Best Practices for Treating Rosacea

best-practice-treating-rosacea

This paper, a sponsored supplement in the DermatologyTimes is detailing the latest and greatest treatments for rosacea.

Drs. Baldwin, Bhatia, Del Rosso, Stein-Gold, and Webster are asked a series of questions relating to their clinical experience in treating rosacea.

Best Practices in the Treatment of Rosacea

In this Dermatology Times supplement, a group of experts in the management and treatment of rosacea discuss the clinical impact of the latest findings regarding understanding of the pathophysiology of the disease, as well as commonly-used therapeutic agents and drug combinations that may be effective in treatment-specific rosacea symptoms.

The opening section asks each of the authors to comment on their understanding of the pathophysiology of rosacea, and genetic links.

One particularly interesting question posed relates to the recent emphasis on a change in how to diagnose rosacea – using a phenotype designation.

Dermatology Times: How, if at all, are you utilizing rosacea phenotyping during the diagnostic process? How is the grouping of rosacea patients by phenotype different than grouping by subtype?

Dr. Bhatia: When I see a new patient with suspected rosacea, my first order of business is to confirm the diagnosis.

These days, you have so many people with static erythema or structural telangiectasias who were told they have rosacea by their neighbor, by “Dr. Google,” or by the guy at the bar. They come in having already made up their mind that they have rosacea, and my number 1 charge is to convince them that they either have it or they don’t. That can be a little daunting without a clear family and medical history.

Assuming that the diagnosis of rosacea is eventually confirmed, then it becomes important to stratify them based on their symptoms: Are they papular, are they more erythematous, or are they a combination of both? That then will help guide treatment.

Oracea Emphasis

Although not mentioned directly by name, the 40mg delayed release doxycyline treatment Oracea is mentioned as a common and useful rosaca treatment.

Rosacea Questions that need an answer

Download the PDF file to read for yourself the answers offered for the following questions.

  • What, if any, new information has recently come to light about the pathophysiology of rosacea that is important for dermatologists to know?
  • What is known about any genetic predisposing factors to the development of rosacea?
  • What are the major clinical features of rosacea? Which do you find to be most burdensome from a patient perspective?
  • Which features of rosacea are most difficult for providers to successfully treat?
  • How do you determine if a patient should be classified as having mild, moderate, or severe rosacea? Do you use any sort of formal diagnostic tool during the process?
  • What are the primary considerations when recommending treatment options for a patient with papulopustular rosacea? How often is cost factored into the equation?
  • How do you approach a discussion with a patient with papulopustular rosacea who perhaps has overly ambitious expectations of therapy?
  • What are your primary initial treatment options in a patient you determine to have mild papulopustular rosacea?
  • What about the approach in a patient you determine to have severe papulopustular rosacea?
  • Which topical/oral combinations are believed to be the most effective in treating papulopustular rosacea?
  • Why is doxycycline believed to work in treating the inflammatory lesions of rosacea?
  • Is a higher dose of doxycycline (ie, 100 mg) more effective in treating papulopustular rosacea than a lower dose (ie, 40 mg)? What does the clinical evidence show?

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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