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Current and emerging pharmacotherapy for rosacea: a misunderstood and undertreated condition
Nashali Vescovacci1, Liddy Malone1, Chenan A Huang1
1Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Expert Opinion on Pharmacotherapy
|July 10, 2026
Summary
This review explores new rosacea treatments targeting immune and neurovascular pathways. Emerging therapies show promise but require more research on long-term safety and cost-effectiveness for widespread use.
Area of Science:
- Dermatology
- Immunology
- Vascular Biology
Background:
- Rosacea is a chronic inflammatory skin condition with diverse symptoms affecting quality of life.
- Its complex pathophysiology involves innate immune, neurovascular, and inflammatory pathways.
- An expanding range of therapeutic options is becoming available.
Purpose of the Study:
- To review established and emerging pharmacologic and procedural therapies for rosacea.
- To evaluate treatments based on mechanism of action, efficacy, and safety.
- To summarize current management and future directions in rosacea treatment.
Main Methods:
- A narrative review of peer-reviewed articles from 2014-2026 was conducted.
- PubMed database was searched using keywords: 'rosacea,' 'advances,' 'emerging,' 'management,' 'treatment,' 'off label,' 'device,' 'lasers,' and 'pathogenesis.'
Main Results:
- Current rosacea management employs a phenotype-driven, personalized approach.
- Emerging agents target novel inflammatory and neurovascular pathways, potentially improving tolerability and response durability.
- Cost and evidence gaps currently limit the adoption of new therapies.
Conclusions:
- Personalized treatment strategies for rosacea are guided by phenotype.
- Novel therapies targeting inflammatory and neurovascular pathways offer potential improvements.
- Further research is needed on long-term safety, comparative efficacy, and cost-effectiveness for optimal individualized treatment.
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