Diagnosing and Treating Rosacea : An Overview

April is Rosacea Awareness Month. While the cause of rosacea is still unknown, what is known is that it is estimated to affect up to 16 million people in the United States alone.

Additionally, a recent survey by the National Rosacea Society indicated that 47% of affect patients were unaware of the disorder prior to their diagnosis, and 95% stated that they knew very little about the signs and symptoms of rosacea.

This Friday, HCPLive will be hosting a variety of discussions and new investigations regarding rosacea in an effort to raise awareness of the condition.

For this episode of DocTalk, Karan Lal, DO, MS, FAAD, of the Schweiger Dermatology Group provides information on how doctors diagnose rosacea, variations of rosacea, what treatments are currently available, and current trends in research regarding the condition.

“I think that we underestimate how much rosacea there is, prevalence-wise,” Lal said. “If you look at the characteristics, I think on any given day if I'm seeing adult patients, about 30 to 40% of those people have signs of rosacea.”

Variations of rosacea include erythematotelangiectatic rosacea which is often categorized by redness and flushing of the facial cheeks, forehead, and chin, as well as papulopustular forms of rosacea that included pimples and a raising of the skin from pustular bumps.

Furthermore, phymatous rosacea involves the swelling of the sebaceous glands and can result in deep-seated swelling in the nose, chin, and ears of patients.

Symptoms and severity of rosacea are dependent on the type of rosacea a patient has. As such, treatment methods may vary, though Lal noted that topical treatments are often used to reduce pustular bumps.

“You want to treat it from an anti-inflammatory perspective, so we most often start with topical anti-inflammatory agents or topical antibiotics or anti-parasiticsl ike metronidazole, which is often a cream or a gel that we can use to make the pus bumps go away,” Lal said. “We then can also consider newer types of treatments like topical ivermectin, also known as Soolantra, or topical minocycline which is called Zilxi. These are newer topical agents and anti-inflammatories that help with the pus bumps and the pimples of rosacea.”

Medicines such as brimonidine or oxymetazoline have been shown to reduce redness for short periods of time, though Lal noted that recent research has indicated that these treatments can help reduce long-term redness.

Additionally, he cited a “multimodal approach” to treating rosacea that can include anti-inflammatory medications, sunscreen, and laser light therapy. Vasoconstrictive agents in particular- when combined with laser therapy- have been associated with prolongued reductions in redness.

“I think it's important to know that there are new options for redness, which is probably the hardest part of rosacea to treat,” Lal said. “And so I think we're going to learn more about that, and we’re getting new data, so I’d like to see what’s to come.”

To hear more from Dr. Lal on the management of rosacea as well as rare forms of rosacia, listen to the full episode of DocTalk above.