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The Latest Advances in Rosacea Treatment: A Systematic Review
Anastazja Andrusiewicz1, Sofiia Khimuk1, Jakub Niżnik1
1Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Pharmaceuticals (Basel, Switzerland)
|July 28, 2026
Summary
This review highlights that current rosacea treatments target vascular, inflammatory, and microbial factors. More high-quality trials are needed to confirm the efficacy and safety of emerging rosacea therapies.
Area of Science:
- Dermatology
- Pharmacology
- Immunology
Background:
- Rosacea is a chronic inflammatory skin condition with complex pathophysiology involving vascular, immune, neurovascular, and microbial elements.
- Recent understanding has spurred the development of targeted rosacea treatments.
- This review evaluates current and emerging therapeutic strategies for rosacea.
Purpose of the Study:
- To systematically review contemporary evidence on emerging and established rosacea treatments.
- To assess the efficacy of interventions targeting multiple disease mechanisms.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched PubMed, Scopus, and Web of Science (2016-2025) for human studies on rosacea interventions.
- Included 15 studies (537 rosacea patients) and assessed risk of bias using JBI tools.
Main Results:
- Evaluated interventions included vascular-targeted therapies, anti-inflammatories, systemic treatments, and microbiome approaches.
- Established treatments like oxymetazoline, laser, ivermectin, azelaic acid, and metronidazole showed benefits.
- Emerging therapies (tofacitinib, oral ivermectin) and microbiome interventions (Demodex-targeted, H. pylori eradication) showed promise.
Conclusions:
- A multimodal, mechanism-based approach is supported for rosacea management.
- Evidence is limited by small sample sizes, methodological heterogeneity, and short follow-up.
- High-quality randomized controlled trials are essential for optimal evidence-based rosacea treatment strategies.
