Medical treatment of rosacea with emphasis on topical therapies.
Due to the development and release of newer topical formulations, the diagnosis and treatment of rosacea has received renewed attention over the past 3-5 years both in the literature and at medical symposia. Rosacea is a very common facial dermatosis. In the US, rosacea is estimated to affect > 14 million people, predominantly adults with approximately 60% of cases diagnosed before the age of 50. A frustrating aspect of the disease is its inherent chronicity punctuated with periods of exacerbation and relative remission. A variety of subtypes have been identified which correlate with clinical presentation. Although the pathogenesis of rosacea is poorly understood, multiple topical agents are available. The efficacy of topical therapy for rosacea relates primarily to reduction in inflammatory lesions (papules, pustules), decreased intensity of erythema, a reduction in the number and intensity of flares and amelioration of symptoms, which may include stinging, pruritus and burning. The list of main topical agents utilised for the treatment of rosacea include metronidazole, sulfacetamide-sulfur, azelaic acid and topical antibiotics (clindamycin, erythromycin). Depending on the severity at initial presentation, topical therapy may be combined with systemic antibiotic therapy (e.g., oral tetracycline derivative). Newer therapeutic choices primarily involve improved vehicle formulations, which demonstrate favourable skin tolerability and cosmetic elegance.
Del Rosso
James Q
JQ
Department of Dermatology, University of Nevada School of Medicine, Las Vegas, Nevada, USA. doctorskin777@yahoo.com
D000287:Administration, Topical; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003998:Dicarboxylic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D010349:Patient Compliance; D012393:Rosacea / Q000188:drug therapy* / Q000209:etiology; D013409:Sulfacetamide / Q000008:administration & dosage / Q000627:therapeutic use; D013455:Sulfur / Q000008:administration & dosage / Q000627:therapeutic use; D013473:Sunscreening Agents / Q000008:administration & dosage / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D003879:Dermatologic Agents; D003998:Dicarboxylic Acids; D013473:Sunscreening Agents; D008795:Metronidazole; D013409:Sulfacetamide; D013455:Sulfur; C010038:azelaic acid