Rosacea (Acne Rosacea)

A cutaneous disorder primarily of convexities of the central part of the FACE, such as FOREHEAD; CHEEK; NOSE; and CHIN. It is characterized by FLUSHING; ERYTHEMA; EDEMA; RHINOPHYMA; papules; and ocular symptoms. It may occur at any age but typically after age 30. There are various subtypes of rosacea: erythematotelangiectatic, papulopustular, phymatous, and ocular (National Rosacea Society's Expert Committee on the Classification and Staging of Rosacea, J Am Acad Dermatol 2002; 46:584-7).

Also Known As:

Networked: 949 relevant articles (184 outcomes, 170 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Erythema
2.	Acne Vulgaris
3.	Rosacea (Acne Rosacea)
4.	Telangiectasis (Telangiectasia)
5.	Flushing

Experts

1.	Del Rosso, James Q: 40 articles (06/2015 - 01/2004)
2.	Gallo, Richard L: 12 articles (05/2015 - 08/2007)
3.	Feldman, Steven R: 11 articles (10/2015 - 11/2005)
4.	Thiboutot, Diane: 10 articles (02/2014 - 06/2003)
5.	Schauber, Jürgen: 9 articles (09/2015 - 08/2008)
6.	Fleischer, Alan B: 9 articles (01/2015 - 11/2003)
7.	Steinhoff, Martin: 8 articles (09/2015 - 12/2011)
8.	Webster, Guy: 8 articles (02/2014 - 06/2005)
9.	Ruzicka, Thomas: 7 articles (09/2015 - 07/2003)
10.	Draelos, Zoe Diana: 7 articles (07/2015 - 10/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Rosacea:

1.	Metronidazole (Metric)FDA LinkGeneric 08/01/2007 - "The remarkable clinical efficacy of metronidazole in the treatment of rosacea is probably due to its ability to decrease ROS via different mechanisms, thereby protecting skin components from induced damage." 05/01/2000 - "Topical metronidazole formulations are significantly more effective than placebo when used in the initial treatment of patients with moderate to severe rosacea. " 05/01/2000 - "Metronidazole preparations (0.75 and 1% cream, 0.75% gel and 0.75% lotion) were significantly more effective than placebo in patients with moderate to severe rosacea when administered to the affected area once or twice daily for 7 to 12 weeks. " 01/01/2012 - "In conclusion, the microemulsion containing metronidazole was found to be more effective in reducing the symptoms of rosacea compared to the commercial gel product." 11/01/2001 - "The papules and pustules of rosacea can be effectively treated with topical metronidazole. "
2.	Doxycycline (Vibramycin)FDA LinkGeneric 01/01/2010 - "After 16 weeks' therapy, anti-inflammatory dose doxycycline 40 mg was significantly more effective in improving rosacea than placebo, providing a greater reduction in the total inflammatory lesion count (primary endpoint) than placebo. " 11/01/2011 - "Recently, a big randomized double-blind dose-response and comparative study revealed that an optimized dosage of 0,3 mg/kg was superior to other dosages and non-inferior to doxycycline as gold standard of systemic rosacea treatment and proved effective and safe in papulopustular and phymatous subtypes. " 01/01/2010 - "Recently, subantimicrobial-dose doxycycline was demonstrated to be an effective treatment for rosacea, due to its inherent anti-inflammatory properties. " 07/01/2007 - "Is low-dose doxycycline effective for rosacea?" 05/01/2007 - "Once-daily anti-inflammatory dose doxycycline appears to be effective and safe for the treatment of rosacea."
3.	azelaic acid (Azelex)FDA Link 10/01/2008 - "There are several topical and oral treatments available, of which azelaic acid 15% gel (Finacea) is the first new treatment for rosacea in more than a decade. " 10/01/2008 - "Clinical studies have shown that azelaic acid 15% gel is an effective and safe first-line topical therapeutic option in patients with mild-to-moderate papulopustular rosacea. " 06/01/2008 - "Twice-daily azelaic acid (AzA) is the conventional regimen for papulopustular rosacea, but once-daily AzA may be equally effective, with greater convenience and dosing flexibility. " 02/01/2006 - "Azelaic acid (AzA) initially was released in a 20% cream formulation, which has been shown to be effective in the treatment of mild to moderate rosacea. " 01/01/2004 - "Azelaic acid is a naturally occurring, straight-chain dicarboxylic acid which is effective in the treatment of rosacea, presumably on account of its anti-inflammatory properties. "
4.	Isotretinoin (Accutane)FDA LinkGeneric 12/01/1986 - "At the end of the study period, isotretinoin was found to be highly effective in the clearing of refractory rosacea lesions." 03/05/1982 - "13-cis-retinoic acid was given with good results to 7 patients with exceptionally severe rosacea. " 11/01/2011 - "Systemic isotretinoin has been known for decades as an effective and safe therapeutic option in the treatment of severe and refractory forms of rosacea. " 07/01/2010 - "Systemic isotretinoin has been known for decades to be effective in the treatment of severe forms of rosacea, but it must be used off-label because of the lack of evidence-based data. " 11/01/2011 - "However, the substance is still not licensed for this indication The efficacy of isotretinoin in rosacea is probably mainly related to anti-inflammatory mechanisms as well as anti-oxidative, anti-angiogenic and antifibrotic properties. "
5.	brimonidine (Alphagan)FDA LinkGeneric 07/01/2014 - "Few studies have looked at the effectiveness of the novel treatment, brimonidine topical gel 0.33%, trademark name Mirvaso®, in the treatment of rosacea. " 09/30/2015 - "Recently, brimonidine - a selective α2-receptor-agonist which causes vasoconstriction of small cutaneous vessels - was approved for the treatment of erythemato-telangiectatic rosacea. " 01/01/2015 - "The role of brimonidine tartrate gel in the treatment of rosacea." 01/01/2015 - "The first available pharmacologic treatment to address the redness associated with rosacea is topical brimonidine. " 01/01/2015 - "Optimizing the use of topical brimonidine in rosacea management: panel recommendations."
6.	pimecrolimus (Elidel)FDA Link 04/01/2007 - "[Steroid-aggravated rosacea: successful therapy with pimecrolimus]." 12/01/2011 - "The results of this study suggest that 1% pimecrolimus cream is an effective and well-tolerated treatment for patients with mild to moderate inflammatory rosacea." 05/01/2008 - "This study suggests that pimecrolimus 1% cream is an effective and well-tolerated treatment for steroid-induced rosacea." 01/01/2006 - "Pimecrolimus cream 1% is effective in a case of granulomatous rosacea." 04/01/2007 - "An open-label pilot study to evaluate the safety and efficacy of topically applied pimecrolimus cream for the treatment of steroid-induced rosacea-like eruption."
7.	Tacrolimus (Prograf)FDA LinkGeneric 02/01/2009 - "Clinical efficacy of tacrolimus in rosacea." 01/01/2004 - "Twenty-four patients with erythrotelangiectatic or papulopustular rosacea were treated with 0.1% tacrolimus topical ointment in a 12-week open-label trial. " 06/01/2015 - "Topical tacrolimus has been observed to induce granulomatous rosacea (GR) in prior case reports and series. " 05/01/2015 - "However, tacrolimus ointment itself has been reported to trigger rosacea in a small number of cases. " 01/01/2004 - "Tacrolimus effect on rosacea."
8.	Azithromycin (Zithromax)FDA LinkGeneric 02/01/2007 - "Nine of 10 subjects treated with azithromycin showed moderate to marked improvement of their acne rosacea. " 05/01/2011 - "Oral azithromycin dosing 500 mg/day for 2 weeks is effective for treatment of intractable rosacea." 09/01/2004 - "Azithromycin was not as effective for the treatment of rosacea. " 10/01/2013 - "Topical azithromycin as a novel treatment for ocular rosacea." 10/01/2013 - "In this study the authors evaluate the effectiveness of topical azithromycin in ocular rosacea. "
9.	Tetracycline (Achromycin)FDA LinkGeneric 08/01/1978 - "Eighteen patients with ocular rosacea were treated with oral tetracycline which resulted in marked improvement in all patients. " 01/01/2010 - "To further elucidate the role of tetracycline agents in rosacea, clinical trials that compare these agents with each other as well as with other effective rosacea treatments are called for. " 07/01/2015 - "We report a rare case of rosacea with ocular involvement in a child that remitted with prolonged anti-inflammatory oral tetracycline therapy and provide general expert recommendations. " 02/01/2011 - "Dermatologists have utilized the non-antimicrobial benefits of using tetracycline, through their success in treating disorders that do not have a primary infectious etiology such as rosacea. " 01/01/2011 - "The dose-dependency of rare tetracycline hepatotoxicity and the desire to reduce antibiotic resistance may prompt safe, yet effective, subantimicrobial doses for rosacea."
10.	Cyclosporine (Ciclosporin)FDA LinkGeneric 09/01/2015 - "Ciclosporin ophthalmic emulsion was effective for ocular rosacea (low-quality evidence). " 06/01/2009 - "This study was designed to compare the efficacy of cyclosporine ophthalmic emulsion 0.05% with an artificial tear solution for the treatment of rosacea-associated eyelid and corneal pathology. " 06/01/2009 - "Efficacy of topical cyclosporine for the treatment of ocular rosacea." 11/01/1992 - "Cyclosporine (6 mg/kg/day) successfully cleared the psoriasis in 8 weeks but did not improve the REM and acne rosacea. " 08/01/2009 - "Twenty-one patients diagnosed with dry eye syndrome secondary to vernal keratoconjunctivitis (7 cases), atopic keratoconjunctivitis (8 cases), and ocular rosacea (6 cases) were treated twice a day with a 0.05% cyclosporin ophthalmic emulsion. "

Therapies and Procedures

1.	Lasers (Laser) 08/01/2014 - "Vascular lasers, including intense pulsed light (IPL), are reportedly safe and effective in treating erythematotelangiectatic rosacea (ETR). " 03/01/2005 - "Despite the increased use of lasers and other light-based therapies, few well-controlled studies have been conducted on their use for the treatment of rosacea. " 11/01/2004 - "Laser treatment of rosacea: a pathoetiological study." 09/01/2015 - "A variety of lasers have been used for the treatment of rosacea. " 08/01/2015 - "Phymatous rosacea is treated primarily with laser or light-based therapies. "
2.	Dye Lasers 06/01/2004 - "We conclude that pulsed dye laser therapy is a useful treatment for rosacea." 06/01/2009 - "Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea." 04/01/2008 - "In this study we investigate the ability of the long pulse-duration pulsed-dye laser to improve rosacea. " 06/01/2015 - "Despite garnering only grade-C or -D level recommendations, a 585-nm or 595-nm flashlamp-pumped pulsed-dye laser can be considered as an effective therapeutic modality for the treatment of rosacea in patients who are refractory to topical and/or systemic treatments. " 04/01/2013 - "The effect of pulsed dye laser on the dermatology life quality index in erythematotelangiectatic rosacea patients: an assessment."
3.	Skin Care 03/01/2009 - "The recognition that epidermal barrier dysfunction and transepidermal water loss (TEWL) play a pathophysiologic role in rosacea and that skin moisturization may help to mitigate signs and symptoms of the disease has led to a deeper appreciation of the importance of proper skin care in the treatment of rosacea. " 09/01/2006 - "The skin care regimen containing Lic A was found to be compatible with the sensitive facial skin of patients with rosacea and improved the appearance of persistent facial redness. " 05/01/2008 - "This article provides an overall discussion of the medical management of rosacea and reviews interim results from a study evaluating the role of designated skin care in rosacea treatment." 10/01/2015 - "Physicians have an opportunity to be a trusted source of information on the strengths and weaknesses of skin care products and other complementary treatments for rosacea." 05/01/2015 - "Patient education regarding trigger avoidance and skin care techniques such as moisturizing and sun protection are important non-pharmacologic first steps in treating rosacea. "
4.	Aftercare (After-Treatment) 04/01/2007 - "The mean level of the L(*)a(*)b(*) values improved significantly after treatment and particularly in the erythematotelangiectatic rosacea patients. " 01/01/2015 - "Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes (P<0.001). " 08/01/2013 - "During a second study, a dermatological evaluation was performed on patients with stage I or II rosacea, a questionnaire containing information about patient characteristics, tolerance, clinical signs, symptoms and skin reactivity to "trigger factors" was completed by dermatologists at baseline and 2 months after treatment with the test formula as either monotherapy or adjunctive therapy. " 07/01/2015 - "To use RCM to monitor the density of Demodex mites in patients with rosacea before and after treatment. " 07/01/2015 - "Reflectance confocal microscopy for monitoring the density of Demodex mites in patients with rosacea before and after treatment."
5.	Solid-State Lasers 09/01/2013 - "The use of Nd-YAG laser and PDL appears to be safe and effective measures in treatment of erythemato-telangiectatic rosacea. " 09/01/2015 - "Treatment Outcomes of Long-Pulsed Nd: YAG Laser for Two Different Subtypes of Rosacea." 06/01/2015 - "In conclusion, we suggest that treatment with a Q-switched 595-nm Nd:YAG laser with low fluence may provide an additional therapeutic option for treating early-stage erythematotelangiectatic rosacea. " 06/01/2015 - "Treatment of early-stage erythematotelangiectatic rosacea with a Q-switched 595-nm Nd:YAG laser." 09/01/2013 - "This split-face comparative study included 15 patients with erythemato-telangiectatic rosacea treated on the right side with Nd-YAG laser and on the left side with PDL: three sessions, 4 weeks apart. "