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Natural cosmeceutical options

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"Natural cosmeceutical options serve as an additional branch of the market available to rosacea patients. Natural ingredients reported in the literature that provide hydrating, anti-inflammatory, and antioxidant properties capable of calming the inflammatory manifestations of rosacea include colloidal oatmeal, niacinamide, feverfew, licorice, teas, coffeeberry, aloe vera, chamomile, turmeric, and mushroom extracts.43 Further, a novel topical lotion (Redness Neutralizer®, SkinCeuticals, New York, NY, USA) containing caffeine, zinc gluconate, bisabolol, Eperua falcata bark extract, and palmitoyl tripeptide-8, was used twice daily in a group of 25 patients with PPR who had been previously treated successfully with topical or oral therapy, but were unsatisfied with the remaining background erythema. All efficacy categories demonstrated statistically significant improvement between baseline and follow-up at weeks 4 and 8. Although one patient developed burning and increased erythema and withdrew from the study, the remaining 24 patients found the treatment very tolerable without clinical signs of irritation. Overall, 95% of patients were satisfied with the products and the results after 8 weeks of twice-daily use.

In another single-center, open-label study, a group of 30 patients with rosacea of variable severity were treated with 4% Quassia amara extract topical gel for 6 weeks. Reportedly, Q. amara possesses antiparasitic and anti-inflammatory properties that have the capability to decrease the inflammatory response with few complications. Efficacy comparable with that of first-line topical treatments like azelaic acid and metronidazole was observed after Q. amara treatment, with superb tolerability. Finally, a formulation of low molecular weight hyaluronic acid sodium salt 0.2% cream (Bionect® Cream, Innocutis Holdings, Charleston, SC, USA) applied twice daily for 8 weeks showed a statistically significant reduction in papules, erythema, burning, stinging, and dryness in a small study. Along with excellent tolerability, a reduction in papules, erythema, burning/stinging, and dryness was clearly apparent by week 4 and remained by the final visit at week 8. Notably, erythema was reduced by the greatest amount, with an approximate 50% improvement by week 2. This study demonstrates the importance of skin barrier maintenance and repair in the pathogenesis of rosacea. With a hydrophilic structure, low molecular weight hyaluronic acid penetrates the stratum corneum where it interacts with fibrin and collagen to support remodeling of the extracellular matrix. This mechanism, along with induction of the antimicrobial peptide ²-defensin 2 release from keratinocytes, ultimately accelerates re-epithelialization and reduces pain and edema."

Update on the management of rosacea
Allison P Weinkle, Vladyslava Doktor, Jason Emer
Accepted for publication 13 January 2015
Published 7 April 2015 Volume 2015:8 Pages 159—177
DOI https://doi.org/10.2147/CCID.S58940

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