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2016 ; 2
(1-2
): 26-34
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Rosacea Management
#MMPMID27843919
Abokwidir M
; Feldman SR
Skin Appendage Disord
2016[Sep]; 2
(1-2
): 26-34
PMID27843919
show ga
BACKGROUND: Rosacea is a chronic inflammatory skin condition associated with four
distinct subtypes: erythematotelangiectatic, papulopustular, phymatous, and
ocular. PURPOSE: To review the different kinds of management for all subtypes.
METHODS: We divided rosacea management into three main categories: patient
education, skin care, and pharmacological/procedural interventions. RESULTS:
Flushing is better prevented rather than treated, by avoiding specific triggers,
decreasing transepidermal water loss by moisturizers, and blocking ultraviolet
light. Nonselective ?-blockers and ?(2)-adrenergic agonists decrease erythema and
flushing. The topical ?-adrenergic receptor agonist brimonidine tartrate 0.5%
reduces persistent facial erythema. Intradermal botulinum toxin injection is
almost safe and effective for the erythema and flushing. Flashlamp-pumped dye,
potassium-titanyl-phosphate and pulsed-dye laser, and intense pulsed light are
used for telangiectasias. Metronidazole 1% and azelaic acid 15% cream reduce the
severity of erythema. Both systemic and topical remedies treat papulopustules.
Systemic remedies include metronidazole, doxycycline, minocycline, clarithromycin
and isotretinoin, while topical remedies are based on metronidazole 0.75%,
azelaic acid 15 or 20%, sodium sulfacetamide, ivermectin 1%, permethrin 5%, and
retinoid. Ocular involvement can be treated with oral or topical antibacterial.
Rhinophyma can be corrected by dermatosurgical procedures, decortication, and
various types of lasers. CONCLUSION: There are many options for rosacea
management. Patients may have multiple subtypes, and each phase has its own
treatment.