Latest Rosacea Treatments

Written by on September 28, 2010 in New Rosacea Treatments with 11 Comments

Every rosacea sufferer who is unsatisfied with the current offering of treatments looks to see what might be available soon. The thought that something new and improved is just around the corner is a source of encouragement for sufferers who just can’t get the relief they long for.

Even though the new and latest and greatest treatments start out largely untested and may turn out to be no better than existing treatments, there is something tantalising about the promise of new treatments.

A colleague of mine had this saying – “Nothing is as good as the next, untested release”. He was referring to software but it applies here too. The promise that the next product will solve all of the problems of the current product is so strong that we can easily get ahead of ourselves and embiggen our expectation.

Bearing this in mind, a recent abstract has all the marks of an exciting paper – Rosacea treatments: What’s new and what’s on the horizon? Sounds exactly like something that will be interesting to many.

The principle author of this paper is Dr. Rosella Gallo from the University of Genoa, not to be confused with another R. Gallo from UC San Diego, who is also promoting possible future rosacea treatments.

Rosacea treatments: What’s new and what’s on the horizon?,

Gallo R, Drago F, Paolino S, Parodi A.,

Am J Clin Dermatol. 2010;11(5):299-303.

Di.S.E.M, University of Genoa, Italy.

Rosacea is a common, chronic, cutaneous disorder presenting with recurrent episodes of facial flushing, erythema, papules, pustules and telangiectasias. It is a multifactorial disease and its various clinical presentations probably represent the consequence of combined different triggers upon a specific background. Its management is largely based on long-established treatments empirically tailored to the specific presenting symptoms and no real breakthrough has occurred to date.

However, recent insights into the still rather obscure pathophysiology of rosacea seem to open the way for etiologically oriented treatments.

These may include, on the one side, the more effective application of traditional drugs, such as tetracyclines and metronidazole, to specifically selected patients or, on the other side, new therapeutic options, such as vitamin D receptor antagonists.

It is to be remarked that the quality of most studies evaluating rosacea treatment is rather poor, mainly due to a lack of proper standardization.

For a major breakthrough to occur in the management of rosacea, we need both a better understanding of its pathogenesis and the adherence of future clinical trials to clearly defined grading and inclusion criteria, which are crucial for investigators to correctly compare and interpret the results of their work.

Even though this is only an abstract we can look at the web site for the journal itself to get a few more clues about what new treatments this paper covers. Based on the keywords listed for this paper, lets look at each one in turn to see what new treatments might be uncovered in this paper;

Alpha-1 adrenergic receptor agonists

See oxymetazoline below;

Antimicrobial cationic peptides

The innate immune system contains peptides that form the basis for the possible development of new therapeutic agents that will complement the existing antibiotic therapies. We have learnt recently that Omiganan (topical cationic peptide) to be trialled as a rosacea treatment.


See Crotamiton below.


Azelaic Acid is the active ingredient in Finacea. It isn’t clear what innovations exist related to Finacea or Azelaic Acid based treatments.

Bacillus infections

This seems to be referring to the recent research that has found that a particular type of bacteria isolated in demodex mites (known as B. oleronius) appears to produce an immune response in some rosacea sufferers. Should further research confirm a causative link between rosacea and this bacteria, interesting treatments may result. See demodex mite bacteria causes the inflammation ? for more information.

Calcitriol receptor antagonists

Calcitriol is a form of Vitamin D. I hope to cover Vitamin D receptor antagonists in a future Rosacea News item.


This drug, also known as Eurax has been trialled as a treatment for demodex mites. (see Demodex Mites Treatment)

Helicobacter pylori Infections

Long part of the rosacea folkore, infection by the HP bacteria has been thought to be responsible for rosacea symptoms. This folklore is fuelled by the fact that treatments for the bacteria, several well known antibiotics also benefit some rosacea symptoms.

Intestinal infections

See Rifaximin below.


Oxymetazoline is known to rosacea sufferers as the active ingredient in decongestant products like Afrin, Sudafed OM and Vicks Sinex as well as in eye drops like Visine LR.

We known that oxymetazoline is good for 6 hours and safe for 3 months and it seems clear that Vicept Therapeutics is trialling V-101 which is based on oxymetazoline. Further trials are expected as oxymetazoline based treatments continue to be assessed as treatment for the redness associated with rosacea.


This is a topical insecticide (see demodex mites ivermectin effective treatment ? ) that is used by some people to kill demodex mites. 5% Permethrin (Elimite Cream) is only available by prescription in the US and is usually used to treat scabies. Some research has shown that treatment-resistant cases of rosacea have been successfully treated with Permethrin.


Photochemotherapy usually refers to treating the skin with something that temporarily makes the skin more sensitive to UVA radiation and then exposing the skin to UVA. This sort of treatment has been around for many years and is often targeted as diseases like psoriasis and vitiligo.


Apart from trials to look at treating the redness of rosacea with Atralin Gel, I haven’t read much about new innovations in the area of retinoids and rosacea treatments.


This antibiotic doesn’t leave the gut, so any benefit to the skin is not based on it’s direct cutaneous action. The quest here is to discover how perhaps small intestinal bacterial overgrowth induces rosacea in the skin (see SIBO eradication clears rosacea: are you serious ? and SIBO diet/treatment).

[update]: We should also include Carbamide Peroxide – see Elorac promoting Carbamide Peroxide as a Rosacea Treatment for more informatoin.

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

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11 Reader Comments

  1. Doug says:

    These seem to be all fine in treating the symptoms of Rosacea but I would like to see something that addresses a cure for Rosacea. So we dont have to continue using so many products.

  2. andy says:

    Personally I don’t mind using a treatment for the rest of my life, as long as said treatment is effective in stopping rednessetc.
    I can live with popping a pill or applying cream but I see the cure as a near impossible step and something thats a long way away so I don’t hold any hopes, a treatment is a more realistic goal

    Can I just say Kudos to the excellent team here on the blog, thankyou for you for efforts we appreciate it

  3. Pavla says:

    I would like to know whether some of you knows any news from the research of Dr. Gallo / San Diego. I was not able to find one new positive info since his well-known article dated 2007 and repeated in various forms many times later.
    My child has erythem. rosacea symptoms since first weeks of life so I personally do not beleive in idea that rosacea is caused by demodex bacteria only. That is why I am so hungry to hear good news from different type of research, more oriented to e.g. auto-immune system, cathelicidins, …etc.
    Thank you in advance for possible reply.

  4. Doug says:

    I know what you are saying.. I wish Gallo would come out with something new to report.

  5. andy says:

    In regards to Oxymetazoline and blocked nose/sinus treatments…
    I noticed something interesting recently.
    I’ve had a cold for about 3-4 days, the usual runny then blocked nose, then runny again. I haven’t had a cold for a year or so and I haven’t used decongestants like sudafed for a couple of years, anyway to cut a long story short…

    I’ve been experiencing more irritation than usual in the past few weeks,nothing major but it has been relatively annoying. However in the past 2-3 days my skin has been reasonably supple and the redness yesterday and today has really improved. My usual forehead/brow redness and soreness that has never gone away has improved greatly. The side of my nose and cheek redness has calmed down on one side of my face to almost normal, the other side is a tad better. The bridge of my nose ironically is still slightly red, but I have had this redness for years predating the rosacea.
    So i’m wondering if the treatment is linked to the improvement?
    This may lead me to some experiments, and I’ll see if it stays like this or goes back to how it was before. I’ll give it a week.

  6. Dave says:

    I purchased and read this article (USD 45) in the expectation that it would give a detailed treatment of new and planned therapies, but was disappointed. As a (non-medical) scientist myself, I expected much more from the leading article in a prominent journal. I learnt almost as much by reading David Pascoe’s comments above. To boot, the definition of something new appears to be anything that’s come along in the last 10 years. As a summary, it’s probably quite useful for newbies, but don’t expect a raft of “tantalising new possibilities.” It concludes by saying that no breakthroughs have occurred in the area of rosacea management and that the current quality of drug trials is poor and inadequately benchmarked. Hardly encouraging, but there are positive remarks on “new” therapies for some forms of rosacea.

  7. I was able to read a full copy of this article after I published this summary, and you are right; the paper doesn’t provide a whole lot more detail that the abstract suggested. It did give the references to the claims it made, but most of those have been covered in Rosacea News already.


  8. Aimee says:

    I have seen this product on Dr Oz. Dr. Audrey Kunin a dermatologist has created PHOTO DYNAMIC THERAPY, a sunlight activated laser lotion. It is ground breaking in that it uses sun or even daylight to give the skin a laser like treatment. You will have to go to the website because I don’t have the knowledge to explain it properly. I have used it, but I am also just healing from a VBeam and not doiing that well, so I have stopped it temporarily.
    I will give it a good try later though.

    No affiliation with this company.

  9. Hi Aimee,

    Certainly an interesting and novel concept to be able to let the red parts of the visible spectrum through from sunlight. It would be great to see a spectral graph to see how it blocks UVA, UVB as well.


  10. Aimee says:

    Yes it would David. Thanks

  11. Lane says:

    This is my first time here. I gave up along time ago on taking prescriptions. If there is any out there that someone with liver damage and high blood pressure can take, let me know. It seems that ever since I came down with this, my life has been an experiment. I can’t imagine how much money that has been wasted. One day I overheard my father say that he had to take fish oil. It was to help with inflammation. Not really believing this, I started taking one fish oil a day. After a couple of months noticed a reduction of redness. I now take 7 fish oil a day at one time. There are times I have flareups but usually stress/sun causes it. In the past my face would get so hot that there would be scrabs from the heat. I am sensitive to alot of things but the fish oil reduced alot of them. I was sensitive to metals and can now wear necklaces for a longer periods before the rash appears. Has anybody else used fish oil for imflammation? My doctors don’t have much of an opinion.

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