Materiały źródłowe

• #1 An update on the treatment of rosacea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5828925/

  Rosacea is a common inflammatory skin disorder that can seriously impair quality of life. […] Treatment starts with general measures which include gentle skin cleansing, photoprotection and avoidance of exacerbating factors such as changes in temperature, ultraviolet light, stress, alcohol and some foods. […] For patients with the erythematotelangiectatic form, specific topical treatments include metronidazole, azelaic acid, and brimonidine as monotherapy or in combination. Laser therapies may also be beneficial. […] For the papulopustular form, consider a combination of topical therapies and oral antibiotics. Antibiotics are primarily used for their anti-inflammatory effects. […] For severe or refractory forms, referral to a dermatologist should be considered. Additional treatment options may include oral isotretinoin, laser therapies or surgery.

• #1 An update on the treatment of rosacea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5828925/

  Patients should be checked after the first 68 weeks of treatment to assess effectiveness and potential adverse effects. […] The treatment plan will be adapted to the subtype of rosacea and then realistic expectations are set and potential adverse effects discussed. This enables the patient to participate in the choice of therapy appropriate for them and consider the balance between the disease and the treatment. […] Treatment can be optimised according to the dominant features. […] Topical therapies are recommended for at least six weeks to effectively review the response. […] Topical corticosteroids should be avoided. […] Treatment for flushing and erythema may involve oral drugs with vasoconstriction properties including adrenergic antagonists including mirtazapine (alpha blocker), propranolol (beta blocker) or carvedilol (both alpha and beta blocker).

• #2 An update on the treatment of rosacea – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/an-update-on-the-treatment-of-rosacea.html

  Rosacea is a common inflammatory skin disorder that can seriously impair quality of life. […] Treatment starts with general measures which include gentle skin cleansing, photoprotection and avoidance of exacerbating factors such as changes in temperature, ultraviolet light, stress, alcohol and some foods. […] For patients with the erythematotelangiectatic form, specific topical treatments include metronidazole, azelaic acid, and brimonidine as monotherapy or in combination. Laser therapies may also be beneficial. […] For the papulopustular form, consider a combination of topical therapies and oral antibiotics. Antibiotics are primarily used for their anti-inflammatory effects. […] For severe or refractory forms, referral to a dermatologist should be considered. Additional treatment options may include oral isotretinoin, laser therapies or surgery.

• #2 An update on the treatment of rosacea – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/an-update-on-the-treatment-of-rosacea.html

  Patients should be checked after the first 6-8 weeks of treatment to assess effectiveness and potential adverse effects. […] The treatment plan will be adapted to the subtype of rosacea and then realistic expectations are set and potential adverse effects discussed. […] Treatment can be optimised according to the dominant features. […] Topical therapies are recommended for at least six weeks to effectively review the response. […] Topical corticosteroids should be avoided. […] Treatment for flushing and erythema may involve oral drugs with vasoconstriction properties including adrenergic antagonists including mirtazapine (alpha blocker), propranolol (beta blocker) or carvedilol (both alpha and beta blocker). […] Clonidine is an oral alpha2 agonist that has been used for flushing.

• #2 An update on the treatment of rosacea – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/an-update-on-the-treatment-of-rosacea.html

  Brimonidine is a topical alpha2 agonist which can reduce erythema for up to 12 hours through direct cutaneous vasoconstriction. […] Topical treatments for this form of rosacea include metronidazole, azelaic acid and brimonidine. […] Laser therapy, including vascular lasers or intense pulse light, may help to reduce refractory background erythema and clinically significant telangiectases, but will not reduce the frequency of flushing episodes. […] Combining topical treatments with oral antibiotics may be needed for papulopustular rosacea. […] Oral isotretinoin is usually reserved for patients who are intolerant to oral or systemic therapies. […] The hypertrophied tissue in patients with phymatous rosacea can be reshaped and contoured with ablative lasers including carbon dioxide or electrosurgery devices.

• #2 An update on the treatment of rosacea – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/an-update-on-the-treatment-of-rosacea.html

  Lid care and artificial tears are used for ocular rosacea, as are oral tetracyclines. […] If there is an important clinical improvement in the first six weeks, the patient may need to stay on therapy for at least six months. […] Rosacea can be a challenging condition to treat. Tailoring therapies to the type of rosacea is an important part of management.

• #3 Rosacea Treatment Algorithms | Rosacea.org

  https://www.rosacea.org/physicians/rosacea-treatment-algorithms

  Rosacea is now identified according to its individual characteristics, or phenotypes, which may appear in different combinations and at different times. […] The following treatment algorithms are based on the 2019 update to the standard management options for rosacea, as well as the original 2009 publication and studies of more recently developed therapies. The algorithms are intended to provide a comprehensive summary of treatment options for the respective phenotypes, allowing physicians to tailor therapy for each individual case to achieve optimal patient outcomes. […] Identification and avoidance of environmental and lifestyle triggers to minimize flushing and irritation may be especially important in addition to an appropriate skin care regimen (including mild moisturizers and cleansers, and broad-spectrum sun protection); nonirritating cosmetics may conceal the appearance of erythema.

• #3 Rosacea Treatment Algorithms | Rosacea.org

  https://www.rosacea.org/physicians/rosacea-treatment-algorithms

  In addition to above: daily application of topical oxymetazoline hydrochloride or brimonidine. Intense pulsed light (IPL), KTP laser or pulsed-dye laser may diminish erythema in patients with Fitzpatrick skin types I-IV. […] In addition to above: oral therapies including minocycline or doxycycline (at sub-antimicrobial doses or full strength), or carvedilol. […] Topical retinoid or oral antibiotics, in combination with surgical intervention for rhinophyma, as described below. […] In addition to above: may require surgical therapy, including cryosurgery, radiofrequency ablation, electrosurgery, heated scalpel, electrocautery, tangential excision combined with scissor sculpturing, skin grafting and dermabrasion; CO2 or erbium lasers may be used as a bloodless scalpel to remove excess tissue and recontour the nose.

• #3 Rosacea Treatment Algorithms | Rosacea.org

  https://www.rosacea.org/physicians/rosacea-treatment-algorithms

  In addition to above: in refractory cases, alternative therapies may be used, such as topical clindamycin, topical retinoids or oral antibiotics, oral isotretinoin, or trimethoprim/sulfamethoxazole. […] Long-pulsed dye or KTP lasers or IPL device or electrosurgery can remove telangiectases and reduce vascular erythema. Topical retinoids may also reduce telangiectasia. […] In addition to above: topical therapies such as oxymetazoline, brimonidine or ivermectin, or oral therapies such as carvedilol, clonidine or propranolol may reduce flushing response. […] A course of oral cyclosporine for 2-3 months may reduce inflammation; oral antibiotics such as sub-antimicrobial minocycline or doxycycline, azithromycin, or trimethoprim/sulfamethoxazole may also be used. […] Care by an ophthalmologist is required and may include a topical steroid, alternative oral medications and potential surgery.

• #4 Rosacea: Diagnosis and treatment

  https://www.aad.org/public/diseases/rosacea/treatment/diagnosis-treat

  Thanks to research breakthroughs, many made by dermatologists, there are numerous rosacea treatments available today. […] A board-certified dermatologist can explain which ones may work best for you. […] If you have rosacea, your dermatologist will create a treatment plan tailored to your individual needs. […] The goals of treatment are to: Reduce (or eliminate) signs of rosacea. Ease your discomfort. Prevent rosacea from worsening. […] Your treatment plan will include tips to help you avoid what triggers your flare-ups, gentle skin care, and sun protection. When used along with medication, laser or light therapy, and other treatment as needed, this type of plan can help to control rosacea. […] Skin care is an essential part of every rosacea treatment plan. […] Here are treatments that your dermatologist may include to treat the following signs and symptoms of rosacea.

• #4 Rosacea: Diagnosis and treatment

  https://www.aad.org/public/diseases/rosacea/treatment/diagnosis-treat

  Medication is another treatment option. Your dermatologist may prescribe one that can reduce flushing. […] When the color stays on your face, your dermatologist may prescribe one of the following FDA-approved medications: Brimonidine gel or oxymetazoline cream: Both of these medications can fade the persistent color for up to 12 hours. […] The right laser can effectively reduce the red or pink (lighter skin tones) or the violet or brown (darker skin tones) color changes that can occur. […] A medication that you apply to your skin (topical) is often effective for treating acne-like breakouts. […] If topical treatment doesn’t work or you need stronger treatment, an oral (take by mouth) antibiotic may be part of your treatment plan. […] Occasionally, your dermatologist may prescribe one of the following medications: Sulfacetamide and sulfur lotion: This medication combines an antibiotic with sulfur, which can remove the top layer of skin.

• #4 Rosacea: Diagnosis and treatment

  https://www.aad.org/public/diseases/rosacea/treatment/diagnosis-treat

  If you wish to treat the visible blood vessels on your face, tell your dermatologist. Treatment is available. […] When rosacea affects your eyes, treatment is essential. […] If your dermatologist treats you, your treatment will include one or more of the following: Warm compresses and eyelid hygiene: This can reduce symptoms. […] The earlier phyma is diagnosed and treated, the better. Your dermatologist may be able to treat it with medication if caught early enough. […] To prevent thickened skin from growing thicker, your dermatologist may prescribe: Doxycycline: This is an antibiotic that can prevent skin from further thickening. […] Once rosacea is under control, your dermatologist may switch you to a maintenance treatment plan. This can help you maintain your results and often requires using a single treatment.

• #5 Rosacea: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0801/p187.html

  Because rosacea can be triggered by a variety of stimuli, avoidance of known triggers is recommended. […] Properly selected skin care products improve and maintain the integrity of the stratum corneum permeability barrier and reduce skin sensitivity. […] Five topical agents are approved by the U.S. Food and Drug Administration (FDA) for the treatment of rosacea: metronidazole 0.75% lotion (Metrolotion), 0.75% cream (Metrocream), and 1% gel (Metrogel); azelaic acid 15% gel (Finacea); sulfacetamide 10%/sulfur 5% cream, foam, lotion, or suspension; brimonidine 0.33% gel (Mirvaso); and most recently, topical ivermectin 1% cream (Soolantra). […] Topical agents are first-line therapy in the treatment of mild to moderate rosacea. […] Oral isotretinoin may have a role in the management of refractory papulopustular and phymatous rosacea.

• #5 Rosacea: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0801/p187.html

  For patients with moderate to severe papulopustular rosacea or those experiencing an inadequate response to topical therapy, limited studies support combination therapy (usually oral subantimicrobial-dose doxycycline and topical metronidazole or azelaic acid). […] Phymatous rosacea can be disfiguring and difficult to treat. Best results are achieved when treatment is instituted early. Oral isotretinoin may be effective in reducing nasal volume in early disease; however, recurrence is likely after discontinuation, and mucinous and fibrotic changes are unresponsive. […] More than 50% of patients with cutaneous rosacea have ocular symptoms that may include tearing, foreign body sensation, itching, photophobia, and blurred vision.

• #5 Rosacea: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0801/p187.html

  First-line therapy for mild to moderate inflammatory rosacea includes topical metronidazole (Metrolotion, Metrocream, Metrogel) or azelaic acid (Finacea). […] Brimonidine (Mirvaso) can be used to treat persistent facial erythema associated with rosacea. […] Topical ivermectin (Soolantra) may be used for the treatment of papulopustular rosacea. […] Subantimicrobial-dose doxycycline (Oracea) can be used to treat inflammatory lesions of papulopustular rosacea. […] Mild ocular rosacea should be treated with eyelid hygiene and topical antibiotic agents, such as metronidazole and erythromycin. […] Topical ophthalmic cyclosporine drops (Restasis) are more effective than artificial tears in the management of mild ocular rosacea. […] Although rosacea findings may change over time, no proven natural progression exists. Treatment decisions are based on the patient’s current clinical manifestations.

• #6 Rosacea: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0801/p187.html

  Rosacea is a chronic facial skin condition of unknown cause. It is characterized by marked involvement of the central face with transient or persistent erythema, telangiectasia, inflammatory papules and pustules, or hyperplasia of the connective tissue. […] The National Rosacea Society Expert Committee defines four subtypes of rosacea (erythematotelangiectatic, papulopustular, phymatous, and ocular) and one variant (granulomatous). Treatment starts with avoidance of triggers and use of mild cleansing agents and moisturizing regimens, as well as photoprotection with wide-brimmed hats and broad-spectrum sunscreens (minimum sun protection factor of 30). For inflammatory lesions and erythema, the recommended initial treatments are topical metronidazole or azelaic acid. Once-daily brimonidine, a topical alpha-adrenergic receptor agonist, is effective in reducing erythema. Papulopustular rosacea can be treated with systemic therapy including tetracyclines, most commonly subantimicrobial-dose doxycycline. Phymatous rosacea is treated primarily with laser or light-based therapies. Ocular rosacea is managed with lid hygiene, topical cyclosporine, and topical or systemic antibiotics.

• #7 Rosacea Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1071429-treatment

  Avoidance of triggering factors […] Before the initiation of therapy, the triggering factors that exacerbate the patient’s rosacea should be identified and avoided if possible. […] Nonablative laser therapy acts against rosacea by remodeling of the dermal connective tissue and improving the epidermal barrier. […] Vascular lasers are the mainstay of rosacea therapy. […] Topical metronidazole is commonly used as a first-line agent. […] Topical azelaic acid, sulfacetamide products, and topical acne medications are also commonly used. […] Topical and oral antibiotics are also very effective, and for oral rosacea, they are usually considered a first-line therapy. […] A topical form of the alpha-2 agonist brimonidine was approved by the US Food and Drug Administration (FDA) in August 2013 for treatment of erythema associated with rosacea.

• #7 Rosacea Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1071429-treatment

  Topical ivermectin is FDA-approved for treatment of the inflammatory lesions of rosacea. […] Sunscreen is recommended for all patients with rosacea. […] Permanent telangiectasia may be treated by means of electrosurgery or the 585-nm pulsed dye laser. […] Cosmetic improvement of rhinophyma may be produced by mechanical dermabrasion, carbon dioxide laser peel, and surgical shave techniques.

• #8 Rosacea: Learn More – What are the treatment options for rosacea? – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279475/

  Facial redness is sometimes treated with beta blockers. This medication causes the blood vessels to become narrower, which lets less blood flow through the skin on the face. […] Raised spots (papules) and pus-filled spots (pustules) on the skin can be treated with medications that are applied directly to the skin. Creams, gels and lotions containing azelaic acid, ivermectin or metronidazole are normally used. […] Azelaic acid (trade names: Skinoren, Finacea) reduces inflammation and helps prevent pores from becoming blocked. […] Ivermectin (trade name: Soolantra) reduces inflammation and also fights certain mites that increase the risk of rosacea (Demodex mites). […] Metronidazole is an antibiotic drug that reduces inflammation. It is very commonly used in the treatment of rosacea.

• #8 Rosacea: Learn More – What are the treatment options for rosacea? – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279475/

  Rosacea can often be treated effectively with topical (externally applied) treatments. If that doesnt help enough or if the symptoms are severe, other possible treatments include medications that are swallowed. Laser treatment and light therapy can be used for visible blood vessels, and surgery is an option for treating severe rhinophyma (a very bulbous nose). […] Reddened facial skin can be treated with medication, usually in the form of a gel containing the active ingredient brimonidine. Laser treatment or intense pulsed light therapy can be used for small visible blood vessels. […] Brimonidine (trade name: Mirvaso) makes the blood vessels narrower, reducing the blood flow to the face and decreasing the redness. […] Laser treatment or intense pulsed light therapy are particularly suitable for rosacea with bothersome red blood vessels.

• #9 Rosacea – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/rosacea

  Oral antibiotics are indicated for patients with multiple papules or pustules and for those with ocular rosacea; options include doxycycline 50 to 100 mg 2 times a day, tetracycline 250 to 500 mg 2 times a day, minocycline 50 to 100 mg 2 times a day, erythromycin 250 to 500 mg 2 times a day, and azithromycin 250 mg once a day or various alternate-day or pulse dose regimens. […] Persistent erythema or flushing may be treated with the topical alpha-2-selective adrenergic agonist brimonidine 0.33% gel applied once a day or with the primarily alpha-1a agonist oxymetazoline hydrochloride 1% cream applied once a day. […] Recalcitrant cases may respond to oral isotretinoin. […] Techniques for treatment of rhinophyma include dermabrasion, laser ablation, and tissue excision; cosmetic results are good. […] Consider laser or electrocautery for telangiectasia.

• #10 Topical Treatment for Rosacea | NYU Langone Health

  https://nyulangone.org/conditions/rosacea/treatments/topical-treatment-for-rosacea

  Our doctors typically prescribe topical antibiotics for six to eight weeks. Together, you and your doctor assess their effectiveness and determine whether treatment should continue. You may see results in as few as two weeks, but its not unusual for this to take longer. […] Topical retinoids may be recommended if you have blemishes associated with rosacea. These blemishes are caused by clogged or inflamed pores, which are the tiny openings in the skin where hair follicles open to the surface. Topical retinoids help to clear the pores by reducing the clogging of the openings and may provide an anti-inflammatory effect as well. […] Azelaic acid is a naturally derived medication. It has been demonstrated to improve the appearance of redness and to reduce blemishes and whiteheads caused by rosacea. Azelaic acid is available over the counter as well as by prescription. Your doctor recommends the appropriate formula based on your symptoms.

• #11 Rosacea – Antibiotic Prescribing

  https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/skin-soft-tissue/rosacea/

  Papulopustular rosacea […] Refer to plastic surgeons or dermatology for discussion regarding shave excision or CO2 laser ablation. […] General Treatment of Rosacea […] SPF 50 cream to be used all year round […] Daily water-based creams and soap free pH balanced cleansers with lukewarm water […] Gentle skin cleanser […] Make up that contains a green / yellow pigment in the form of a primer can help camouflage erythema […] Topical treatments can be irritants especially at the start of treatment. To reduce this, apply every second day. Some patients may initially need to apply for one hour and then wash off, eventually building up tolerance over time to a once daily application […] Avoid topical steroids which are known to exacerbate rosacea. […] Combination therapy may be necessary to achieve satisfactory control of disease.

• #12 Advances in Rosacea Therapy

  https://www.dermatologytimes.com/view/advances-in-rosacea-therapy

  With all the recent advances in therapy for the chronic inflammatory and relapsing central facial dermatosis known as rosacea, the condition can nevertheless be very challenging to treat. […] The mainstay of rosacea treatment has classically been topical medications such as metronidazole 0.75% and 1% gel; azelaic acid 15% gel or 20% cream; sulfacetamide 10% and sulfur 5% lotion; tretinoin 0.25% to 1% cream; oral antibiotics from the tetracycline family; as well as the oral retinoids used alone or in combination with other treatment modalities. […] Depending on the severity of symptoms, I will sometimes opt for the submicrobial low-dose tetracyclines, because we know rosacea is not a bacterial issue but an inflammatory one. Therefore, it is the anti-inflammatory effect we want so we can lower the [adverse] effects of the oral antibiotic, particularly in patients who may require long-term therapy, Daveluy said.

• #13 Rosacea

  https://www.racgp.org.au/afp/2017/may/rosacea

  Rosacea is a chronic and common cutaneous condition characterised by symptoms of facial flushing and a broad spectrum of clinical signs. […] The objective of this article is to provide evidence-based clinical updates to clinicians, specifically general practitioners (GPs), to assist with their everyday practice, and effective assessment and treatment of rosacea. […] Therapeutic modalities are chosen on the basis of the subtypes and clinical features identified; often a combination of these therapies is required. […] The goals of pharmacotherapy for rosacea are to reduce morbidity and symptoms, and achieve disease control, as rosacea is not curable. […] Oral antibiotics reduce the inflammatory lesions, such as papules and pustules, as well as the ocular symptoms of rosacea. […] Doxycycline 50100 mg once daily is recommended as initial oral therapy.

• #13 Rosacea

  https://www.racgp.org.au/afp/2017/may/rosacea

  Alternative antibiotics include minocycline, erythromycin, cotrimoxazole or metronidazole. […] Topical agents are first-line therapy in the treatment of mild-to-moderate rosacea. […] For mild rosacea, it is recommended to use metronidazole cream or gel intermittently or long term. […] Azelaic acid is also helpful. […] Ivermectin cream is used to control Demodex mites. […] Brimonidine (eg Mirvaso) is shown to be effective in the treatment of ETR. […] Vascular laser therapy specifically targets haemoglobin in vessels, and hence, effectively treats facial erythema and telangiectasia. […] Phymatous rosacea can be disfiguring and difficult to treat. […] Oral isotretinoin is used to reduce nasal volume in early disease; however, after discontinuing the medication, recurrence is often seen.

• #13 Rosacea

  https://www.racgp.org.au/afp/2017/may/rosacea

  The subtype of rosacea and its associated clinical features determine which therapeutic modalities a clinician will use. […] Often, patients require a combination of therapies for effective treatment, as different subtypes co-exist, and because of the recalcitrant and persistent nature of rosacea.

• #14 Treatment Options for Acne Rosacea | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0901/p461.html

  Three studies have investigated the effectiveness of sulfacetamide/sulfur cream. […] Evidence for using oral antibiotics to treat rosacea is limited and is often based on clinical experience or older, low-quality studies instead of on well-designed RCTs. […] Initial therapy for moderate to severe rosacea should include oral treatment or a combination of topical and oral treatments. […] Subantimicrobial dose antibiotics may act as anti-inflammatory agents without creating bacterial resistance. […] Isotretinoin (Accutane) has been reported to be effective for treating rosacea, including rhinophyma, and appears to positively affect more than one subtype of the disease. […] Nearly 60 percent of persons with rosacea have ocular involvement. […] Mild ocular rosacea usually responds well to topical agents and eyelid hygiene. Moderate ocular rosacea should be treated with oral therapy.

• #15 Rosacea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rosacea/diagnosis-treatment/drc-20353820

  For more serious rosacea with bumps and pimples, you may be prescribed an oral antibiotic pill such as doxycycline (Oracea, others). […] For severe rosacea that doesn’t respond to other medicine, you may be prescribed isotretinoin (Amnesteem, Claravis, others). […] Laser treatment can help improve the look of enlarged blood vessels. It also can help the long-term redness of rosacea. […] Talk with a member of your healthcare team about the risks and benefits of laser treatment. […] The full effect of the treatment might not be seen for weeks. Repeat treatments may be needed to keep the improved look of your skin. […] Laser treatment for rosacea is sometimes considered a cosmetic procedure.

• #16 Rosacea | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/rosacea/

  Although rosacea cant be cured, treatment can help keep the symptoms under control. […] Treatment choices depend on which type of symptom is most troublesome, but usually involves a combination of self-help measures and medication. […] If you have round red bumps that rise from your skin (papules) and pus-filled swellings (pustules) caused by rosacea, there are a number of different medications that can be effective. […] Topical medications are usually prescribed first. […] If your symptoms are more severe, an oral antibiotic medication may be recommended as these can help reduce inflammation of the skin. […] Isotretinoin is a medicine often used to treat severe acne, but at lower doses its also occasionally used to treat rosacea. […] Treating facial redness and flushing caused by rosacea is generally more difficult than treating papules and pustules caused by the condition.

• #16 Rosacea | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/rosacea/

  Theres currently no cure for rosacea, but treatment can help control the symptoms. […] Long-term treatment is usually necessary, although there may be periods when your symptoms improve and you can stop treatment temporarily. […] For most people, treatment involves a combination of self-help measures and medication, such as: avoiding known triggers for example, avoiding drinks containing alcohol or caffeine, creams and gels medications applied directly to the skin to reduce spots and redness, oral medications tablets or capsules that can help clear up more severe spots, such as oral antibiotics. […] In some cases procedures such as laser and intense pulsed light (IPL) treatment may be helpful. These involve beams of light being aimed at the visible blood vessels in the skin to shrink them and make them less visible.

• #17 Lasers and lights: How well do they treat rosacea?

  https://www.aad.org/public/diseases/rosacea/treatment/lasers-lights

  Rosacea patient before and after with laser treatment Rosacea patient before and after 2 laser treatments: After treatment (right), the many tiny blood vessels on this patients cheek cleared. If you have rosacea, laser or light therapy may be a part of your treatment plan. Its unlikely to be your only treatment, though. […] When dermatologists create a treatment plan for rosacea, the plan often consists of medication, a rosacea friendly skin care plan, and tips to help you avoid flare-ups. Sometimes, a treatment plan also includes a procedure, such as laser therapy. […] A laser or light treatment can reduce (or get rid of) the blood vessels. To remove thickening skin, dermatologists may use laser resurfacing. […] Laser treatment can also reduce redness. In a few small studies, lasers were used to treat permanent redness on the face or the redness surrounding acne-like blemishes. Some patients saw a considerable reduction in redness. Most patients, however, had about a 20% reduction in redness.

• #17 Lasers and lights: How well do they treat rosacea?

  https://www.aad.org/public/diseases/rosacea/treatment/lasers-lights

  When used to treat visible blood vessels, most patients see a 50% to 75% reduction in visible blood vessels after 1 to 3 treatments. Some people see a 100% reduction. […] If you have thickening skin, a skilled cosmetic dermatologist can give you very good results with in-office surgery and laser resurfacing. […] When used to treat blood vessels, the results tend to last 3 to 5 years. Treated blood vessels dont reappear, but new ones can form. […] To help you get the best results, you should receive instructions that explain how to care for your treated skin. Follow these instructions carefully. […] Researchers continue to study how lasers and light treatments can treat rosacea. As we learn more, these devices may play a bigger role in treating rosacea.

• #18 Medical Therapy for Rosacea | Rosacea.org

  https://www.rosacea.org/patients/management-options/medical-therapy-for-rosacea

  Therapy: FDA-approved topical therapies considered very effective include ivermectin, azelaic acid and metronidazole. […] Light devices such as IPL, pulsed dye laser and KTP laser have been well studied to rid the skin of visible blood vessels. […] The topical therapies brimonidine and oxymetazoline may be used, as well as antibiotics, alpha- and beta-blockers, IPL and, more rarely, KTP laser. […] Therapy: Topical therapies include antibiotics and the immunosuppressive therapies cyclosporin and tacrolimus. […] Your doctor may advise you to keep a daily diary of lifestyle and environmental factors that appear to affect your rosacea to help identify and avoid your personal triggers. […] Gentle skin care and sun protection are important components of rosacea management. […] The goal of daily skin care is to maintain the integrity of the skin barrier while avoiding agents that aggravate inflammation or flushing.

• #18 Medical Therapy for Rosacea | Rosacea.org

  https://www.rosacea.org/patients/management-options/medical-therapy-for-rosacea

  Medical Therapy for Rosacea: Because of the potential complexity of rosacea and so little was known, for many years it was divided into subtypes according to signs and symptoms that often occur together. […] A growing range of therapies is now available to address each of these signs and symptoms, and research and clinical experience have found that medications used in combination may have a synergistic outcome that is more effective than use of a single therapy alone. […] Accordingly, your doctor will tailor your treatment regimen to address your individual case. […] As with any medical treatment, outcomes may vary from case to case. Compliance with therapy using each medication exactly as your doctor prescribes is an important key to success. Please consult a dermatologist or other physician to determine the appropriate regimen for you and how precisely to use it.

• #18 Medical Therapy for Rosacea | Rosacea.org

  https://www.rosacea.org/patients/management-options/medical-therapy-for-rosacea

  Therapeutic Options: Treatments targeted for individual phenotypes, alone or in combination, include a wide variety of topical and oral therapies as well as light devices and surgical interventions. […] An NRS Expert Committee recently assessed the various options according to effectiveness as well as the number of clinical studies. […] Therapy: Clinical evidence for the topical FDA-approved therapies brimonidine and oxymetazoline was strong and effective, while oral antibiotic therapies were less often used for this feature. […] For active cases with inflammation, topical retinoids are sometimes used in combination with oral therapies and/or treatments with surgical lasers. […] Treatment of the thickened skin of fixed phymas has been well studied and may often be effectively eradicated with a surgical laser or any of the other devices and/or surgical treatments mentioned above.

• #19 Non-Pharmacologic Treatment of Rosacea

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/non-pharmacologic-treatment-of-rosacea/

  Nonpharmacologic Treatment of Rosacea – CAM 20171 […] Description: Rosacea is a chronic, inflammatory skin condition without a known cure; the goal of treatment is symptom management. Nonpharmacologic treatments, including laser and light therapy, as well as dermabrasion, are proposed for patients who do not want to use or are unresponsive to pharmacologic therapy. […] Summary of Evidence For individuals who have rosacea who receive nonpharmacologic treatment (e.g., laser therapy, light therapy, dermabrasion), the evidence includes systematic reviews and several small, randomized, split-face design trials. […] The systematic reviews reported favorable effects on erythema and telangiectasia with several laser types, including intense pulsed light (IPL), pulsed dye lasers, and neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers. […] Overall, the systematic review results were insufficient to establish whether any laser type is more effective and safe than others. […] There is a need for RCTs that compare nonpharmacologic treatments with placebo controls and with pharmacologic treatments. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

• #20 Management of rosacea – UpToDate

  https://www.uptodate.com/contents/management-of-rosacea

  Management of rosacea […] Rosacea is a chronic and relapsing inflammatory skin disorder that primarily involves the central face. Common clinical features include facial erythema, telangiectasias, and inflammatory papules or pustules. Many patients seek therapy due to concern over the effect of rosacea on physical appearance. As there is no cure for rosacea, treatment is focused on symptom suppression. […] The management of rosacea will be discussed here. The pathogenesis and clinical features of rosacea are reviewed separately. […] Nonpharmacologic interventions may be useful for the management of the cutaneous manifestations of rosacea. These include avoidance of triggers of flushing, gentle skin care, sun-protection, and the use of cosmetic products. […] Given the common presence of multiple features, combination therapy may be necessary to achieve satisfactory control of disease.

• #21 Rosacea Treatment Houston TX

  https://www.dermlasersurgery.com/skin-conditions/rosacea/

  Our Houston Dermatologists Offer Advanced Rosacea Treatment […] Dr. Friedmand and Dr. Richmond, the Board-Certified Dermatologists at Dermatology Laser Surgery Center, are committed to advancing the effectiveness of treatment for rosacea. They have co-authored a clinical study on rosacea treatment that was published in Lasers in Surgery and Medicine, a distinguished peer-reviewed scientific journal. Their study found that a combination therapy of 2 pulsed dye laser treatments along with topical oxymetazoline 1.0% cream was safe and effective in reducing the dilated blood vessels (telangiectasia) as well as the background redness of rosacea.

• #22

  https://link.springer.com/article/10.1007/s13555-020-00461-0

  Laser and intense pulsed light (IPL) therapy are recommended for the treatment of erythema and mainly telangiectasia in the updated systematic review on interventions for rosacea. […] To date, two injection therapies have been demonstrated to be useful in rosacea treatment, namely, botulinum toxin and interleukin (IL)-17 inhibitors. […] The recent rosacea treatment update from the global ROSacea COnsensus (ROSCO) panel recommends that treatment for phyma should depend on whether it is inflamed or noninflamed. […] Combination therapy to target specific features is necessary to achieve effective treatment, especially in patients with severe rosacea or multiple rosacea features. […] In this review we summarize recent advances in rosacea treatment, including skin care and cosmetic treatments, topical therapies, oral therapies, laser-/light-based therapies, injection therapies, treatments for specific types of rosacea and treatments for systemic comorbidities, and combination therapies, in the era of phenotype-based diagnosis and classification for rosacea. […] Large-scale clinical research based on the phenotype approach is highly warranted in the future.

• #23 Rosacea: Practical Guidance and Challenges for Management | CCID

  https://www.dovepress.com/rosacea-practical-guidance-and-challenges-for-clinical-management-peer-reviewed-fulltext-article-CCID

  Tetracyclines, macrolides, and isotretinoin are considered mainstay oral medications and first-line therapies in the treatment of inflamed phymas and papulopustular rosacea. […] Although the quality of evidence is narrow, light therapies and lasers have been successful in the management of rosacea features, particularly telangiectasias and phymatous change. […] Combinative multimodal therapy is often utilized and required when treating patients with overlapping features of rosacea. […] The key to effectively managing rosacea is identification of phenotype, assessment of symptom severity, and choosing treatments that meet the patients needs and expectations.

• #24 Rosacea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rosacea/symptoms-causes/syc-20353815

  Flare-ups might be brought on by: Sun or wind. Hot drinks. Spicy foods. Alcohol. Very hot and cold temperatures. Emotional stress. Exercise. Drugs that dilate blood vessels, including some blood pressure medicines. Some cosmetic, skin and hair care products. […] Anyone can develop rosacea. But you may be more likely to develop it if you: Have skin that burns easily in the sun. Are between the ages of 30 to 50 years. Have a history of smoking. Have a family member with rosacea.

• #25 Advances in the Pathogenesis and Treatment of Rosacea: A Phenotype-Based Therapeutic Approach

  https://www.mdpi.com/2079-9284/11/1/11

  The key aspects of the phenotype-based therapeutic approaches in rosacea are summarized in Table 1. […] To date, different therapeutic strategies are available for the treatment of flushing and facial erythema, including topical, systemic, or combined approaches; with regard to telangiectasias, vascular lasers and light-based therapies should be preferred. […] Among the topical treatments, brimonidine tartrate (BT) topical gel is a highly selective α2 agonist approved for moderate-to-severe subtype I rosacea that induces the vasoconstriction of small arteries and veins, reducing vasodilation and edema. […] Oxymetazoline hydrochloride 1% cream represents another topical option for erythemato-telangiectatic rosacea. […] Several clinical trials on topical calcineurin inhibitors in papulopustular rosacea, such as pimecrolimus and tacrolimus, have shown excellent results in reducing the erythematous inflammatory component.

• #25 Advances in the Pathogenesis and Treatment of Rosacea: A Phenotype-Based Therapeutic Approach

  https://www.mdpi.com/2079-9284/11/1/11

  Finally, a few studies have demonstrated that topical metronidazole and topical azelaic acid may reduce erythema in rosacea patients, although their efficacy has only been demonstrated in patients suffering from the papulopustular subtype. […] Concerning oral therapies, the role of vasoactive compounds is still controversial. […] Vascular lasers and light-based therapies remain one of the most effective strategies for persistent vascular manifestation, including erythema and telangiectasia. […] In conclusion, patients with prominent telangiectasia will significantly benefit from laser/light-based therapies, but in case of prominent underlying erythema, which may impair the discrimination of telangiectasia, combination therapies can also be used. […] An intradermal injection of botulinum toxin (BTX) in large dilution has recently been used off-label in erythemato-telangiectatic rosacea resistant to previous treatments, with the aim of reducing flushing, erythema, and inflammatory lesions.

• #26 Rosacea Treatment – Nurx™

  https://www.nurx.com/rosacea-treatment/?srsltid=AfmBOop9DXbs1sXiptud28dx0zCUlmzZYq_YMrydoPjiBSFhHFBYDV81

  Once you share your health history and pay $40 for your medical consultation, a Nurx healthcare provider will evaluate your skin and determine the right treatment plan for you. Depending on the medication, you might receive an oral or topical medication in a 1-month or 3-month supply. […] Rosacea has many causes, including a family history of rosacea and the immune system overreacting to normal bacteria. Treatment usually focuses on zapping surface bacteria with some combination of an antibiotic cream, gel, or wash and a treatment like azelaic acid which reduces inflammation. Our medical team may also prescribe an oral antibiotic, especially if you experience more extensive pimple and pustule-like bumps. […] Rosacea medication isn’t one-size-fits-all, and the Nurx medical team will work to find what’s right for your skin. They prescribe medication (topical, oral or both), as appropriate, proven to reduce redness, bumps and other rosacea symptoms, and will follow up to make sure the treatment works.

• #27 Rosacea – Skin Therapy Letter

  https://www.skintherapyletter.com/rosacea/

  Read articles about rosacea, diagnosis, symptoms, management, and treatment. […] Rosacea is a common, chronic cutaneous condition that affects the face. Various conventional and emerging therapies for rosacea are reviewed. […] This article reviews data on Ivermectin cream 1%, a new topical treatment for PPR. […] This article reviews a variety of treatments for treatments for rosacea, including topical and systemic therapies. […] Research interest has led to the development of other emerging therapies including topical ivermectin, brimonidine and oxymetazoline that hold promise for patients suffering from this condition. […] The importance of tailored treatment is discussed as well as topical therapies. […] Many options exist for the treatment of rosacea, including topical and systemic therapies, laser and light-based therapies, and surgical procedures. The goals of therapy include reduction of papules, pustules, erythema, physical discomfort, and an improvement in quality of life.

• #28 Rosacea – Canadian Dermatology Association

  https://dermatology.ca/public-patients/diseases-conditions/skin-conditions/rosacea/

  Rosacea is a chronic inflammatory skin condition that affects over three million Canadians. […] There is no known cure, but it can be managed with appropriate treatment and lifestyle changes. […] Rosacea does not resolve on its own and untreated rosacea can worsen over time. […] Your family doctor or dermatologist can prescribe various treatments and recommend appropriate skin care products and cosmetics. While there is no cure, it can be managed with appropriate treatment and lifestyle changes. […] Sticking with your recommended treatment will can improve signs and symptoms within a few weeks. […] Topical Metronidazole: This topical agent, which has anti-inflammatory and antimicrobial effects, is considered a standard treatment for the pimples of rosacea. […] Azelaic Acid: Azelaic acid is a naturally occurring dicarboxylic acid possessing antibacterial activity. It is as effective as metronidazole for the pimples of rosacea.

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