Treatment management for rosacea: current pharmacological and non-pharmacological options

Rosacea is a chronic skin condition classified into four subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular involvement. The physical symptoms and recurrent nature can impact patient quality of life. Effective treatment requires a phenotype-directed strategy that addresses both clinical features and patient concerns.

This review summarizes current treatment guidelines and therapeutic options for rosacea, categorized into topical agents, oral medications, procedural interventions, and lifestyle modifications. A literature search was conducted using PubMed, Google Scholar, and ClinicalTrials.gov to identify relevant studies.

Rosacea management is most effective when treatment is individualized based on phenotype. Topical medications such as metronidazole, azelaic acid, ivermectin, and minocycline are used as first-line treatment for mild to moderate rosacea. Oral medications, including doxycycline and minocycline, are efficacious in treating mild to moderate forms of rosacea. Oral medications can be prescribed in combination with topical therapy. Pulse dye lasers, intense pulsed light, and other laser therapies can be used for severe rosacea. Procedural interventions such as electrosurgery, dermabrasion, and surgical resurfacing may be necessary in cases with severe phymatous changes. Alongside these medical treatments, lifestyle modifications, such as avoiding known triggers and implementing sun protection, are essential for managing rosacea flare-ups and preventing exacerbations.