From the Guidelines
Rosacea symptoms can be effectively managed with a phenotype-led treatment approach, prioritizing trigger avoidance and general skincare, as recommended by the global rosacea consensus panel 1. The condition typically presents with facial redness, visible blood vessels, small red bumps or pustules, eye irritation, skin thickening, and burning sensations.
- Symptoms can be triggered by sun exposure, hot or spicy foods, alcohol, extreme temperatures, stress, and certain skincare products.
- The condition is chronic, with no cure, but symptoms can be managed with proper treatment and trigger avoidance.
- A study published in 2024 found that once-daily oral doxycycline, formulated as a 40-mg dose, was effective in reducing inflammatory lesions in patients with moderate-to-severe rosacea 1.
- The global rosacea consensus panel recommends a treatment algorithm based on the individual patient's expression of concern and desire for treatment, taking into account disease activity, severity, and presenting features 1.
- The use of topical α-adrenergics, such as brimonidine, and oral beta blockers, such as carvedilol, are viable treatment options for transient erythema in rosacea, although evidence is limited 1.
- General skincare, including sun protection factor 30+, moisturizers, gentle cleansers, and trigger avoidance, underlies the treatment approach to managing cutaneous and ocular features of rosacea 1.
- Treatment should be allowed sufficient time to take effect, typically 6-12 weeks, before considering it a failure and choosing another option 1.
From the Research
Rosacea Symptoms
- Rosacea is a chronic cutaneous disorder 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
- 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, with women being affected more often than men 2
Clinical Features
- The diagnosis of rosacea is based on the presence of either phymatous changes or centrofacial persistent erythema, or any two of: flushing/transient erythema, papules and pustules, telangiectases, or ocular manifestations 3
- Clinical subtypes and grading of the disease have been defined in the literature, with the papulopustular subtype being one of the most common 4
Treatment Options
- Topical medications such as azelaic acid, metronidazole, and sulfacetamide/sulfur are commonly used to treat rosacea, with oral antibiotics such as tetracyclines and oral retinoids also being effective 2, 5
- Light therapies such as intense pulsed light and pulsed dye laser are best used for the erythemato-telangiectatic type of rosacea 2
- Newer treatment options include topical brimonidine, oxymetazoline, ivermectin, and low-dose modified-release tetracyclines, which have shown promise in treating rosacea symptoms 2, 3, 6