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Interventions for rosacea.

Esther J van Zuuren1, Sharon Kramer, Ben Carter

  • 1Department of Dermatology, Leiden University Medical Center, PO Box 9600, B1-Q, Leiden, Netherlands, 2300 RC.

The Cochrane Database of Systematic Reviews
|March 18, 2011
PubMed
Summary
This summary is machine-generated.

Topical metronidazole, azelaic acid, and doxycycline show effectiveness for moderate to severe rosacea. Cyclosporine ophthalmic emulsion is effective for ocular rosacea, though more research is needed.

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Area of Science:

  • Dermatology
  • Ophthalmology
  • Evidence-Based Medicine

Background:

  • Rosacea is a common chronic facial skin condition with symptoms including flushing, redness, pimples, and dilated blood vessels.
  • Ocular involvement and skin thickening (phymas) can occur in some rosacea patients.
  • Current treatment options for rosacea exist, but their comparative effectiveness remains unclear.

Purpose of the Study:

  • To systematically assess the available evidence on the efficacy and safety of various treatments for rosacea.
  • To identify the most effective interventions for managing moderate to severe rosacea and ocular rosacea.

Main Methods:

  • Conducted an updated systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches.
  • Included 58 trials with 6633 participants evaluating interventions such as topical metronidazole, oral antibiotics, azelaic acid, and others.
  • Assessed study selection, data extraction, and risk of bias by two independent reviewers.

Main Results:

  • Topical metronidazole demonstrated greater efficacy than placebo based on physician assessments (RR 1.95).
  • Azelaic acid and doxycycline also showed significant effectiveness compared to placebo in physician and participant assessments.
  • Doxycycline at 40 mg was effective with fewer adverse effects than higher doses. Cyclosporine ophthalmic emulsion was superior to artificial tears for ocular rosacea.

Conclusions:

  • Topical metronidazole, azelaic acid, and low-dose doxycycline (40 mg) show evidence of effectiveness for moderate to severe rosacea.
  • Cyclosporine 0.5% ophthalmic emulsion is effective for ocular rosacea.
  • High risk of bias in many studies necessitates further well-designed, adequately-powered randomized controlled trials.