From the Guidelines
Rosacea symptoms should be managed using a phenotype-led treatment approach, considering the individual patient's expression of concern and desire for treatment, as recommended by the global rosacea consensus (ROSco) panel 1. The symptoms of rosacea can vary, but typically include:
- Facial redness (erythema)
- Visible blood vessels (telangiectasia)
- Small red bumps (papules)
- Pus-filled pimples (pustules)
- Burning or stinging sensation on the face Many patients experience flushing episodes that worsen with triggers like sun exposure, hot beverages, spicy foods, alcohol, stress, and extreme temperatures.
Treatment Options
The treatment approach should be based on the individual patient's symptoms and severity of the condition.
- For transient erythema, topical α-adrenergics, such as brimonidine, and oral beta blockers, such as carvedilol, are viable treatment options 1.
- For persistent erythema, topical treatments like azelaic acid and metronidazole, as well as oral doxycycline, can be effective 1.
- For inflammatory papules and pustules, oral doxycycline and topical ivermectin are considered first-line treatments 1.
General Skincare and Prevention
In addition to medical treatments, general skincare and eye care are essential in managing cutaneous and ocular features of rosacea 1. This includes:
- Sun protection with a sun protection factor (SPF) of 30 or higher
- Gentle cleansers and moisturizers
- Trigger avoidance, such as avoiding hot beverages, spicy foods, and extreme temperatures By recognizing the symptoms of rosacea early and using a combination of trigger avoidance, gentle skincare, sun protection, and medical treatments, patients can effectively manage their condition and improve their quality of life.
From the Research
Rosacea Symptoms
- 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 2
- Episodes of flushing (acute-subacute intermittent vasodilation) are common 2
- Swelling and erythema of the nose along with dilatation of the pilosebaceous poral orifices, known as rhinophyma, can be noted in chronic cases 2
- 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 2
Types of Rosacea
- Erythematotelangiectatic rosacea: characterized by flushing, redness, and visible blood vessels 3
- Papulopustular rosacea: characterized by papules, pustules, and inflammation 3
- Phymatous rosacea: characterized by thickening of the skin and enlargement of the nose (rhinophyma) 3
- Ocular rosacea: characterized by inflammation of the eyes and eyelids 4
Treatment Options
- Topical medications: azelaic acid, metronidazole, sulfacetamide/sulfur, and ivermectin 5, 6, 2, 3, 4
- Oral antibiotics: tetracyclines, doxycycline, and minocycline 5, 6, 4
- Laser and light-based therapies: pulsed dye laser, intense pulsed light therapy, and Nd:YAG laser 4
- Other treatments: brimonidine, oxymetazoline, and isotretinoin 2, 4