Which treatments are effective for rosacea?
Rosacea is a common chronic skin condition affecting the face, characterized by flushing, redness, pimples, and dilated blood vessels. Inflammation of the eyes and thickening of the skin, especially of the nose, can occur in some people. Although the cause of rosacea remains unclear, a wide variety of treatments are available for this persistent and recurring and often distressing disease. These include medications applied directly to the skin, oral medications, and light-based therapies. While there are a range of treatment options available, it is unclear which are most effective.
A team of Cochrane authors based in Bahrain, the Netherlands, the United Kingdom, and Canada worked with the Cochrane Skin Group to assess the efficacy and safety of treatments for rosacea.
The authors included 106 randomized controlled trials involving 13,631 people with moderate to severe rosacea in this review. Most of the treatments appeared to be effective in treating rosacea. There was high-quality evidence to support the effectiveness of topical azelaic acid, topical ivermectin, brimonidine, and oral subantimicrobial dose (40 mg) doxycycline and isotretinoin for rosacea. Moderate-quality evidence was available for topical metronidazole and oral tetracycline. There was low-quality evidence for low-dose minocycline, laser and intense pulsed light therapy, and ciclosporin ophthalmic emulsion for ocular rosacea.
“We are happy to see that additional effective treatment options are available and have been included in this update of our review. Trial investigators are paying more attention to patient-reported outcomes, including quality of life, which is important as rosacea has a significant negative impact on quality of life,” said Esther J van Zuuren, a researcher at the Leiden University Medical Center in the Netherlands and lead author of the Cochrane Review. “A major area for improvement would be in the standardization of outcome reporting in any future research, as suggested by the COMET (Core Outcome Measures in Effectiveness Trials) Initiative. Furthermore, more studies on treatments for ocular rosacea are needed.”