[Topical therapy of rosacea]

Area of Science:

• Dermatology
• Pharmacology

Context:

• Rosacea management involves approved topical agents like metronidazole and azelaic acid.
• Off-label topical treatments are common for rosacea and its subtypes.
• Topical steroids are generally contraindicated due to significant side effects.

Purpose:

• To review current topical treatment options for rosacea.
• To highlight the limitations of existing therapies and introduce emerging treatments.

Summary:

• Metronidazole and azelaic acid are the only FDA-approved topical rosacea treatments.
• Topical steroids are reserved for short-term use in acute rosacea flares.
• Papulopustular rosacea is the primary indication for topical therapy.
• Glandular-hypertrophic and erythematous rosacea show limited response to topical agents.
• Brimonidine, an alpha-2-adrenoreceptor agonist, is a new topical option for erythema.
• Severe rosacea requires initial combination therapy (topical and systemic).

Impact:

• Provides a comprehensive overview of topical rosacea treatments.
• Informs clinicians about approved, off-label, and emerging therapeutic options.
• Emphasizes the risks associated with topical steroid use in rosacea.