Early investigational agents for the treatment of rosacea: drugs in phase II and III clinical development

INTRODUCTION: Rosacea is a chronic inflammatory facial skin disease with an incompletely understood pathogenesis and limited efficacy of current treatments. A number of clinical trials are underway for the development of new drugs to improve patient care. AREAS COVERED: Based on a literature search of PubMed, Embase, Cochrane Library, and Clinicaltrials.gov using the keywords 'rosacea clinical trials'，'rosacea treatment ' we discuss treatments undergoing phase II and III clinical trials for rosacea. EXPERT OPINION: As the pathogenesis of rosacea is better understood and researched, many clinical trials are being conducted to develop new drugs for the treatment of rosacea based on new mechanisms and targets. Currently under investigation are biologics, antidepressants, PDE4 inhibitors, and neuropeptide modulation. Current treatments often focus on monotherapy targeting specific phenotypes, such as inflammatory papules or persistent erythema. However, single-agent therapy is often insufficient to address the multiple clinical manifestations of rosacea simultaneously. Therefore, we need to explore how combination or sequential treatments can be tailored to a patient's specific symptoms to minimize the patient's psychological burden.