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S2k guideline: Rosacea
Benjamin M Clanner-Engelshofen1, Dominik Bernhard1, Sonja Dargatz2
1Department and Clinic for Dermatology and Allergology, University Hospital Munich, LMU Munich, Germany.
Summary
This S2k guideline updates rosacea diagnosis and treatment. Key recommendations include trigger avoidance, topical therapies like metronidazole and azelaic acid, and systemic options for severe cases.
Area of Science:
- Dermatology
- Clinical Guidelines
Background:
- Rosacea is a common chronic inflammatory skin condition primarily affecting the face.
- It presents with erythema, telangiectasia, flushing, and inflammatory papulopustules, potentially progressing to severe manifestations like phyma.
Purpose of the Study:
- To provide an updated and upgraded S2k guideline for the diagnosis and treatment of rosacea.
- To consolidate recommendations from an interdisciplinary committee representing various medical societies and patient organizations.
Main Methods:
- Development of an interdisciplinary guideline by a committee including representatives from dermatology, ophthalmology, dermopharmacy, and patient advocacy groups.
- Review and synthesis of current evidence for rosacea diagnosis and treatment strategies.
Main Results:
- Recommendations include avoiding trigger factors and using topical treatments such as metronidazole, azelaic acid, or ivermectin.
- For persistent erythema, topical vasoconstrictors (brimonidine, oxymetazoline) are suggested.
- Systemic therapy with low-dose doxycycline or isotretinoin is recommended for severe or therapy-resistant papulopustular rosacea.
- Ocular rosacea management involves lid margin hygiene and topical agents like ciclosporin, azithromycin, ivermectin, or metronidazole.
Conclusions:
- The guideline offers comprehensive, evidence-based recommendations for managing rosacea across its various presentations.
- Emphasizes a multidisciplinary approach and tailored treatment strategies based on disease severity and subtype.
