Rosacea is a bucket term that encompasses a group of closely related skin conditions that are characterized by facial redness, papules and pustules resembling acne, and broken blood vessels. Rosacea usually affects fair skinned white adults. Symptoms may wax and wane in intensity. What is known about rosacea is that there seem to be altered function of the top lay of skin, with altered permeability.
Papulopustular Rosacea – characterized by central facial redness and inflammatory papules and pustules.
Erythematotelangiectatic Rosacea – characterized by facial redness and broken capillaries without inflammatory lesions.
Phymatous Rosacea – affects the nose, affects more men than women.
Ocular Rosacea – involves the eyes, symptoms may include a sense of eye grittiness, dryness, itching. blurred vision and sensitivity to light. Although there was insufficient evidence to support the efficacy of topical metronidazole for ocular rosacea, there was some evidence of a consistent improvement in all outcomes with ciclosporin 0·05% ophthalmic emulsion and that it was more effective than artificial tears in the treatment of ocular rosacea
Treatments for Rosacea
Topical Azelaic Acid gel 15% – Azelaic acid is naturally occurring in many foods, such as barley, wheat and rye. Recommended application is twice daily. A single daily dose of azelaic acid appears to be as effective as the twice-daily dose and is also likely to result in improved compliance.
Sulfur (Sodium Sulfacetamine 10%/sulfur 5%) Topical
Oral Doxycycline – There is evidence that the 40-mg dose is at least as effective as the 100-mg dose, has a correspondingly lower risk of adverse effects, and that, albeit these events may be mild to moderate, more were reported with the 100-mg dose of doxycycline than the 40-mg dose.[
Intense Pulsed Light Therapy – reduces redness and decreases size of dilated facial capillaries.
A gentle cleanser and moisturizer is recommended to reduce the symptoms of rosacea and to increase the tolerability of the above topical therapies.