On October 30, 2021, the advisors convened a face-to-face meeting to discuss the outcome of literature searches and reach a consensus on the algorithm based on the selected literature.21,22 During the meeting, the advisors reviewed the systematic literature review results and discussed and adopted the algorithm using evidence coupled with their expert opinion and experience. A further online process was to fine-tune the algorithm, reach a consensus and prepare and review the publication (Figure 1). The advisors' consensus on the algorithm was established as an eighty-five percent (6/7) agreement was obtained.
Literature Review
A literature review included guidelines, consensus papers, and publications describing current best-practice in rosacea and skin barrier dysfunction features to inform the development of a clinical algorithm for rosacea treatment and maintenance, including skincare. The searches further included clinical and other research studies relevant to rosacea, treatment, maintenance, and skincare use as an adjunct in the English language from January 2010 to December 2020. Excluded were articles with no original data (unless a review was deemed relevant), articles not dealing with skincare for treatment and maintenance, and publication language other than English.
In addition, a dermatologist and a physician/scientist (the reviewers) conducted the searches on August 16 and 17, 2021 on PubMed and Google Scholar as a secondary source of the English-language literature, using the terms: Rosacea, pathophysiology, skin barrier dysfunction in rosacea, lipid abnormalities in rosacea-prone skin, prescription treatment and maintenance, rosacea guidelines, algorithm, consensus recommendations. OTC rosacea skincare and sunscreen use, cleansers and moisturizers for rosacea treatment, maintenance, adjunctive treatment, efficacy, safety, tolerability, skin irritation of OTC skincare use, quality of life aspects, handling and comfort, treatment adherence.
The results of the searches were evaluated independently by the two reviewers, resolving discrepancies by discussion. The searches yielded one hundred and sixty-eight publications. After reviewing the abstracts, the publications lacking data contributing to the current algorithm [n = 104] were removed, leaving 64 papers. Thirty-four papers remained after excluding duplicates and articles deemed irrelevant for the algorithm ([n = 30] other subjects, low quality, a small number, case studies). Twenty-five review articles (including sixteen guidelines, algorithms, and systemic literature reviews) and nine clinical studies were used in the development of the algorithm.
Literature Review
A literature review included guidelines, consensus papers, and publications describing current best-practice in rosacea and skin barrier dysfunction features to inform the development of a clinical algorithm for rosacea treatment and maintenance, including skincare. The searches further included clinical and other research studies relevant to rosacea, treatment, maintenance, and skincare use as an adjunct in the English language from January 2010 to December 2020. Excluded were articles with no original data (unless a review was deemed relevant), articles not dealing with skincare for treatment and maintenance, and publication language other than English.
In addition, a dermatologist and a physician/scientist (the reviewers) conducted the searches on August 16 and 17, 2021 on PubMed and Google Scholar as a secondary source of the English-language literature, using the terms: Rosacea, pathophysiology, skin barrier dysfunction in rosacea, lipid abnormalities in rosacea-prone skin, prescription treatment and maintenance, rosacea guidelines, algorithm, consensus recommendations. OTC rosacea skincare and sunscreen use, cleansers and moisturizers for rosacea treatment, maintenance, adjunctive treatment, efficacy, safety, tolerability, skin irritation of OTC skincare use, quality of life aspects, handling and comfort, treatment adherence.
The results of the searches were evaluated independently by the two reviewers, resolving discrepancies by discussion. The searches yielded one hundred and sixty-eight publications. After reviewing the abstracts, the publications lacking data contributing to the current algorithm [n = 104] were removed, leaving 64 papers. Thirty-four papers remained after excluding duplicates and articles deemed irrelevant for the algorithm ([n = 30] other subjects, low quality, a small number, case studies). Twenty-five review articles (including sixteen guidelines, algorithms, and systemic literature reviews) and nine clinical studies were used in the development of the algorithm.
