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Rosacea treatment

Dev R Sahni, Steven R Feldman, Sarah L Taylor
Rosacea is a chronic and recurrent disease with a variety of cutaneous manifestations. The disorder is a centrofacial inflammatory dermatosis with significant financial, physical and psychological impacts. There are a number of topical, oral and systemic treatments available. Yet, treatment for rosacea remains difficult. The multifactorial nature of the disease combined with an incomplete understanding of the pathophysiology is challenging for providers and patients. Areas covered: This article provides an in-depth review of rosacea treatment and emerging use of ivermectin 1% cream for papulopustular rosacea based on multiple clinical trials...
March 16, 2018: Expert Opinion on Pharmacotherapy
Janet DuBois, Jeffrey S Dover, Terry M Jones, Robert A Weiss, David R Berk, Gurpreet Ahluwalia
BACKGROUND: Rosacea is a chronic dermatologic condition with limited treatment options. OBJECTIVE: This phase 2 study evaluated the optimal oxymetazoline dosing regimen in patients with moderate to severe persistent facial erythema of rosacea. METHODS: Patients were randomly assigned to oxymetazoline cream, 0.5%, 1.0%, or 1.5%, or vehicle, administered once daily (QD) or twice daily (BID) for 28 consecutive days. The primary efficacy endpoint was the proportion of patients with ≥2-grade improvement from baseline on the Clinician Erythema Assessment (CEA) and the Subject Self-Assessment of erythema (SSA-1) on day 28...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Leslie Baumann, David J Goldberg, Linda Stein Gold, Emil A Tanghetti, Edward Lain, Joely Kaufman, Emily Weng, David R Berk, Gurpreet Ahluwalia
Rosacea is a chronic dermatologic condition with limited treatment options, particularly for persistent erythema. This pivotal phase 3 study evaluated oxymetazoline, an a1A-adrenoceptor agonist, for the treatment of moderate to severe persistent erythema of rosacea. Eligible patients were randomly assigned 1:1 to receive oxymetazoline cream 1.0% or vehicle applied topically to the face once daily for 29 days. The primary efficacy outcome was ≥2-grade improvement from baseline on both Clinician Erythema Assessment (CEA) and Subject Self-Assessment for rosacea facial redness (SSA) (composite success) at 3, 6, 9, and 12 hours postdose on day 29...
March 1, 2018: Journal of Drugs in Dermatology: JDD
James Q Del Rosso
Until recently, the potential modes of action of topical ivermectin in rosacea have been speculated but not studied. Short-term studies (12 week), long-term studies (up to 52 weeks), and case report series have now been completed, and topical ivermectin (IVM), formulated as a 1% cream that is applied once daily, has been shown to be effective, well-tolerated, and safe for the treatment of rosacea. This article reviews outcomes from studies that support dual modes of action, including both anti-inflammatory and anti-parasitic effects...
September 2017: Journal of Clinical and Aesthetic Dermatology
Alexis Lara Rivero, Margot Whitfeld
No abstract text is available yet for this article.
February 2018: Australian Prescriber
Jackson G Turbeville, Hossein Alinia, Sara Moradi Tuchayi, Naeim Bahrami, Leah A Cardwell, Olabola Awosika, Irma Richardson, Karen E Huang, Steven R Feldman
The recalcitrance of rosacea to many treatment options may prompt patients to spend exorbitant amounts of money on unsubstantiated treatment regimens in an effort to achieve relief. The authors examine the relationship between disease severity and treatment cost across several demographic and socioeconomic strata. Familiarization of evidence-based clinical recommendations and consensus guidelines may equip physicians to educate patients about the most efficacious and cost-effective treatment options to assist patients in making cost-conscious decisions in the management of their rosacea...
April 2018: Dermatologic Clinics
Abigail Cline, Sean P McGregor, Steven R Feldman
Persistent centrofacial erythema is a predominant component of rosacea. The authors review the topical and systemic treatments for rosacea-related erythema and flushing to aid in treatment decision making in clinical practice. Databases were searched for literature pertaining to treatment options for erythema related to rosacea. The paucity of large-scale clinical trials in patients with the erythematotelangiectatic rosacea subtype makes it difficult to draw firm conclusions regarding treatment. Although certain topical and oral treatments appear to have modest benefit in reducing erythema, there is a need for high-quality, well-designed, and rigorously reported studies for the treatments for rosacea...
April 2018: Dermatologic Clinics
Sean P McGregor, Hossein Alinia, Alyson Snyder, Sara Moradi Tuchayi, Alan Fleischer, Steven R Feldman
Papulopustular rosacea is characterized by papules and pustules in the central facial region. We review the literature surrounding the treatment of papulopustular rosacea. PubMed, EMBASE, and Cochrane (Central) databases searches of articles published from 1980 to 2015 were performed using the MeSH terms or keywords "rosacea" and "clinical trial." Additional searches were performed to include rosacea and each treatment modality used. Topical metronidazole, azelaic acid, ivermectin, and oral doxycycline have the most robust data to support their use...
April 2018: Dermatologic Clinics
Nora Vera, Nupur U Patel, Lucia Seminario-Vidal
Rosacea is a chronic inflammatory cutaneous disorder with an unclear pathogenesis. It has been associated with multiple comorbidities, including cardiovascular diseases, malignancies, depression, migraines, dementia, Parkinson disease, gastrointestinal disorders, and autoimmune conditions. The extent, clinical significance, and implications of these associations remain a topic of discussion. Further evaluation of these comorbidities may offer valuable insight for future screening practices and treatment recommendations...
April 2018: Dermatologic Clinics
E Forbat, F R Ali, F Al-Niaimi
Whilst the use of isotretinoin has revolutionized the treatment of acne vulgaris, isotretinoin is increasingly recognized as a useful therapeutic option for many other cutaneous conditions. We review the evidence underlying the use of isotretinoin for a variety of dermatological indications including hidradenitis suppurativa, sebaceous gland pathology, rosacea, scarring alopecia, cosmetic dermatology and non-melanoma skin cancer prophylaxis amongst other uses, and thus consider alternative uses within dermatology practice...
February 26, 2018: Journal of Dermatological Treatment
F M N Forton, V De Maertelaer
BACKGROUND: Papulopustular rosacea and rosacea-like demodicosis have numerous similarities but they are generally considered as two distinct entities, mainly because the causal role of the Demodex mite in the development of rosacea is not yet widely accepted. Several clinical characteristics are traditionally considered to differentiate the two conditions; for example, papulopustular rosacea is typically characterised by central facial papulopustules and persistent erythema, whereas small superficial papulopustules and follicular scales rather suggest rosacea-like demodicosis...
February 25, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Amy W Kuang, Janet DuBois, Mayssa Attar, Gurpreet Ahluwalia
BACKGROUND: Oxymetazoline cream 1.0% is FDA-approved for the topical treatment of persistent facial erythema associated with rosacea in adults. This phase 2, multicenter, randomized, double-blind, parallel-group study assessed the pharmacokinetics, safety, and tolerability of oxymetazoline in patients with moderate to severe erythema associated with rosacea. METHODS: Eligible patients were randomized to 1 of 8 treatment groups (oxymetazoline cream 0.5%, 1.0%, or 1...
February 1, 2018: Journal of Drugs in Dermatology: JDD
Julie Harper, James Q Del Rosso, Ilia L Ferrusi
Rosacea is a chronic skin condition characterized by persistent central facial erythema. To explore the burden of illness of rosacea in US adults, a cross-sectional web-based survey was conducted. Participants answered questions on sociodemographics, clinical characteristics, bothersome symptoms, coping and avoidance behaviors, self-perceptions, and health care resource utilization, and completed 2 quality of life instruments, the 21-item rosacea-specific quality of life questionnaire (RosaQoL) and the 36-item Short Form Health Survey (SF-36)...
February 1, 2018: Journal of Drugs in Dermatology: JDD
Eungyeong Jang, Kyung-Soo Inn, Young Pyo Jang, Kyung-Tae Lee, Jang-Hoon Lee
Sanguisorba officinalis Linne (S. officinalis, Rosaceae) has been used as a medicinal plant for the treatment of burns, hematemesis, melena, intestinal infections, and dermatitis for a long time in China, Korea, and Japan. The therapeutic efficacy of this herb is intimately associated with its anti-oxidant, anti-inflammatory, antiviral, antifungal, hemostatic, and anticancer activities. Its root contains triterpenoid saponins (zigyuglycoside I: C[Formula: see text]H[Formula: see text]O[Formula: see text] and ziyuglycoside II: C[Formula: see text]H[Formula: see text]O8) and tannins (sanguiin H-6: C[Formula: see text]H[Formula: see text]O[Formula: see text])...
February 12, 2018: American Journal of Chinese Medicine
W J Song, X M Yan
Intense pulsed light (IPL) is a broad spectrum incoherent light which is produced by high-output xenon lamp. Since the invention of the first-generation IPL in 1994, IPL technology has been developing rapidly and extensively utilized in multiple fields relevant to dermatology across the world. In 2004, the fourth-generation IPL system was introduced with the optimal pulse technology (OPT) and has soon been used for cosmetic purposes all over the world. In 2002, Dr. Toyos found that the meibomian gland dysfunction (MGD) and dye eye disease (DED)symptoms of the rosacea patients who received IPL treatment have been improving significantly, therefore he started to explore the application of IPL system to treatment of dry eye disease...
February 11, 2018: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Linda Stein-Gold, Leon H Kircik, Zoe Diane Draelos, Philip Werschler, Janet DuBois, Edward Lain, Leslie Baumann, David J Goldberg, Joely Kaufman, Emil A Tanghetti, Nancy Alvandi, Emily Weng, David R Berk, Gurpreet Ahluwalia
BACKGROUND: Rosacea is a chronic dermatologic condition with limited treatment options. OBJECTIVE: To evaluate topical oxymetazoline cream 1.0% in patients with moderate to severe persistent erythema of rosacea. METHODS: Data were pooled from two identically designed phase 3 trials. Patients were randomized to receive oxymetazoline or vehicle once daily for 29 days and were followed for 28 days posttreatment. The primary efficacy outcome was the proportion of patients with ≥2-grade improvement from baseline on both Clinician Erythema Assessment (CEA) and Subject Self-Assessment (SSA) at 3, 6, 9, and 12 hours postdose, day 29...
January 30, 2018: Journal of the American Academy of Dermatology
Zoe Diana Draelos, Michael H Gold, Robert A Weiss, Leslie Baumann, Steven K Grekin, Deanne Mraz Robinson, Steven E Kempers, Nancy Alvandi, Emily Weng, David R Berk, Gurpreet Ahluwalia
BACKGROUND: Limited treatments are available for persistent erythema of rosacea. OBJECTIVE: To examine long-term safety and efficacy of oxymetazoline cream 1.0% in rosacea patients with moderate to severe persistent erythema. METHODS: Patients applied oxymetazoline once daily for 52 weeks. Safety assessments included treatment-emergent adverse events (TEAEs), skin blanching, inflammatory lesion counts, telangiectasia, disease severity, and rebound effect...
January 30, 2018: Journal of the American Academy of Dermatology
David Limón, María José Fábrega, Ana C Calpena, Josefa Badia, Laura Baldomà, Lluïsa Pérez-García
The overexpression and increased activity of the serine protease Kallikrein 5 (KLK5) is characteristic of inflammatory skin diseases such as Rosacea. The use of inhibitors of this enzyme-such as 4-(2-aminoethyl)benzenesulfonyl fluoride hydrochloride (AEBSF·HCl) or the anti-human recombinant Kallikrein 5 (anti-KLK5) antibody-in the treatment of the disease has been limited due to their low bioavailability, for which their immobilization in drug delivery agents can contribute to making serine protease inhibitors clinically useful...
February 23, 2018: Bioconjugate Chemistry
Tom Barrett, Sally de Zwaan
Minocycline is a commonly prescribed tetracycline antibiotic used for the treatment of a number of dermatological conditions including acne and rosacea. Long-term adverse effects of minocycline include cutaneous hyperpigmentation. Various treatment options have been suggested for the treatment of minocycline pigmentation. We report a case of a patient on long-term low-dose minocycline for the treatment of rosacea with type III minocycline hyperpigmentation. A comparison was made between Q-Switch Nd:YAG and picosecond laser over a nine 9-period with treatments spaced 1 month apart, with a clearance in the patient pigmentation after four treatments with picosecond laser...
February 5, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Ulrich Mrowietz, Tal Hetzroni Kedem, Rita Keynan, Meir Eini, Dov Tamarkin, Dror Rom, Mitchell Shirvan
OBJECTIVE: Our objective was to demonstrate the safety, tolerability, and efficacy of a minocycline foam, FMX103, in the treatment of moderate-to-severe facial papulopustular rosacea. METHODS: This was a phase II, randomized, double-blind, multicenter study. Healthy subjects aged ≥ 18 years with moderate-to-severe rosacea that had been diagnosed ≥ 6 months previously and with ≥ 12 inflammatory facial lesions were randomized (1:1:1) to receive once-daily 1...
February 2, 2018: American Journal of Clinical Dermatology
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