Rosacea: New and Emerging Treatments

Abstract

Rosacea is a chronic inflammatory skin condition that negatively impacts patients' quality of life. We sought to review important aspects of the pathogenesis of rosacea and the role of new treatment options in its management. New, emerging treatments show promise; however, quality randomized controlled trials for many of these drugs are lacking. Brimonidine tartrate is an effective newly approved treatment for erythematotelangiectatic rosacea. Topical oxymetazoline has potential for the treatment of erythematotelangiectatic rosacea, with efficacy described in case reports and randomized controlled trials currently underway. Both oral and topical ivermectin have been studied for the treatment of papulopustular rosacea, both showing benefit; however, only topical ivermectin 1 % cream has been studied in randomized controlled trials. As our understanding of the etiology of rosacea continues to evolve, so will our options for therapeutic interventions. Further studies need to be performed to assess the long-term safety and efficacy of these treatments.

Ivermectin: A Review in Rosacea

“…There is currently no cure for rosacea and it can be difficult to treat [1,4]. In addition to general skin care approaches (e.g.…”

“…Rosacea is a common chronic inflammatory skin disease that occurs mainly in adults [1,2]. The affected skin is usually located centrally on the face and can sting and feel like it is burning; these sensations may also be accompanied by inflammatory lesions (e.g.…”

“…The affected skin is usually located centrally on the face and can sting and feel like it is burning; these sensations may also be accompanied by inflammatory lesions (e.g. pustules/papules), erythema, scaling and/or phymatous growth, which can be disfiguring and distressing [1][2][3]. Of the various forms of rosacea (classified mainly on the basis of symptoms and lesion morphology [4]), papulopustular rosacea, which is characterized by persistent erythema and transient papules/pustules, is one of the most inflammatory [2]; however, in practice, the range of symptoms experienced by patients with rosacea often overlap more than one subtype [4].…”

“…Pharmacological agents that target inflammatory pathways associated with rosacea have historically been the focus of therapy [1,5], with topical metronidazole or azelaic acid and oral antibacterials (mainly of the tetracycline class) being widely used for this reason [5]. In addition, there is growing interest in using agents that have supplementary anti-parasitic properties, as there is potential for commensal Demodex mite overgrowth to be involved in rosacea pathophysiology [1,6]. The Demodex load of rosacea skin is increased (i.e.…”

Ivermectin cream for rosacea

“…General measures for people with rosacea include avoiding irritants and triggers (such as extremes of temperature, alcohol, exercise and vasodilatory drugs such as calcium-channel blockers), and using high-factor sunscreen and cosmetic camouflage 8,9. Treatment strategies for people with rosacea are usually tailored to the specific subtype when possible.…”