Related Articles Stepwise Surgical Treatment of Gnathophyma. Dermatol Surg. 2019 01;45(1):158-160 Authors: Moiin A, Mahmood SH, Kurtovic A PMID: 29642112 [PubMed - indexed for MEDLINE] {url} = URL to article

Natural Skin Care Products as Adjunctive to Prescription Therapy in Moderate to Severe Rosacea J Drugs Dermatol. 2019 Feb 01;18(2):141-146 Authors: Draelos ZD, Gunt H, Levy SB Abstract Background: Rosacea is characterized by irritation associated with erythema, telangiectasias and papules/pustules. Whole formula nature-based sensitive skin products are formulated to maintain skin barrier and appropriate hydration that can lead to soothing benefits. Objective: To evaluate the efficacy and tolerability of a regimen consisting of a cleanser containing natural oils, beeswax, and witch hazel and day and night creams containing natural oils, glycerin, and botanical anti-inflammatories (NR); and a synthetic dermatologist-recommended regimen of cetyl alcohol, sodium lauryl sulphate-containing cleanser, and glycerin, polyisobutene-containing lotion (CR) in subjects with rosacea. Methods: 80 female subjects with rosacea who received 6 weeks of 0.75% metronidazole gel, were randomized to receive NR or CR, twice daily, for 4 weeks in conjunction with the gel. Blinded investigator global assessment of rosacea, investigator-rated, and subject-rated overall skin appearance was assessed using a 5-point scale (0=none, 4=severe) at baseline, 2 weeks, and 4 weeks. Noninvasive skin assessments for skin hydration and skin barrier function were made by corneometry and TEWL, respectively. Results: NR resulted in improvement in investigator global assessment of rosacea measures at 4 weeks from baseline (erythema, 28%; telangiectasia, 26%; papules/pustules, 34%: P<0.001) and CR resulted in a 8 to 12% improvement. Differences between treatments were statistically significant. Overall skin appearance measured by the investigator was clinically and statistically improved from baseline by 32% and 12% with NR and CR, respectively. Overall skin appearance measured by subjects was improved by both NR and CR from baseline with no differences between treatments. Both regimens improved barrier function from baseline to week 4 (13%, NR; 14%, CR). NR decreased hydration by 21% from baseline at week 4 while CR increased hydration by 14% (P<0.001 from NR). No clinically significant tolerability issues were reported in either regimen at week 4. Conclusion: NR was effective, well tolerated, and superior to CR in the management of rosacea, concomitantly treated with metronidazole. National Clinical Trial Identifier: NCT03392558 J Drugs Dermatol. 2019;18(2):141-146. PMID: 30794364 [PubMed - as supplied by publisher] {url} = URL to article

"As you’re already aware, standard FDA-approved therapies for rosacea include topical preparations: metronidazole, clindamycin, azelaic acid, sulfur, sodium sulfacetamide and oral medications: tetracycline, doxycycline and minocycline. As all dermatologists know, these therapies sometimes do not work, so an awareness of off-label uses of other medication groups and approaches is useful to avoid treatment failure, patient frustration and dermatologist exasperation. I will focus on four groups and approaches: retinoids, anti-parasitic agents, Helicobacter pylori treatment and second-generation macrolides." When Rosacea Resists Standard Therapies, the dermatologist This is an old article, written in 2008, which doesn't even mention the gold standard of treatment for rosacea, but you may find it helpful if you haven't heard of any of these treatments. These treatments are mentioned in the category:  Forum Home > Forums >  Public Forum >  Rosacea Topics >  Prescription Treatments  There are other options or alternatives  also reported using oral ivermectin and metronidazole, other prescriptions, secondary therapy, the ZZ Cream, demodex treatments,  probiotics (probiotic therapy), or a growing list of non prescription or over the counter treatments (our affiliate store).