The Rosacea Research Digest from the National Rosacea Society keeps you up to date on recently published basic and clinical research on rosacea, as well as news, reviews, and presentations. It goes out on the last weekday of each month.

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Research

Efficacy of widely used topical drugs for rosacea: a systematic review and meta-analysis.

Gao X, Xiang W. Actas Dermosifiliogr. 2025 Apr 15:S0001-7310(25)00282-0. English, Spanish. Epub ahead of print. doi:10.1016/j.ad.2024.12.026. PMID: 40246142.

Topical interventions for rosacea are often used to relieve local symptoms. However, currently, there are few articles to systematically analyze the efficacy profile of topical drugs for rosacea. This study aimed to investigate the efficacy profile of widely used topical drugs. To acquire appropriate information from related literature, we looked into 4 databases. Efficacy was appraised with the Investigator Global Assessment, Clinician's Erythema Assessment, Patient's Self-Assessment and Subject Self-Assessment of Rosacea Facial Redness scales. Treatment-emergent adverse events and dermal tolerability were also recorded. According to 21 randomized controlled trials included, a total of 6 topical drugs including minocycline, ivermectin, azelaic acid, metronidazole, brimonidine and oxymetazoline were reported. These drugs are well-tolerated and safe. Ivermectin is more effective than azelaic acid and metronidazole. Azelaic acid has a better efficacy profile than metronidazole according to included studies. Minocycline turned out to be effective improving the symptoms of rosacea. Brimonidine and oxymetazoline both have significant effects on reducing facial redness.

Patients with rosacea exhibit lower minimal erythema doses to both UVA and UVB.

Wei R, Wang X, Lei W, et al. Photodermatol Photoimmunol Photomed. 2025 May;41(3):e70019. doi:10.1111/phpp.70019. PMID: 40223794.

Background: Rosacea, a prevalent chronic inflammatory skin condition primarily affecting the central facial convexities, is categorized into four clinical subtypes: erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), phymatous rosacea (PhR), ocular rosacea (OR). While ultraviolet (UV) radiation is recognized as a risk factor for rosacea, the differential skin sensitivity to UVA and/or UVB between healthy individuals and rosacea patients remains ambiguous. Methods: This study comprised 70 patients diagnosed with rosacea and 100 healthy controls. The minimal erythema doses (MED-UVA and MED-UVB) were ascertained using an SUV-2000 solar UV simulator. A comparative analysis was conducted on the MED-UVA and MED-UVB results between the rosacea patient group and the healthy control group, as well as among rosacea patients with varying clinical subtypes. Furthermore, the correlation between MED values in rosacea patients and factors such as age, skin type, antinuclear antibodies (ANA), and the Clinical Erythema Assessment (CEA) scale was evaluated. Results: In comparison to the healthy control group, the rosacea group demonstrated significantly lower MED-UVA (p < 0.05) and MED-UVB (p ≤ 0.001) values. However, no significant differences were observed in the MED-UVA (p > 0.05) and MED-UVB (p > 0.05) values among patients with varying clinical subtypes of rosacea, specifically between ETR and PPR. Conclusion: Patients diagnosed with rosacea demonstrate a decreased minimal erythema dose to both UVA and UVB, suggesting heightened sensitivity to ultraviolet radiation. Consequently, it is advisable for individuals with rosacea to minimize sun exposure in order to mitigate or prevent exacerbation of the condition.

Off-label treatment in inflammatory skin diseases-European point of view.

Sternicka J, Nowicki RJ, Bieniaszewski L, Purzycka-Bohdan D. J Clin Med. 2025 Mar 30;14(7):2376. doi:10.3390/jcm14072376. PMID: 40217831; PMCID: PMC11989427.

Off-label treatment is the use of a drug approved for marketing, outside the registration in terms of indication, age group, dose or route of administration. Despite the constant appearance of new preparations on the market, treatment outside the SmPCs guidelines is a current clinical problem. It is believed that it is based on the needs of patients unmet by classical therapy methods. This work focuses on off-label treatment in inflammatory dermatoses such as atopic dermatitis, psoriasis, acne vulgaris and rosacea. Publications on this subject, available on PubMed, Google Scholar and the Cochrane Library, were analyzed in the form of a review, taking into account the mechanisms of action, efficacy and safety of preparations. Based on the literature analysis, it can be concluded that the use of drugs outside the SmPC indications is a common situation in dermatology. However, it is difficult to determine its exact frequency-there is a lack of data on the prevalence of off-label appliances in inflammatory dermatoses from a European perspective. Publications demonstrate varying effectiveness and safety of this form of therapy, depending on the specific preparation. Off-label treatment in dermatology remains an important and current clinical issue that should be explored in further research.