Rosacea is a common inflammatory skin condition affecting approximately 5% of the world population. Therapeutic approaches to rosacea are focused on symptom suppression employing anti-inflammatory agents. Photodynamic therapy, especially light-emitting diodes, has been introduced as a valid alternative to conventional therapy.
Because of rosacea's potential complexity, it has been classified into subtypes according to signs and symptoms that often occur together. Patients may have characteristics of more than one subtype at the same time. Although the cause of rosacea is unknown, several possibilities are currently being studied, including flushing, inflammatory pathways, and Demodex mites. Simultaneously, a growing range of therapies is available to address rosacea's signs and symptoms. While your doctor will tailor medical therapy to your individual case, treatment options may often be keyed to standard subtypes and level of severity.1
As with any medical therapy, outcomes of rosacea treatment may vary from case to case. Compliance with therapy — using your medication as your doctor prescribes — is an important key to success. Please consult a dermatologist or other physician to determine the appropriate therapy for your individual case.
Subtype 1: Facial Redness
Subtype 1 (erythematotelangiectatic) rosacea is characterized by flushing and persistent facial redness. Visible blood vessels may also be present, and facial discomfort is common.
Research into the physical processes involved in rosacea has recently led to new prescription therapy to relieve facial redness. It may also be important for you to identify and avoid lifestyle and environmental factors that trigger flushing or irritating your skin. The most common factors are covered in Rosacea Triggers, and a Rosacea Diary is available to help you identify and avoid those factors that affect your individual case.
The appearance of flushing, redness, and visible blood vessels may also be concealed with cosmetics, and facial discomfort may benefit from appropriate skincare, both discussed under Skin Care & Cosmetics.
Visible blood vessels and severe background redness may be reduced with lasers or intense pulsed light therapy. Several sessions are typically required for satisfactory results, and touch-up sessions may later be needed as the underlying disease process is still present.
In specific cases, extensive flushing may be moderated somewhat through the use of certain drugs.
Subtype 2: Bumps and Pimples
Subtype 2 (papulopustular) rosacea is characterized by persistent facial redness and acne-like bumps and pimples and is often seen after or at the same time as subtype 1. Fortunately, however, several medications have been extensively studied and approved for this common form of rosacea and may also be used on a long-term basis to prevent symptoms recurrence.
In mild to moderate cases, doctors often prescribe oral and topical rosacea therapy to bring the condition under immediate control, followed by long-term use of topical therapy alone to maintain remission. A version of oral therapy with less risk of microbial resistance has also been developed specifically for rosacea and is safe for long-term use.
Higher doses of oral antibiotics may be prescribed, and other drugs may be used for patients who are unresponsive to conventional treatments.
Subtype 3: Skin Thickening
Subtype 3 (phymatous) rosacea is characterized by skin thickening and enlargement, most frequently around the nose. This condition develops primarily in men. Although mild cases may be treated with medications, moderate to severe manifestations, typically require surgery.
A wide range of surgical options is available, including cryosurgery, radiofrequency ablation, electrosurgery tangential excision combined with scissor sculpturing, and skin grafting. A surgical laser may be used as a bloodless scalpel to remove excess tissue and recontour the nose, often followed by dermabrasion.
Subtype 4: Eye Irritation
Subtype 4 (ocular) rosacea is characterized by any one of many eye symptoms, including a watery or bloodshot appearance, foreign body sensation, burning or stinging, dryness, itching, light sensitivity, and blurred vision. A history of having styles is a strong indication and has “dry eye” or blepharitis.
Treatment for mild to moderate ocular rosacea may include artificial tears, oral antibiotics, and the eyelashes' daily cleansing with baby shampoo on a wet washcloth. More severe cases should be examined by an eye specialist, who may prescribe ophthalmic treatments, as potential corneal complications may involve visual acuity loss.
Treatment and Conditions
Currently, there are two traditional treating methods, such as medications and physical treatment. Doctors can prescribe medications. Usually, the medications are antibiotics. The thing is, however, there are side effects from the antibiotics. Additionally, there is no proof that Rosacea is a bacterial condition. So the effectiveness of treatment could remain uncertain. Plus, going to see a doctor can be time-consuming & money consuming.
Physical treatment can be soup or gel to help better improve the skin. However, people have different skin types. Usually, it is super expensive to diagnose the skin condition in great detail; people have different skin types. The wrong usage of beauty products could lead to worsen skin problems or increase sensitivity.
Several therapeutic approaches are currently available for treating rosacea, and they are mainly aimed at controlling disease symptoms. The therapeutic plan has to be adapted to the rosacea subtype and tailored according to the patient's dominant manifestations. In general, the reduction of oral therapy in favor of topical or physical therapy is desirable to reduce side effects for patients and increase the treatment's safety.
The therapeutic approach has blue (480 nm ± 15 nm) and red (650 ± 15 nm) LED light-based therapy in patients affected by rosacea. Previous research reported the efficacy of red and blue light coupled with mild to moderate acne lesions. Blue light (400–470 nm), due to its lower penetration, is useful in such skin conditions related to the skin's epidermis layer; therefore, it can also interfere with human sebocyte proliferation. On the other hand, red light (630 nm) is reported to affect sebum production significantly. The benefits deriving from PDT using LEDs are not limited to its efficacy but are also related to its safety and tolerance by patients; therefore, its advantages can be extended to a broad range of dermatological conditions.
Two AM, Wu W, Gallo RL, Hata TR. Rosacea: part I. Introduction, categorization, histology, pathogenesis, and risk factors. J Am Acad Dermatol. 2015;72(5):749–58. quiz 759–60. PMID: 25890455
Plewig G, Kligman AM. History of Acne and Rosacea. In: ACNE and ROSACEA. Berlin: Springer; 2000.
Odom R, Dahl M, Dover J, Draelos Z, Drake L, Macsai M, Powell F, Thiboutot D, Webster GF, Wilkin J. Standard management options for rosacea, part 2: Options according to subtype. Cutis, 2009;84:97–104.
Kolontaja-Zauber, I., Ināra Ančupāne, Andra Dērveniece, Aija Žileviča, & Ilze Ķikuste. (, 2018). Impact of intense pulsed light therapy on the quality of life of rosacea patients. Proceedings of the Latvian Academy of ences Section B Natural Exact and Applied sciences, 72(1), 9–15.
Kim, B. Y., Moon, H. R., & Ryu, H. J. . (2018). Comparative efficacy of short-pulsed intense pulsed light and pulsed dye laser to treat rosacea. Journal of Cosmetic & Laser Therapy, 1–6.
Bo, Young, Kim, Hye-Rim, Moon, & Hwa, et al. (2018). Comparative efficacy of short-pulsed intense pulsed light and pulsed dye laser to treat rosacea. Journal of Cosmetic & Laser Therapy Official Publication of the European Society for Laser Dermatology.
Smith, J. P. K. . (1984). The eyes have it: young children’s discrimination of age in masked and unmasked facial photographs. Journal of Experimental Child Psychology.