The American Acne & Rosacea Society have published another paper in their series looking at the state of the art in rosacea treatments.

This part is dedicated to rosacea topicals, and how to use them to manage rosacea symptoms.

What do you need to know about what the American Acne & Rosacea Society has to say about your expensive rosacea topical?

The paper is described as reviewing “topical agents approved by the US Food and Drug Administration (FDA) for the treatment of rosacea as well as other non-FDA-approved agents that have been discussed in the literature”.

My Summary

Whilst you won’t find much in here that isn’t already well known to rosacea sufferers who research online, it is a solid, multi reviewed list of rosacea topical research.

It is encouraging to see that the list of topicals is up to date and also to see a canonical list of references to back up the conclusions for each topical.

All in all I think this is an important paper because it is the sort of article that doctors may well want to see before helping you get relief from your rosacea symptoms.

Abstract

Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 2: a status report on topical agents.

Cutis. 2013 December;92(6):277-284.

James Q. Del Rosso, DO; Diane Thiboutot, MD; Richard Gallo, MD; Guy Webster, MD; Emil Tanghetti, MD; Larry Eichenfield, MD; Linda Stein-Gold, MD; Diane Berson, MD; Andrea Zaenglein, MD

A variety of topical therapies have been utilized in the treatment of rosacea.

In part 2 of this 5-part series, topical agents that have been utilized in the treatment of the common clinical presentations of rosacea, including those that have been approved by the US Food and Drug Administration (FDA) as well as alternative agents, are reviewed.

It is important to note that adjunctive skin care and photoprotection are integral components of rosacea treatment that may assist in optimizing therapeutic outcomes.

For a discussion of Part 1 of the 5 part series, see AARS publish their Rosacea Treatment Guidelines.

This abstract is worth reading just to see all of the links between the authors of this paper and the pharmaceutical industry.

FDA Approved Topicals

Mentions ;

• 0.75% Metronidazole twice a day (Rozex, Metrogel),
• 1% Metronidazole Gel and Cream once-daily (Metrogel 1%)
• 15% Azelaic Acid Gel (Finacea)
• 1-% Sodium Sulfacetamide, 5% Sulfur cleanser and leave-on formulation (Clarifoam EF)

These topicals have been shown to reduce the papules and pustules of rosacea. Finacea mentions that it can reduce the redness of rosacea, although it is not FDA approved for erythema.

All 3 families of topicals can be combined with oral tetracycline, most commonly doxycycline, for increased effectiveness. Here increased effectiveness means faster results, and greater overall reduction in the papules and pustules of rosacea.

Alternative Topicals

Mentions ;

• topical corticosteroids
• tacrolimus/pimecrolimus
• macrolides
• benzoyl peroxide
• clindamycin
• permethrin
• retinoids.

New and Emerging Topicals

Mentions ;

• brimonidine tartrate (aka Mirvaso)
• oxymetazoline (product name still unknown – currently AGN-199201 – Now Rhofade)
• topical ivermectin (product name unknown – currently CD5024 – Now Soolantra)

Disclosures

• Dr. Del Rosso is an advisory board member and consultant for Allergan, Inc; Bayer Health Care Pharmaceuticals; Galderma Laboratories,
  LP; Onset Dermatologics; Promius Pharma; Ranbaxy Laboratories Limited; Unilever; Valeant Pharmaceuticals International, Inc; and Warner
  Chilcott. He also is a researcher for Allergan, Inc; Bayer Health Care Pharmaceuticals; Galderma Laboratories, LP; Onset Dermatologics;
  and Valeant Pharmaceuticals International, Inc. Dr. Del Rosso also is a speaker for Allergan, Inc; Bayer Health Care Pharmaceuticals;
  Galderma Laboratories, LP; Onset Dermatologics; Promius Pharma; Ranbaxy Laboratories Limited; Valeant Pharmaceuticals International,
  Inc; and Warner Chilcott.
• Dr. Thiboutot is a consultant and investigator for Allergan, Inc, and Galderma Laboratories, LP. (see AAD: off-label and future rosacea treatments)
• Dr. Gallo is a consultant for and has received research grants from Allergan, Inc; Bayer Health Care Pharmaceuticals; and Galderma Laboratories, LP.
• Dr. Webster is a consultant for Allergan, Inc; Cutanea Life Sciences; Galderma Laboratories, LP; and Valeant Pharmaceuticals International,
  Inc. (see Sansrosa and Afrin Updates from Dr. Fowler & Dr. Webster)
• Dr. Tanghetti is a consultant, speaker, and investigator for Allergan, Inc; Cynosure, Inc; and Galderma Laboratories, LP. (see Inactive Ingredients Just as Important as Active Ingredients)
• Dr. Eichenfield is a consultant and investigator for Galderma Laboratories, LP, and Stiefel, a GSK company.
• Dr. Stein-Gold is an advisory board member, consultant, investigator, and speaker for Galderma Laboratories, LP, and LEO Pharma; an advisory board member, consultant, and investigator for Anacor Pharmaceuticals, Inc; an advisory board member, investigator, and speaker for Stiefel, a GSK company; an advisory board member and consultant for Taro Pharmaceuticals USA, Inc; a consultant and investigator for Topica Pharmaceuticals,
  Inc; an investigator and speaker for Allergan, Inc, and Novartis Corporation; a speaker for Promius Pharma and Ranbaxy Laboratories
  Limited; and a consultant for Ferndale Laboratories, Inc.  (see AARS publish their Rosacea Treatment Guidelines)
• Dr. Berson is an advisory board member and consultant for Allergan, Inc; Anacor Pharmaceuticals, Inc; Galderma Laboratories, LP; La Roche-Posay Laboratoire Dermatologique; Procter & Gamble; and Rock Creek Pharmaceuticals.
• Dr. Zaenglein reports no conflict of interest.

The American Acne & Rosacea Society and the authors did not receive any form of funding or compensation for this series of articles, including this manuscript.

References

The paper has an impressive live of references – 85 of them!

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