capsule of istotretinoin for four to six months. Typically, isotretinoin is most commonly used in the treatment of severe, common acne called acne vulgaris. Close physician monitoring and blood testing are necessary while on isotretinoin. Generally, at least two forms of birth control are required for females using this medication, as pregnancy is absolutely contraindicated while on isotretinoin.
The National Rosacea Society is a 501(c)(3) nonprofit organization whose mission is to improve the lives of people with rosacea by raising awareness, providing public health information and supporting medical research on this widespread but little-known disorder. The information the Society provides should not be considered medical advice, nor is it intended to replace
Apply fresh lemon juice. Lemon juice has natural skin bleaching properties, and can help to effectively lighten your acne scars. Simply combine equal parts lemon juice and water and apply this liquid directly onto your scars, avoiding the surrounding skin. Wash off the lemon juice after 15 to 25 minutes or you could put the lemon juice on overnight as a mask.

There are simple things you can do on your own to help prevent adult acne and keep it from getting worse. First, wash your skin once or twice a day with a non-drying, non-comedogenic cleanser that won't clog your pores. Look for cosmetic products labeled oil-free, non-comedogenic and non-acnegenic (unlikely to cause acne breakouts). In addition, avoid heavy skin creams or hair products which may aggravate your skin condition.
The National Rosacea Society is a 501(c)(3) nonprofit organization whose mission is to improve the lives of people with rosacea by raising awareness, providing public health information and supporting medical research on this widespread but little-known disorder. The information the Society provides should not be considered medical advice, nor is it intended to replace
Another study focused in on dairy. In 2005, an article in the Journal of the American Academy of Dermatology took on milk and milk products. By examining the diets of 47,355 women, researchers observed a significant connection between milk and dairy intake and breakouts. Some researchers believe this is caused by high levels of hormones found in our milk products. Much of the milk consumed is produced by pregnant cows, who pump out progesterone, IGF-1, and other compounds that are then passed into the milk. We may also be subject to Bovine Growth Hormone (BGH). These hormones can signal the oil glands to start producing more sebum, which can affect acne. Unfortunately, switching to organic milk doesn’t seem to make a difference, and neither do skim milk options. In fact, skim milk has been observed to worsen the skin, which researches have attributed to lower levels of estrogen and different processing activities. Milk is also known to contain a number of vitamins, some good and some not so beneficial to your skin. Research has shown a correlation between acne and vitamin A in milk. 
Old marks still sticking around take patience and consistency to treat. One way to even out skin tone over time is with regular exfoliating. "[Exfoliating] is important in treating acne scars at home as it lifts dead skin and allows new skin to grow and proliferate," Dr. Moy explains. This exfoliator contains papaya enzymes to break down dead skin cells and microderm crystals to buff away acne scars. Aloe vera, coconut, and vitamins E and B nourish the skin simultaneously.
Another source of hormonal changes: stress. Whether you work full time, are a full-time mom, or juggle both, chances are, your stress levels are high. "When you're stressed, you have an organ called the adrenal gland that makes the stress hormone cortisol, and puts it out into the body to help the body deal with stress," Dr. Schultz explains. Unfortunately, a tiny bit of testosterone leaks out with it. For a woman, this male hormone can drive the oil glands to produce more oil—the root cause of breakouts. (Thanks a lot, hormones!)
Mix and match: "Since acne scars vary, so do treatments. Depending on the individual, I often use a multimodal approach to treating acne scars. First, I might use Fraxel treatments to smooth out the skin texture. Then, I often use a combination of the fillers Restylane and Belotero to lift the depressed scars. Finally, I perform a few punch excisions to surgically remove any deep scars that may remain," says Dr. Bowe. There are also topical treatment options for active breakouts that help prevent scarring, which can be used to get out ahead of things.

Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] or the steroids that bodybuilders or athletes sometimes take). Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium (Eskalith, Lithobid). Most cases of acne, however, are not drug related.
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