An update on the treatment of rosacea

Rosacea is a common inflammatory skin disorder that can seriously impair quality of life.Treatment starts with general measures which include gentle skin cleansing, photoprotection and avoidance of exacerbating factors such as changes in temperature, ultraviolet light, stress, alcohol and some foods.For patients with the erythematotelangiectatic form, specific topical treatments include metronidazole, azelaic acid, and brimonidine as monotherapy or in combination.Laser therapies may also be beneficial.For the papulopustular form, consider a combination of topical therapies and oral antibiotics.Antibiotics are primarily used for their anti-inflammatory effects.For severe or refractory forms, referral to a dermatologist should be considered.Additional treatment options may include oral isotretinoin, laser therapies or surgery.Patients should be checked after the first 6-8 weeks of treatment to assess effectiveness and potential adverse effects.• papules • pustules • telangiectases.In addition, at least one of the secondary features of burning or stinging, a dry appearance, plaque formation, oedema, central facial location, ocular manifestations and phymatous changes are considered enough to make the diagnosis accurately in most cases.Rosacea usually follows a pre-rosacea stage that involves flushing only.Rosacea can seriously affect a patient's quality of life.This should prompt clinicians to diagnose it early and start treatment.1 DiagnosisThe diagnosis of rosacea is usually made on history and clinical features.If it is not clear, differential diagnoses must be considered and ruled out (see Box). 1,5,6 Clinical manifestationsThe presence of at least one of the following primary features indicates rosacea:• flushing (transient redness)• non-transient redness