References

Abram K, Silm H, Maaroos HI, Oona M. Risk factors associated with rosacea. J Eur Acad Dermatol Venereol. 2010; 24:(5)565-571 https://doi.org/10.1111/j.1468-3083.2009.03472.x

Alam M, Voravutinon N, Warycha M Comparative effectiveness of nonpurpuragenic 595-nm pulsed dye laser and microsecond 1064-nm neodymium:yttrium-aluminum-garnet laser for treatment of diffuse facial erythema: a double-blind randomized controlled trial. J Am Acad Dermatol. 2013; 69:(3)438-443 https://doi.org/10.1016/j.jaad.2013.04.015

Aldrich N, Gerstenblith M, Fu P Genetic vs environmental factors that correlate with rosacea: a cohort-based survey of twins. JAMA Dermatol. 2015; 151:(11)1213-1219 https://doi.org/10.1001/jamadermatol.2015.2230

Bassi A, Campolmi P, Dindelli M Laser surgery in rhinophyma. G Ital Dermatol Venereol. 2016; 151:(1)9-16

Bikowski JB. Subantimicrobial dose doxycycline for acne and rosacea. Skinmed. 2003; 2:(4)234-245 https://doi.org/10.1111/j.1540-9740.2003.03014.x

Del Rosso JQ. Evaluating the role of topical therapies in the management of rosacea: focus on combination sodium sulfacetamide and sulfur formulations. Cutis. 2004; 73:29-33

Del Rosso JQ. Advances in understanding and managing rosacea: part 2: the central role, evaluation, and medical management of diffuse and persistent facial erythema of rosacea. J Clin Aesthet Dermatol. 2012; 5:(3)26-36

Elewski BE, Draelos Z, Dreno B, Jansen T, Layton A, Picardo M. Rosacea—global diversity and optimized outcome: proposed international consensus from the Rosacea International Expert Group. J Eur Acad Dermatol Venereol. 2011; 25:(2)188-200 https://doi.org/10.1111/j.1468-3083.2010.03751.x

Forton FMN. The pathogenic role of demodex mites in rosacea: a potential therapeutic target already in erythematotelangiectatic rosacea?. Dermatology Ther (Heidelb). 2020; 10:(6)1229-1253 https://doi.org/10.1007/s13555-020-00458-9

Fowler J, Jackson M, Moore A Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. 2013; 12:(6)650-656

Gether L., Overgaard LK, Egeberg A, Thyssen JP. Incidence and prevalence of rosacea: a systematic review and meta-analysis. Br J Dermatol. 2018; 179:(2)282-289

Guertler A, Jøntvedt NM, Clanner-Engelshofen BM, Cappello C, Sager A, Reinholz M. Efficacy and safety results of micellar water, cream and serum for rosacea in comparison to a control group. J Cosmet Dermatol. 2020; 19:(10)2627-2633 https://doi.org/10.1111/jocd.13591

Handler MZ, Bloom BS, Goldberg DJ. IPL vs PDL in treatment of facial erythema: a split-face study. J Cosmet Dermatol. 2017; 16:(4)450-453 https://doi.org/10.1111/jocd.12365

Kim MJ, Kim JH, Cheon HI Assessment of skin physiology change and safety after intradermal injections with botulinum toxin: a randomized, double-blind, placebo-controlled, split-face pilot study in rosacea patients with facial erythema. Dermatol Surg. 2019; 45:(9)1155-1162 https://doi.org/10.1097/dss.0000000000001819

Ilkovitch D, Pomerantz RG. Brimonidine effective but may lead to significant rebound erythema. J Am Acad Dermatol. 2014; 70:(5)109-110 https://doi.org/10.1016/j.jaad.2014.01.853

Reinholz M, Ruzicka T, Steinhoff M Pathogenesis and clinical presentation of rosacea as a key for a symptom-oriented therapy. J Dtsch Dermatol Ges. 2016; 14:4-15 https://doi.org/10.1111/ddg.13139

Rivero AL, Whitfeld M. An update on the treatment of rosacea. Aust Prescr. 2018; 41:(1)20-24 https://doi.org/10.18773/austprescr.2018.004

Santoro F, Lachmann N. An open-label, intra-individual study to evaluate a regimen of three cosmetic products combined with medical treatment of rosacea: cutaneous tolerability and effect on hydration. Dermatol Ther. 2019; 9:(4)775-784 https://doi.org/10.1007/s13555-019-00331-4

Sbidian E, Vicaut E, Chidiack H A randomized-controlled trial of oral low-dose isotretinoin for difficult-to-treat papulopustular rosacea. J Invest Dermatol. 2016; 136:(6)1124-1129 https://doi.org/10.1016/j.jid.2016.01.025

Sorbellini E, De Padova MP, Rinaldi F. Coupled blue and red light-emitting diodes therapy efficacy in patients with rosacea: two case reports. J Med Case Rep. 2020; 14:(1) https://doi.org/10.1186/s13256-019-2339-6

Steinhoff M, Schmelz M, Schauber J. Facial erythema of rosacea—aetiology, different pathophysiologies and treatment options. Acta Derm Venereol. 2016; 96:(5)579-586 https://doi.org/10.2340/00015555-2335

Stucker FJ, Lian T, Sanders K. The ABCs of rhinophyma management. Am J Rhinol. 2003; 17:(1)45-49 https://doi.org/10.1177/194589240301700108

Taieb A, Ortonne JP, Ruzicka T, Roszkiewicz J, Berth-Jones J, Peirone MH, Jacovella J. Ivermectin Phase III study group. Superiority of ivermectin 1% cream over metronidazole 0.75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial. Br J Dermatol. 2015; 172:(4)1103-1110 https://doi.org/10.1111/bjd.13408

Tan J, Almeida LM, Bewley A Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROSacea Consensus (ROSCO) 2019 panel. Br J Dermatol. 2017; 176:(2)431-438 https://doi.org/10.1111/bjd.15122

Thiboutot D, Thieroff-Ekerdt R, Graupe K. Efficacy and safety of azelaic acid (15%) gel as a new treatment for papulopustular rosacea: results from two vehicle-controlled, randomized phase III studies. J Am Acad Dermatol. 2003; 48:(6)836-845 https://doi.org/10.1067/mjd.2003.308

van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MM, Charland L. Interventions for rosacea. Cochrane Database Syst Rev. 2015; 2015:(4) https://doi.org/10.1002/14651858.CD003262.pub5

van Zuuren EJ. Rosacea. N Engl J Med. 2017; 377:(18)1754-1764 https://doi.org/10.1056/nejmcp1506630

Valentín S, Morales A, Sánchez JL, Rivera A. Safety and efficacy of doxycycline in the treatment of rosacea. Clin Cosmet Investig Dermatol. 2009; 2:129-140 https://doi.org/10.2147/ccid.s4296

Wang Y, Zhang H, Fang R, Tang K, Sun Q. The top 100 most cited articles in rosacea: a bibliometric analysis. J Eur Acad Dermatol Venereol. 2020; 34:(10)2177-2182 https://doi.org/10.1111/jdv.16305

Yamasaki K, Di Nardo A, Bardan A Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nat Med. 2007; 13:(8)975-980 https://doi.org/10.1038/nm1616

Dermatology

An introduction to treating rosacea

02 April 2022
Clinical
02 April 2022
Volume 11 · Issue 3

Abstract

Rosacea is a fairly common condition, especially in fair-haired, blue-eyed people, that mainly affects the centre of the face, causing erythema and papules and pustules. It is a chronic condition and requires correct diagnosis and careful management to achieve optimal results. Gentle skincare is vital. Topical agents, such as azelaic acid, metronidazole, ivermectin and brimodinine tartrate are useful. Oral antibiotics, such as doxcycline and clarithromycin, as well as isotretinion, also play a role. Aesthetic clinics may see patients presenting for laser or intense pulsed light treatments for the telangectasia that is often present. This forms only part of the overall package of treatments.

Rosacea is a common chronic skin condition that affects the face. It is most common in fair-haired, blue-eyed people, and affects approximately 5% of the world's population (Gether et al, 2018). There is a bimodal prevalence, with the main peak occurring between the ages of 40–50 years.

Diagnosis of rosacea can be difficult at times. The rash in this condition is central on the face, sparing the periorbital and perioral region.

There is:

Other features include rhinophyma, which is marked thickening of the nose skin, and ocular involvement in 50% of cases, which includes conjunctivitis, blepharitis, chalazion and episcleritis. There may even be iritis and keratitis.

Features that might aid diagnosis include:

The following can aggravate the symptoms of rosacea:

Other conditions that may be confused with rosacea include:

Diagnosis can still be difficult, and conditions can co-exist. Sometimes a biopsy is necessary for diagnosis.

In 2017, Tan et al endorsed a consensus of diagnostic criteria, constructed by a panel of international experts from ROSacea COnsensus (ROSCO). It is considered to be a useful diagnostic schema.

Register now to continue reading

Thank you for visiting Journal of Aesthetic Nurses and reading some of our peer-reviewed resources for aesthetic nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month

Register
Or continue by

Signing in with your registered email address

Rosacea
Diagnosis
Skincare
Topical agents
Light-based treatments