Systemic Therapy for Rosacea

H. E. Baldwin, MD


Skin Therapy Letter. 2007;12(2) 

In This Article

Abstract and Introduction

Rosacea is a common condition that affects people of all races. In addition to the visible aspects of this disease, it can have a psychosocial impact that must be evaluated when considering the treatment options. More aggressive and innovative uses of existing oral agents have resulted in novel therapeutic approaches, which can provide long-term therapy and sustained remission.

Rosacea is a common disorder that is thought to affect 13-14 million people in the US alone.[1,2] It is likely that the actual number is substantially higher. Rosacea affects all races, although erythema may be less prevalent in patients with skin types IV and V. The rate of occurrence appears to be higher in women; however, men are more likely to develop phymas. Patients are most often diagnosed with this condition in their 30s-50s.

To truly understand the effects of rosacea on patients, the psychosocial impact must be evaluated along with the visible aspects of this disease. For many of our patients, the stigma of a 'drinker's nose' and the social and professional isolation that can result from low self-esteem is far more significant than the clinical reality.

Contributing to the frustration experienced by patients with rosacea is the fact that as clinicians, we do not truly treat rosacea, but rather manage it. We cannot offer patients cures, simply improvements. As with all chronic conditions, continual therapy inevitably leads to non-adherence. The benefits derived from a combination of both medical and psychological approaches cannot be overemphasized. The overall objective is the improvement of the quality of life of patients, and in 2007, this goal is easier to attain thanks to topical medications that reduce skin irritation. Furthermore, with the advent of safer, once-daily systemic medications, it is possible to liberate patients from the use of topical products.


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