Can consider a trial of a different oral antibiotic (such as a macrolide), or intralesional triamcinolone if lesions are discrete. However, I would likely proceed with a course of oral isotretinoin if there are no contraindications, given the recalcitrant nature of the disease. Doses usually range b...

I have seen several similar patients. A central aspect of chronic inflammation on the nose in rosacea is sebaceous gland hyperplasia-most likely due to chronic UVA photodamage. My approach has been isotretinoin 0.5mg/kg till maximal improvement. The inflammation and thickness and coarseness of the n...