New standard management options for rosacea were recently published in the Journal of the American Academy of Dermatology.1 Developed by a consensus committee and review panel of 27 rosacea experts worldwide, the updated guidelines are intended to provide a comprehensive summary of treatment options for the respective signs and symptoms, also known as phenotypes, identified in the recently updated standard classification of rosacea, allowing physicians to tailor therapy for each individual case to achieve optimal patient outcomes.
“The growing scientific understanding of rosacea has established a consistent disease process that underlies the various potential clinical manifestations of the disorder, designated in the new standard classification system as phenotypes,” said Dr. Diane Thiboutot, professor of dermatology at the Pennsylvania State University. “At the same time, important advances in medical therapy have been developed for specific manifestations of the disorder, making multiple options available so that clear or near clear skin may be possible for increasing numbers of patients.”
Dr. Thiboutot noted that the standard management options, listed in tables by phenotype, also include expert evaluations of effectiveness and quality of evidence to serve as a guide for providing targeted treatment and care on an individual basis.
According to the updated classification system, the presence of one of two phenotypes – persistent facial erythema or, less commonly, phymatous changes where the nose or facial skin thickens – is considered diagnostic of rosacea. Additional major cutaneous signs, which often appear with the diagnostic features, include papules and pustules, flushing, telangiectasia and certain ocular manifestations. The presence of two or more major phenotypes independent of the diagnostic features is also considered diagnostic of rosacea. Secondary phenotypes, which must appear with one or more diagnostic or major phenotypes, include burning, stinging, swelling and dry appearance.
While there is no cure for rosacea, the standard management options provide information on how its features can be reduced or controlled with a range of topical and oral therapies and light devices, as well as appropriate skin care and lifestyle management to avoid factors that may aggravate the condition in individual cases. Combination therapy to target the specific features is often necessary for effective treatment.
The NRS has produced a free PDF for patients that provides a listing of the updated standard management options for rosacea by phenotype. Visit the Patients section to download a copy.
1. Thiboutot D, Anderson R, Cook-Bolden F, et al. Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2020;82(6):1501–1510.