Updates to the Treatment of Rosacea, with Hilary Baldwin, MD

In a talk titled ‘Acne and Rosacea Update 2024’ featured at the Maui Derm NP+PA Fall conference in Nashville, 3 presenters highlighted the latest approaches to treatment of acne and rosacea. Challenging case scenarios were also presented at this talk.

Hilary Baldwin, MD, medical director of the Acne Treatment & Research Center in New York, spoke with the HCPLive team about the elements of her talk on rosacea that she hopes attendees will walk away with a greater understanding of.

“My hope is that the attendees at this meeting will walk away with a better understanding of which topical medications are most likely to work and least likely to irritate the skin of their patients,” Baldwin said. “Our older products were much less efficacious and also tended to cause much more in the way of intolerability.”

Baldwin highlighted approved treatments for subtypes such as background erythema, including brimonidine and oxymetazoline, as well as those for papules and pustules, such as azelaic acid, metronidazole, ivermectin, and minocycline foam. Baldwin noted the efficacy of the modified release doxycycline for rosacea, which is also known for having very few side effects.

“I'm very happy with the drugs that we have for papulopustular rosacea,” Baldwin said. “Just make sure that you're using them in combination. If a solo agent doesn't work well enough for vascular disease, we have our alpha-agonist to help to suppress the background erythema for flushing, perhaps a beta blocker like carvedilol. We also have botulinum toxin now for treating the flushing of rosacea, so we're in a pretty good position.”

Baldwin was also asked about unmet needs among patients with rosacea, which she noted are primarily around flushing.

“We have at the alpha-agonists that do a nice job with fixed facial erythema, but we're not quite there yet with flushing,” Baldwin explained. “We have 2 things that people use quite frequently, the beta-blockers, with carvedilol, appearing to be the most effective with the fewest side effects. And botulinum toxin, which unfortunately is expensive and generally uncovered for this, this indication. That's the area in which I'd like to see some work being done.”

To find out more about this discussion, view the full interview posted above this summary.

The quotes used in this description were edited for the purposes of clarity.

Baldwin reported personal fees from Galderma, Bausch Health, Almirall, and Sun Pharma outside the submitted work. Dr Bewley reported consultancy fees with Almirall, AbbVie, Janssen, LEO Pharma, UCB, Bristol Myers Squibb, Pfizer, Novartis, and Sanofi; and nonfinancial support as immediate past president of European Society for Dermatology and Psychiatry outside the submitted work. Dr Cohen reported personal fees from Ferndale, FIDE, SFJ, Cosmetic Ingredient Review, UCB, LEO Pharma, and Medimetriks; equity and board member of Evommune and Timber; and being a past board member of Novartis, Kadmon, and Dermira.