From the Guidelines
For the treatment of rosacea, microencapsulated benzoyl peroxide 5% (E-BPO 5%) is a recommended topical agent due to its effective and well-tolerated delivery of benzoyl peroxide to the skin, as evidenced by its recent approval by the US Food and Drug Administration (FDA) in 2022 1.
Key Considerations for Rosacea Treatment
- Rosacea is a chronic relapsing facial skin disease characterized by recurrent flushing, erythema, inflammatory lesions, phymas, and telangiectasias, affecting an estimated 16 million people in the USA, with many more undiagnosed cases, especially in skin of color 1.
- The treatment of rosacea involves long-term avoidance of common triggers, use of gentle skin care, and adherence to pharmacologic treatment, with phenotype-based medical management being a fundamental strategy for rosacea control 1.
- Topical therapy is often the preferred initial treatment, with E-BPO 5% being a novel option that enables the effective and well-tolerated delivery of benzoyl peroxide to the skin through a novel microencapsulation technology 1.
Treatment Approach
- The use of E-BPO 5% is tailored by the signs and symptoms the clinician observes and the patient finds most troubling, rather than following a specific algorithm 1.
- More severely affected patients may initially need topical therapy plus a systemic agent to gain more rapid control of rosacea, with E-BPO 5% being a valuable addition to the current treatment landscape 1.
- Other topical therapeutic options, such as minocycline foam, which was FDA approved for rosacea in 2020, may also be considered in the treatment of rosacea 1.
From the Research
Definition and Characteristics of Rosacea
- Rosacea is a chronic cutaneous disorder affecting primarily the face, characterized by erythema, transient or persistent, telangiectasia, and inflammatory lesions including papulo-pustules and swelling 2.
- The essential component of the disease is the persistent erythema of facial skin, with episodes of flushing (acute-subacute intermittent vasodilation) being common 2.
- Rosacea can lead to swelling and erythema of the nose, along with dilatation of the pilosebaceous poral orifices, known as rhinophyma, in chronic cases 2.
Prevalence and Demographics
- Rosacea affects up to 10% of the world population and is especially noted in fair-skinned individuals aged 35-50 2.
- Women are affected more often than men, although the exact reasons for this disparity are not fully understood 2.
Treatment Options
- Several treatment modalities are available for the management of rosacea, including topical medications, systemic drugs, lasers, and light-based therapies 2, 3, 4, 5.
- Topical medications such as azelaic acid, metronidazole, and sulfacetamide/sulfur are commonly used, as well as oral antibiotics like tetracyclines and oral retinoids 2, 3, 4.
- Light therapies like intense pulsed light and pulsed dye laser are best used for the erythemato-telangiectatic type of rosacea 2.
- New additions to the therapeutic armamentarium include topical brimonidine, oxymetazoline, ivermectin, tacrolimus, pimecrolimus, low-dose modified-release tetracyclines, and botulinum toxin 2.
Comparison of Treatment Efficacy
- A study comparing once-daily metronidazole 1% gel with twice-daily azelaic acid 15% gel found similar reductions in inflammatory lesion counts and high success rates in both global severity and erythema 6.
- The efficacy of these treatments, including reduction in erythema, was similar, with both showing promise in the treatment of moderate rosacea 6.