However, the combined medications have similar working mechanisms and have not been studied together. Thus, the remaining question is whether to combine or not to combine the medications.
More studies, especially cost-effectiveness studies, are needed to identify efficient and cost-efficient treatments for rosacea patients [ 86 ]. Rosacea treatment remains challenging for dermatologists, especially in refractory or recalcitrant cases.
The pathogenesis of rosacea is not well understood. Immune dysfunction [ 87 ], Demodex [ 88 ], ultraviolet radiation exposure [ 89 ], and vascular hyperreactivity [ 90 ] may all play a role in the pathogenesis of rosacea. The pathogenesis and related mechanisms need further exploration to develop more etiological treatment modalities.
The waxing and waning course of rosacea may disturb patients to a large extent, and rosacea is also related to many psychiatric disorders, such as anxiety and depression [ 91 ]. Dermatologists should focus on patient experience and patient education, and they should schedule regular follow-ups if necessary. The evolvement of rosacea classification from subtyping to phenotyping may make the selection of treatment more rational by emphasizing the specific presentation and concerns of the individual patient [ 2 ].
Individualized treatment should be applied to rosacea patients [ 95 ]. In the era of the phenotype approach, van Zuuren and colleagues systematically reviewed interventions for rosacea based on the new approach, using the GRADE guidelines to assess certainty of evidence [ 19 ].
Based on the systematic review published in , we completed the descriptive review on treatment modalities in rosacea presented here, with special focus on the newly emerged modalities, with more emphasis on the expansion of treatment options and less emphasis on GRADE assessments.
The treatment modalities that have newly emerged in the last 2 years might not be that helpful to clinical decision-making compared to those modalities recommended in that systematic review of 20, participants [ 19 ]. However, these emerged modalities may be applied to and be potentially useful in the treatment of refractory or recalcitrant cases. These modalities should be emphasized, and they may attract the attention of investigators who need a broader perspective and comprehensive understanding of rosacea treatment.
Researchers should expand and verify rosacea treatment options, with a major focus on large-scale clinical research based on the phenotype approach. There is still much to accomplish for precise treatment modalities for rosacea patients, and additional modalities also need to be developed and validated. This review may act as a supplement of recent rosacea treatment guidelines and expert consensuses. Large-scale clinical research based on the phenotype approach is highly warranted in the future.
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Because of its red-faced, acne-like effects on personal appearance, however, it can cause significant psychological, social and occupational problems if left untreated. Learn more. Among rosacea patients with severe symptoms, 88 percent said the disorder had adversely affected their professional interactions, and 51 percent said they had even missed work because of their condition. Any one of the following warning signs is a signal to see a dermatologist or other knowledgeable physician for diagnosis and appropriate treatment before the disorder becomes increasingly severe: Redness on the cheeks, nose, chin or forehead.
Small visible blood vessels on the face. Bumps or pimples on the face. Watery or irritated eyes.
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