A Review on Pathophysiology and Current Treatment Trends of Rosacea

Review Article

Abstract

Rosacea is a chronic inflammatory erythematous condition characterized by recurrent flushing, telangiectasia, papules, pustules, and potential progression to rhinophyma in advanced stages. The condition affects approximately 5.46% of the global population, predominantly individuals of northern European descent and those with fair skin. Rosacea's impact extends beyond physical manifestations, often leading to significant psychosocial complications including anxiety, depression, and social isolation. The pathophysiology of Rosacea involves vascular dysfunction, immune dysregulation, microbiome alterations, and environmental triggers. Management strategies vary based on disease subtype and severity, with topical agents such as metronidazole, azelaic acid, and ivermectin serving as first-line treatments for mild to moderate cases. Systemic therapies, including oral antibiotics and retinoids, are reserved for moderate to severe presentations. Laser and light-based treatments have shown considerable efficacy in addressing vascular manifestations. Recent treatment trends include using probiotics, microbiome modulation, and targeted biologics, including interleukin-17 inhibitors, interleukin-23 inhibitors, and CGRP antagonists. Despite the therapeutic advances, challenges persist regarding drug resistance and treatment limitations