Introduction:
Rosacea is a common, chronic and relapsing inflammatory
skin disease of the centrofacial area. Despite advancing knowledge on its pathogenesis, diagnosis, and treatment, some major unknowns still remain, including systematic evidence-based guidelines useful both for clinical assessment and therapeutic management. Topical treatment is regarded as a first-line option for mild to moderate
rosacea and includes traditional and new FDA-approved
prescription drugs, as well as off-label alternative topical agents.Areas covered: Since improved awareness of
rosacea pathogenetic mechanisms has led to the development of new potential therapeutic agents, a search was performed on the ClinicalTrial.gov registry. The results identified several investigational topical drugs able to target one or more of the pathogenetic factors of
rosacea.Expert opinion: The main unmet needs in the topical treatment of
rosacea remain the management of vasomotor flushes and
telangiectasias, as well as of troublesome symptoms such as burning and/or stinging. No single agent effective on all
rosacea phenotypes is available so far, and preventive treatments capable of halting
disease progression have not been identified yet. Finally, data on long-term efficacy and tolerability are still incomplete, especially for drugs more recently introduced in the market.