Rosacea treatment aims to eliminate and maintain clearance of signs and symptoms of the disease in order to eliminate negative effects the condition has on an individual’s QOL. Communication with patients is necessary to reveal an individual’s personal concerns, goals, and desires, which often differ from that predicted by clinicians.14 For example, erythema has been described as the most troublesome symptom, however, these findings come from predominantly fair-skinned populations and it is plausible that erythema is not as bothersome in non-white populations. Alternatively, erythema may not be appreciated by clinicians, but nonetheless can be bothersome to patients, highlighting the need for individually tailored patient care reflecting the patient’s wishes.14 Optimal results and improved patient outcomes are achieved by understanding the patient’s subjective disease severity and goals of treatment prior to initiating therapy.11 Choice of therapy should incorporate patient preferences and values that can include cost of procedural therapies that are typically not covered by health insurance or preference for topical vs oral or frequency of administration.11
Rosacea is a chronic inflammatory skin condition due to immune and neurovascular dysfunction that has significant effects on QOL. Though more prevalent in patients with fair skin, rosacea occurs in people of all races and ethnicities and until recently has been largely under recognized in nonwhite populations. In order to optimize treatment of rosacea, recognizing more subtle or less typical features in special patient groups is essential. A patient centered approach targeting disease features most bothersome to patients contributes to improved outcomes including QOL. Future studies should continue to evaluate efficacy in diverse populations to accurately reflect the patients in need of treatment.
- Bolognia J, Jorizzo, Joseph L.Schaffer, Julie V. Dermatology. Vol 37. Philadelphia: Elsevier Saunders; 2012.
- Wilkin J, Dahl M, Detmar M, et al. Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. J Am Acad Dermatol. 2002;46(4):584-587.
- Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Taylor SC. Global epidemiology and clinical spectrum of rosacea, highlighting skin of color: Review and clinical practice experience. J Am Acad Dermatol. 2018.
- Rainer BM, Kang S, Chien AL. Rosacea: Epidemiology, pathogenesis, and treatment. Dermatoendocrinol. 2017;9(1):e1361574.
- Del Rosso JQ, Thiboutot D, Gallo R, et al. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 1: a status report on the disease state, general measures, and adjunctive skin care. Cutis. 2013;92(5):234-240.
- Tan J, Schofer H, Araviiskaia E, Audibert F, Kerrouche N, Berg M. Prevalence of rosacea in the general population of Germany and Russia - The RISE study. J Eur Acad Dermatol Venereol. 2016;30(3):428-434.
- Alinia H, Tuchayi SM, James SM, et al. Measurement of disease severity in a population of rosacea patients. Dermatol Clin. 2018;36(2):97-102.
- Al-Dabagh A, Davis SA, McMichael AJ, Feldman SR. Rosacea in skin of color: not a rare diagnosis. Dermatol Online J. 2014;20(10).
- Aldrich N, Gerstenblith M, Fu P, et al. Genetic vs environmental factors that correlate with rosacea: a cohort-based survey of twins. JAMA Dermatol. 2015;151(11):1213-1219.
- Chang ALS, Raber I, Xu J, et al. Assessment of the genetic basis of rosacea by genome-wide association study. J Invest Dermatol. 2015;135(6):1548-1555.
- Schaller M, Almeida LM, Bewley A, et al. Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel. Br J Dermatol. 2017;176(2):465-471.
- Callender VD, Barbosa V, Burgess CM, et al. Approach to treatment of medical and cosmetic facial concerns in skin of color patients. Cutis. 2017;100(6):375-380.
- van der Linden MM, van Rappard DC, Daams JG, Sprangers MA, Spuls PI, de Korte J. Health-related quality of life in patients with cutaneous rosacea: a systematic review. Acta Derm Venereol. 2015;95(4):395-400.
- Oussedik E, Bourcier M, Tan J. Psychosocial burden and other impacts of rosacea on patients' quality of life. Dermatol Clin. 2018;36(2):103-113.
- Zeichner JA, Eichenfield LF, Feldman SR, Kasteler JS, Ferrusi IL. Quality of life in individuals with erythematotelangiectatic and papulopustular rosacea: findings from a web-based survey. J Clin Aesthet Dermatol. 2018;11(2):47-52.
- Moustafa F, Lewallen RS, Feldman SR. The psychological impact of rosacea and the influence of current management options. J Am Acad Dermatol. 2014;71(5):973-980.
- Buddenkotte J, Steinhoff M. Recent advances in understanding and managing rosacea. F1000Res. 2018;7.
- Diffey BL, Fajuyigbe D, Wright CY. Sunburn and sun protection in black skin. Int J Dermatol. 2019.
- van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MM, Charland L. Interventions for rosacea. Cochrane Database Syst Rev. 2015(4):Cd003262.
- Que SK, Fraga-Braghiroli N, Grant-Kels JM, Rabinovitz HS, Oliviero M, Scope A. Through the looking glass: basics and principles of reflectance confocal microscopy. J Am Acad Dermatol. 2015;73(2):276-284.
- Alexis AF, Webster G, Preston NJ, Caveney SW, Gottschalk RW. Effectiveness and safety of once-daily doxycycline capsules as monotherapy in patients with rosacea: an analysis by Fitzpatrick skin type. J Drugs Dermatol. 2012;11(10):1219-1222.