Rosacea Treatment: Review and Update

Zhang, Hanlin; Tang, Keyun; Wang, Yuchen; Fang, Rouyu; Sun, Qiuning

doi:10.1007/s13555-020-00461-0

Cited by 61 publications

(68 citation statements)

References 87 publications

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“…6 A variety of treatment modalities have been reviewed, including skin care and cosmetic treatments, topical therapies, oral therapies, laser-and light-based therapies, injection therapies, and combination therapies, based on their anti-demodex, anti-inflammatory, and anti-angiogenesis effects. [36][37][38][39] However, recalcitrant, refractory, and persistent rosacea remains challenging in rosacea treatment. 12,40 Botulinum toxin, especially type A, has many off-label uses in aesthetic treatments.…”

Section: Discussionmentioning

confidence: 99%

Use of Botulinum Toxin in Treating Rosacea: A Systematic Review

Zhang

Tang

Wang

et al. 2021

CCID

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Background Rosacea is a chronic skin disorder characterized by erythema, flushing, telangiectasia, papules and pustules, phymatous changes, and ocular involvement. The aim of this study was to examine all published research articles in which botulinum toxin was used to treat rosacea and to evaluate the efficacy and safety of this treatment. Methods PubMed, Embase, Cochrane Library, and Web of Science database were used to identify articles eligible for systematic review on March 26, 2021. Prospective or retrospective studies which directly used botulinum toxin to treat rosacea were included and reviewed. Results Nine studies were included in this systematic review. Two were randomized controlled trials, graded as Level 2 for the quality of evidence. The total number of participants was 130, and the number of participants in each study ranged from 1 to 25. The improvement was observed in all studies in signs and symptoms compared with baseline. Adverse events were transitory and self-limited. Conclusion Botulinum toxin could have overall satisfying efficacy and safety in the treatment of rosacea, though limited by small sample size, imperfect study design, and short follow-up visits.

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Section: Discussionmentioning

confidence: 99%

Use of Botulinum Toxin in Treating Rosacea: A Systematic Review

Zhang

Tang

Wang

et al. 2021

CCID

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“… 5 Treatment of rosacea depends on the severity and phenotype presentation and may include topical therapies, oral therapies, laser- and light-based therapies, injection therapies, skin care, and lifestyle management. 6 , 7 Currently, treatment approved by the Food and Drug Administration (FDA) mainly targets papules and pustules, but the difficulties in the clinical treatment are the persistent facial erythema and recurrent flushing. Some adrenergic agonists (brimonidine, oxymetazoline, etc.)…”

Section: Introductionmentioning

confidence: 99%

Willingness-to-Pay and Benefit–Cost Analysis of Botulinum Toxin for the Treatment of Rosacea in China: Findings from a Web-Based Survey

Yang¹,

Ouyang²,

Deng³

et al. 2021

PPA

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Purpose Botulinum toxin (BTX) is a new treatment approach primarily aimed at relieving flushing and erythema for rosacea, but it is expensive and lacks economic benefit evaluation studies.This study aimed to investigate willingness-to-pay (WTP) of BTX treatment and conduct benefit–cost analysis (BCA) to assess if BTX treatment for rosacea is recommendable from a viewpoint of economics in China. Methods WTP of BTX treatment in rosacea and information of sociodemographic and clinical characteristics were inquired via an online questionnaire among the Chinese rosacea patients. The WTP was inquired by photos of three cases with different severities of rosacea before and after BTX treatment. The benefit–cost ratio (BCR) was calculated by dividing WTP by cost. Factors associated with WTP were identified using logistic regression models. Results The average costs of BTX treatment were USD410.09. The mean WTP for Case 1, Case 2, and Case 3 was USD295.53, 307.91, and 311.78, respectively (p<0.05 for Case 1 vs Case 3). 44.31% to 47.52% of Chinese rosacea patients were willing to pay for the BTX treatment. The BCRs were 0.72, 0.75, and 0.76 for Case 1, Case 2, and Case 3, respectively. A positive correlation between WTP and visiting frequency in the past year (OR=1.181–1.200, p=0.015–0.032, for Cases 1 and 2) or Dermatology Life Quality Index (DLQI) score (OR=2.022–2.266, all p<0.01) was observed, but duration (OR=0.521–0.564, p<0.05, for Cases 1 and 2) of rosacea was negatively correlated with WTP. Conclusion For rosacea patients with poor quality of life, and those with high visiting frequency, BTX should be regarded as a recommendable new treatment in China.

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“…It can be categorized into erythematotelangiectatic, papulopustular, phymatous and ocular rosacea. 1 The overall rosacea manifestations are flushing, transient or persistent erythema, telangiectasia, papules, pustules, phymata, and (micro)edema. Worldwide, the prevalence of rosacea is estimated to reach over 5% in the adult population.…”

Section: Introductionmentioning

confidence: 99%

Sodium Bituminosulfonate Used to Treat Rosacea Modulates Generation of Inflammatory Mediators by Primary Human Neutrophils

Schiffmann

Gunne

Henke

et al. 2021

JIR

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Background Sodium bituminosulfonate is derived from naturally occurring sulphur-rich oil shale and is used for the treatment of the inflammatory skin disease rosacea. Major molecular players in the development of rosacea include the release of enzymes that process antimicrobial peptides which, together with reactive oxygen species (ROS) and vascular endothelial growth factor (VEGF), promote pro-inflammatory processes and angiogenesis. The aim of this study was to address the molecular mechanism(s) underlying the therapeutic benefit of the formulation sodium bituminosulfonate dry substance (SBDS), which is indicated for the treatment of skin inflammation, including rosacea. Methods We investigated whether SBDS regulates the expression of cytokines, the release of the antimicrobial peptide LL-37, calcium mobilization, proteases (matrix metalloproteinase, elastase, kallikrein (KLK)5), VEGF or ROS in primary human neutrophils. In addition, activity assays with 5-lipoxygenase (5-LO) and recombinant human MMP9 and KLK5 were performed. Results We observed that SBDS reduces the release of the antimicrobial peptide LL-37, calcium, elastase, ROS and VEGF from neutrophils. Moreover, KLK5, the enzyme that converts cathelicidin to LL-37, and 5-LO that produces leukotriene (LT)A 4 , the precursor of LTB 4 , were both inhibited by SBDS with an IC 50 of 7.6 µg/mL and 33 µg/mL, respectively. Conclusion Since LTB 4 induces LL-37 which, in turn, promotes increased intracellular calcium levels and thereby, ROS/VEGF/elastase release, SBDS possibly regulates the LTB 4 /LL-37/calcium – ROS/VEGF/elastase axis by inhibiting 5-LO and KLK5. Additional direct effects on other pro-inflammatory pathways such as ROS generation cannot be ruled out. In summary, SBDS reduces the generation of inflammatory mediators from human neutrophils possibly accounting for its anti-inflammatory effects in rosacea.

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Rosacea Treatment: Review and Update

Cited by 61 publications

References 87 publications

Use of Botulinum Toxin in Treating Rosacea: A Systematic Review

Use of Botulinum Toxin in Treating Rosacea: A Systematic Review

Willingness-to-Pay and Benefit–Cost Analysis of Botulinum Toxin for the Treatment of Rosacea in China: Findings from a Web-Based Survey

Sodium Bituminosulfonate Used to Treat Rosacea Modulates Generation of Inflammatory Mediators by Primary Human Neutrophils

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