Long‐term maintenance treatment of rosacea: experts' opinion

Abstract

BackgroundRosacea is a chronic inflammatory dermatosis characterized by remissions and flares. Although the rosacea active treatment phase is well established, the long‐term maintenance phase is still challenging.ObjectiveTo discuss and make recommendations on how to treat patients during the long‐term maintenance phase for the main rosacea phenotypes.MethodsA panel of six board‐certified Brazilian dermatologists and one American dermatologist gathered to compose a consensus based upon an initial statement on how to treat rosacea during the long‐term maintenance phase based on the methodology Nominal Group Technique. The experts discussed each factor based upon an initial statement on how to treat rosacea patients in the long‐term maintenance phase. A sequence of comprehensive narrative reviews was performed; a questionnaire preparation about the definition of the maintenance phase and its management was presented; an interpersonal discussion and ranking of the ideas were conducted. Recommendations were made if the specialists had 75% agreement.ResultsThe maintenance treatment phase, which starts by achieving IGA 0 or 1 grades at the active phase, should be considered at least during the 9‐month period after remission. The recommendations of all treatments target this period. Daily skincare regimen and sunscreen are crucial. Active treatment phase should be recommended if signs or symptoms reappear or worsen.ConclusionMaintenance phase success depends on patient's adherence to daily skin care, appropriate treatments, continued follow‐up with dermatologist, and self‐assessment to identify new signs and symptoms indicating disease relapse.

Ivermectin: A Multifaceted Drug With a Potential Beyond Anti-parasitic Therapy

“…Rosacea is a chronic, progressive, inflammatory skin condition. With a prevalence of almost 5.5%, it is a disorder that can cause a great disease burden, including its impact on self-esteem and the quality of life of affected individuals [53]. Rosacea usually involves the face and initially presents with recurrent erythema, telangiectasia, and flushing [53].…”

“…With a prevalence of almost 5.5%, it is a disorder that can cause a great disease burden, including its impact on self-esteem and the quality of life of affected individuals [53]. Rosacea usually involves the face and initially presents with recurrent erythema, telangiectasia, and flushing [53]. As the disease progresses, it presents with persistent erythema with papulopustules, follicular papules, and pustules [54].…”

“…Most approved agents on the market provide symptomatic relief. Topical metronidazole, azelaic acid, and ivermectin are all approved for rosacea treatment [53]. Low-dose doxycycline and isotretinoin also contribute to the management of rosacea [54].…”