From the Research
Rosacea is a chronic inflammatory skin disease affecting the central face of adults, characterized by symptoms such as telangiectasia, persistent erythema, burning/stinging sensation, dry skin sensation, and pruritus, with a complex etiopathogenesis that is not fully elucidated.
Definition and Classification
The condition is often associated with anxiety and depression, reducing the quality of life of affected patients 1. According to the National Rosacea Society (NRS), rosacea can be classified into four subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular, as well as one variant, lupoid or granulomatous rosacea 2.
Pathophysiology and Management
Recent advancements have reshaped our understanding of rosacea from both a pathophysiologic perspective and clinical approach to therapy, introducing novel agents that have improved patient outcomes and reduced morbidity 3. The therapeutic spectrum for effective management of rosacea includes a combination of skincare practices and medications, such as gentle cleansers, daily sunscreen use, and avoiding triggers like spicy foods, alcohol, and extreme temperatures. Topical medications such as metronidazole 0.75% gel applied twice daily, azelaic acid 15-20% applied twice daily, or ivermectin 1% cream applied once daily are effective first-line treatments. For moderate to severe cases, oral antibiotics like doxycycline (40-100mg daily for 8-12 weeks) may be necessary, while persistent redness can be treated with brimonidine 0.33% gel applied once daily. Laser or light therapy can help reduce visible blood vessels, and for severe cases with thickening skin (rhinophyma), isotretinoin might be prescribed.
Key Points
- Rosacea is a chronic inflammatory skin disease with a complex etiopathogenesis
- The condition is characterized by symptoms such as telangiectasia, persistent erythema, and pruritus
- Classification includes four subtypes and one variant
- Management involves a combination of skincare practices and medications, including topical and oral antibiotics, and laser or light therapy
- Recent advancements have improved patient outcomes and reduced morbidity 1, 3. The most effective approach to managing rosacea is a comprehensive treatment plan that addresses the individual patient's needs and symptoms, with a focus on reducing morbidity and improving quality of life.