Facial flushing and erythema of rosacea improved by carvedilol

Abstract

Flushing and erythema are the most common symptoms of rosacea; however, management of these symptoms remains challenging. Recent case studies suggest that treatment with carvedilol may reduce facial flushing and persistent erythema in the pathogenesis of rosacea. To find the effect of carvedilol in the treatment of facial flushing and erythema in rosacea. Twenty-four rosacea patients treated with carvedilol for facial flushing and erythema were retrospectively reviewed. All patients were prescribed carvedilol 6.25 mg either once or twice per day, and the daily dose was gradually titrated up to 12.5 mg. Clinical erythema severity was assessed by the Clinician's Erythema Assessment (CEA) and Patient's Self-Assessment (PSA) scales. Improvement of CEA and PSA scores compared to the baseline were assessed. The proportion of patients with improvement of two or more points from baseline in CEA score was analyzed by sex, previous treatment exposure, disease duration, and subtypes. The mean change of −1.6 in the CEA score and of −1.8 in the PSA score showed significant improvement from baseline. Erythematotelangiectatic rosacea (ETR) patients achieved more than 2-points improvement in the CEA score, compared with non-ETR patients (53.8% vs 16.7% [P = .035]). No statistically significant differences were observed by sex, disease duration, or previous treatment exposure. No serious adverse event was observed. Carvedilol can be an effective and safe treatment option for rosacea patients suffering from facial flushing and erythema.

Topical calcineurin inhibitors as a double‐edged sword in rosacea: A systematic review

“…Rosacea can be managed through topical agents, oral agents, laser and light‐based therapies, and botulinum toxin injections 10‐13 . Herbal medicine also plays a role in health and skin treatment, including rosacea 14‐16 .…”

“…Rosacea can be managed through topical agents, oral agents, laser and light-based therapies, and botulinum toxin injections. [10][11][12][13] Herbal medicine also plays a role in health and skin treatment, including rosacea. [14][15][16] Pimecrolimus (1% cream as common dosage form) and tacrolimus (0.1% or 0.03% ointment as common dosage form) are two approved calcineurin inhibitors in China, used as topical immunomodulators.…”

Advances in the Pathogenesis and Treatment of Rosacea: A Phenotype-Based Therapeutic Approach

“…Concerning oral therapies, the role of vasoactive compounds is still controversial. Nonselective β-blockers, especially carvedilol, are thought to decrease erythema and flushing, as well as α2-adrenergic agonist clonidine [91,92]. However, evidence supporting their efficacy is still limited.…”

Rosacea pathogenesis and therapeutics: current treatments and a look at future targets

“…The drug’s primary function is inhibition of sebaceous gland function but has also been shown to downregulate the TLR-2 pathway ( 77 , 78 ). Carvedilol is another off-label medication used in rosacea to reduce persistent facial flushing and erythema ( 79 ). It is a non-selective beta blocker, with alpha-1 adrenergic antagonistic activity, that also functions as a potent antioxidant ( 80 ).…”