Take 5: Promising Therapies for Rosacea

1. Novel Gel May Bring Benefit to Rosacea Patients.

A novel topical agent, brimonidine tartrate (BT) might be efficacious for moderate to severe rosacea, according to a recent study (Br J Dermatol. e-Pub Nov 2). A single application of the highlighy selective γ(2)-adrenergic receptor antagonistgel in a gel formulation reduced facial erythema in a dose-dependent fashion. Significant difference between BT 0.5% and vehicle in chromameter redness value was observed from 30 minutes to 12 hours after application. In a follow-up study, BT 0.5% had a statistically superior success profile compared to vehicle. All regimens were safe and well-tolerated with similarly low incidence of adverse events.

2. New Studies Clarify Immunological Role in Rosacea.

A new study examined a common link shown in recent molecular studies between the triggers of rosacea and the cellular response (J Investig Dermatol Symp Proc. 15(1):12-5). These observations suggest that an altered innate immune response is involved in disease pathogenesis. The authors suggest that understanding rosacea as a disorder of innate immunity explains the benefits of current treatments and suggests new therapeutic strategies for alleviating it.

3. Consider Isotretinoin and Other Systemic Therapies.

A new German study supports low-dose systemic therapy with retinoids for treating severe and refractory forms of rosacea (Hautarzt. 62(11):820-7). Authors examined a recent randomized, double-blind, dose-response and comparative study revealing an optimized dosage of 0.3 mg/kg of isotretinoin was superior to other dosages and non-inferior to doxycycline as the gold standard of systemic rosacea treatment, while also proving effective and safe in papulopustular and phymatous subtypes. They speculate that the efficacy of isotretinoin in rosacea is probably mainly related to anti-inflammatory mechanisms as well as anti-oxidative, anti-angiogenic and antifibrotic properties.

4. Novel System Found Effective.

A novel rosacea treatment system consisting of cleanser, metronidazole 0.75% gel, hydrating complexion corrector, and sunscreen SPF30 has been developed to treat rosacea and a new study finds it efficacious (J Drugs Dermatol. 10(10):1179-85). Investigators noted that in patients treated with the skincare system alone, erythema was significantly lower from day 14 onward, versus unchanged with metronidazole plus standard sunscreen and cleanser (M+SSC). The proportion of patients reporting their skin was easily irritated at least sometimes was 40 percent with the system alone, 70 percent with system+M, and 89 percent with M+SSC.

5. Study Re-enforces Efficacy of Pimecrolimus.

A study offers new evidence that 1% pimecrolimus cream is an effective treatment for rosacea (J Dermatol. 38(12):1135-9). In a four-week, open-label study, patients experienced significantly reduced rosacea clinical scores from 9.65±1.79 at baseline to 7.27±2.11 at the end of treatment. Mexameter-measured erythema index decreased significantly from 418.54±89.56 at baseline to 382.23±80.04 at week 4. Side effects were mostly transient local irritations.