A Review of the Challenges and Nuances in Treating Rosacea in Asian Skin Types Using Cleansers and Moisturizers as Adjuncts

January 2023 | Volume 22 | Issue 1 | 45 | Copyright © January 2023


Published online January 1, 2023

Kanokvalai Kulthanan MDa, Anneke Andriessen PhDb, Xian Jiang MD PhDc, Chih-Hung Lee MD PhDd, Cheng-Feng Zhang MD PhDe

aDepartment of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
bAndriessen Consultants and Radboud University, Nijmegen, The Netherlands
cDepartment of Dermatology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
dDepartment of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan eDepartment of Dermatology, Huashan Hospital of Fudan University, Shanghai, China



fragrances, and PABA. When asked whether there are any other situations in which they would use non-prescription skin care for rosacea therapy, the panel answered: adjunctive therapy after laser treatment of rosacea; before and after intense pulsed light, CO2 laser, chemical peel; maintenance phase; very sensitive skin with easy flushing. Regarding the first through third sunscreen preferences, the panel gave a variety of answers.

Statement 5. Educate Asian rosacea patients on the importance of:
• Avoidance of triggers33
• Using gentle cleansers33
• Avoiding skincare products that are irritating and have an elevated pH6
• Avoiding excessive cleansing and exfoliating6
• Frequent use of quality moisturizers33
• Choosing skincare that can reestablish a healthy barrier6
• Using sun protection with SPF ≥ 30 and additional UVA protection33

The skin of patients with rosacea is characterized by severe dryness, increased pH, loss of water through the epidermis, and decreased hydration.34 For general skincare, the 2017 ROSacea Consensus (ROSCO) guidelines instruct that the following are essential skincare components: using sunscreen with a sun protection factor of at least 30, applying moisturizer often, using non-prescription cleansers that are gentle, and avoiding triggers.33 Baldwin and team also emphasize the importance of using the right skincare products. Statements 1 through 4 and their associated literature support the rationale for, and importance of, the approach outlined in statement 5.

CONCLUSION

Rosacea is an inflammatory disease primarily of the facial skin, which may be underrecognized in Asians. This review covers 5 consensus statements of an expert panel of dermatologists who practice in Asia and the supporting literature. Adjunctive skincare was considered an important part of treatment and maintenance in Asian rosacea patients and prescription treatment. Equally important was the absence of potentially irritating substances due to the highly sensitive skin of these patients.

LIMITATIONS

Head-to-head studies of non-prescription products used in patients with rosacea are scarce. Studies that incorporate biophysical measurements with clinical parameters would improve our understanding of the performance of nonprescription products in patients with rosacea.

DISCLOSURES

The authors disclose receipt of an unrestricted educational grant from CeraVe International for support with the research of this work, and also received consultancy fees for their work on this project.
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