Rosacea (from Latin acne rosacea – rosacea) – a chronic relapsing disease of the skin of the face, characterized by redness, expansion of small and superficial vessels of the skin of the face, the formation of papules, pustules and edema. The pathogenesis of rosacea is based on a change in the tone of the superficial skin arterioles under the influence of pro-inflammatory factors, probably of autoimmune origin.
There are several forms of rosacea that require adequate treatment. In the article estet-portal.com you can learn in detail the distinctive characteristics of treatment tactics depending on the clinical form of rosacea.
Rosacea: epidemiology and classification
The Rosacea Society National Review Committee identifies four subtypes of rosacea: erythematotelangiectatic, papulo-pustular, phymatous, and ocular, although these patterns are not always single in clinical practice (see figure).
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Rosacea affects all ethnic groups, but fair-skinned people of European ancestry are most vulnerable, with one Swedish study putting a prevalence rate of 10%. The global prevalence of rosacea is 5.41% in women and 3.9% in men, and the condition primarily occurs in adults aged 45 to 60 years of age.
Differentiated approach to the treatment of rosacea
Different types of rosacea require different treatments. In this context, each patient with rosacea needs their own individual treatment plan.
1. Papulo-pustular rosacea
This subtype responds well to topical metronidazole (0.75%, 1%), azelaic acid, and ivermectin. Medicines such as topical sulfacetamide or dapsone may also be helpful, either on their own or as part of a combination treatment. The choice of daily care is also important, as gel or foam should be recommended for oily skin patients, while creams or lotions are best for those with dry skin.
Low-dose dosicycline (40 mg/day) is the only FDA-approved treatment for papulopustular rosacea; however, evidence supports the beneficial use of minocycline and azithromycin. Some severe cases of papulopustular rosacea respond well to low-dose oral isotretinoin, but patients tend to relapse after stopping the drug.
Treatment of rosacea with botulinum toxin type A
2. Erythemo-telangiectatic rosacea
In contrast, this subtype of rosacea does not respond well to oral antibiotics. These patients benefit from trigger avoidance, gentle skin care, photoprotection, and judicious use of topical vasoconstrictors.
To date, two topical alpha-adrenergic receptor agonists have been approved by the FDA for the treatment of persistent facial erythema rosacea: bramimonidine tartrate 0.5% gel and 1% oxymetazoline hydrochloride.
Patients using these topical vasoconstrictors experience temporary erythema mitigation, but some may experience habituation problems.
According to recent studies, daily caffeine intake can reduce the symptoms of rosacea.
3. Phymatous rosacea
This subtype is the most difficult to treat and usually requires a combination of topical antimicrobials; low-dose doxycycline; and mechanical, laser and/or radiofrequency treatment of hypertrophic tissue for optimal treatment is acceptable.
4. Ocular rosacea
Patients with signs or symptoms of ocular rosacea should be referred to an ophthalmologist for optimal treatment; this form may require a combination of low-dose doxycycline, topical azithromycin, and/or cyclosporine. Early detection and intervention are critical in this form.
Thus, knowing the nuances of rosacea treatment will help the doctor prescribe the most effective treatment option, which will significantly improve the patient's quality of life.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Dermatology" section. You may be interested in Which drugs are more likely to cause toxicoderma
Adapted from Medscape
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