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12-03-2025 | Rosacea | Disease Management

Take a personalised approach when treating older adults with rosacea

Authors: Michael B. Brown, Sheridan M. Hoy

Published in: Drugs & Therapy Perspectives

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Abstract

Rosacea is a chronic inflammatory skin condition characterized by erythema, telangiectasia and inflammatory lesions on the face. Rosacea, and the adverse events occurring during its treatment, are commonly more severe in older versus younger adults (adults aged > 65 years). Treatment personalisation is especially relevant for older adults. Personalising treatment by basing it on an individual’s presenting features aids in improving treatment versatility and patient-centred care in this population. Potential adverse events, comorbidities and drug-drug interactions should be considered when prescribing treatment. Therapeutic options include topical and oral pharmacological agents, light-based therapies and minimally invasive surgeries.
Literature
1.
go back to reference Lee JJ, Chien AL. Rosacea in older adults and pharmacologic treatments. Drugs Aging. 2024;41(5):407–21.CrossRefPubMed Lee JJ, Chien AL. Rosacea in older adults and pharmacologic treatments. Drugs Aging. 2024;41(5):407–21.CrossRefPubMed
2.
go back to reference Two AM, Wu W, Gallo RL, et al. Rosacea: part I. Introduction, categorization, histology, pathogenesis, and risk factors. J Am Acad Dermatol. 2015;72(5):749–60. Two AM, Wu W, Gallo RL, et al. Rosacea: part I. Introduction, categorization, histology, pathogenesis, and risk factors. J Am Acad Dermatol. 2015;72(5):749–60.
4.
go back to reference Chiu CW, Tsai J, Huang YC. Health-related quality of life of patients with rosacea: a systematic review and meta-analysis of real-world data. Acta Derm Venereol. 2024;104:adv40053. Chiu CW, Tsai J, Huang YC. Health-related quality of life of patients with rosacea: a systematic review and meta-analysis of real-world data. Acta Derm Venereol. 2024;104:adv40053.
5.
go back to reference Helfrich YR, Maier LE, Cui Y, et al. Clinical, histologic, and molecular analysis of differences between erythematotelangiectatic rosacea and telangiectatic photoaging. JAMA Dermatol. 2015;151(8):825–36.CrossRefPubMed Helfrich YR, Maier LE, Cui Y, et al. Clinical, histologic, and molecular analysis of differences between erythematotelangiectatic rosacea and telangiectatic photoaging. JAMA Dermatol. 2015;151(8):825–36.CrossRefPubMed
6.
go back to reference Clanner-Engelshofen BM, Bernhard D, Dargatz S, et al. S2k guideline: rosacea. J Dtsch Dermatol Ges. 2022;20(8):1147–65.CrossRefPubMed Clanner-Engelshofen BM, Bernhard D, Dargatz S, et al. S2k guideline: rosacea. J Dtsch Dermatol Ges. 2022;20(8):1147–65.CrossRefPubMed
7.
go back to reference Nie T. Personalise treatment for rosacea by selecting from a range of options for individual features. Drugs Ther Perspect. 2024;40:221–5.CrossRef Nie T. Personalise treatment for rosacea by selecting from a range of options for individual features. Drugs Ther Perspect. 2024;40:221–5.CrossRef
8.
go back to reference Zuuren EJ, Fedorowicz Z, Tan J, et al. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol. 2019;181(1):65–79.CrossRefPubMedPubMedCentral Zuuren EJ, Fedorowicz Z, Tan J, et al. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol. 2019;181(1):65–79.CrossRefPubMedPubMedCentral
9.
go back to reference Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2018;78(1):148–55.CrossRefPubMed Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2018;78(1):148–55.CrossRefPubMed
10.
go back to reference Yang F, Wang L, Shucheng H, et al. Differences in clinical characteristics of rosacea across age groups: a retrospective study of 840 female patients. J Cosmet Dermatol. 2023;22(3):949–57.CrossRefPubMed Yang F, Wang L, Shucheng H, et al. Differences in clinical characteristics of rosacea across age groups: a retrospective study of 840 female patients. J Cosmet Dermatol. 2023;22(3):949–57.CrossRefPubMed
11.
go back to reference Thiboutot DM, Fleischer AB Jr, Del Rosso JQ, et al. Azelaic acid 15% gel once daily versus twice daily in papulopustular rosacea. J Drugs Dermatol. 2008;7(6):541–6.PubMed Thiboutot DM, Fleischer AB Jr, Del Rosso JQ, et al. Azelaic acid 15% gel once daily versus twice daily in papulopustular rosacea. J Drugs Dermatol. 2008;7(6):541–6.PubMed
12.
go back to reference Stein Gold L, Kircik L, Fowler J, et al. Long-term safety of ivermectin 1% cream vs azelaic acid 15% gel in treating inflammatory lesions of rosacea: results of two 40-week controlled, investigator-blinded trials. J Drugs Dermatol. 2014;13(11):1380–6.PubMed Stein Gold L, Kircik L, Fowler J, et al. Long-term safety of ivermectin 1% cream vs azelaic acid 15% gel in treating inflammatory lesions of rosacea: results of two 40-week controlled, investigator-blinded trials. J Drugs Dermatol. 2014;13(11):1380–6.PubMed
13.
go back to reference Schaller M, Kemeny L, Havlickova B, et al. A randomized phase 3b/4 study to evaluate concomitant use of topical ivermectin 1% cream and doxycycline 40-mg modified-release capsules, versus topical ivermectin 1% cream and placebo in the treatment of severe rosacea. J Am Acad Dermatol. 2020;82(2):336–43.CrossRefPubMed Schaller M, Kemeny L, Havlickova B, et al. A randomized phase 3b/4 study to evaluate concomitant use of topical ivermectin 1% cream and doxycycline 40-mg modified-release capsules, versus topical ivermectin 1% cream and placebo in the treatment of severe rosacea. J Am Acad Dermatol. 2020;82(2):336–43.CrossRefPubMed
14.
go back to reference Gold LS, Rosso JQ, Kircik L, et al. Minocycline 1.5% foam for the topical treatment of moderate to severe papulopustular rosacea: results of 2 phase 3, randomized, clinical trials. J Am Acad Dermatol. 2020;82(5): 1166–73. Gold LS, Rosso JQ, Kircik L, et al. Minocycline 1.5% foam for the topical treatment of moderate to severe papulopustular rosacea: results of 2 phase 3, randomized, clinical trials. J Am Acad Dermatol. 2020;82(5): 1166–73.
15.
go back to reference Werschler WP, Sugarman J, Bhatia N, et al. Long-term efficacy and safety of microencapsulated benzoyl peroxide cream, 5%, in rosacea: results from an extension of two phase III, vehicle-controlled trials. J Clin Aesthet Dermatol. 2023;16(8):27–33.PubMedPubMedCentral Werschler WP, Sugarman J, Bhatia N, et al. Long-term efficacy and safety of microencapsulated benzoyl peroxide cream, 5%, in rosacea: results from an extension of two phase III, vehicle-controlled trials. J Clin Aesthet Dermatol. 2023;16(8):27–33.PubMedPubMedCentral
16.
go back to reference Jesudason DI, Appalanaidu N, Khan A. Symptomatic bradycardia associated with topical brimonidine gel (Mirvaso) administration: a case report. Eur Heart J Case Rep. 2024;8(7):ytae329. Jesudason DI, Appalanaidu N, Khan A. Symptomatic bradycardia associated with topical brimonidine gel (Mirvaso) administration: a case report. Eur Heart J Case Rep. 2024;8(7):ytae329.
17.
go back to reference Kaufman BP, Aman T, Alexis AF. Postinflammatory hyperpigmentation: epidemiology, clinical presentation, pathogenesis and treatment. Am J Clin Dermatol. 2018;19(4):489–503.CrossRefPubMed Kaufman BP, Aman T, Alexis AF. Postinflammatory hyperpigmentation: epidemiology, clinical presentation, pathogenesis and treatment. Am J Clin Dermatol. 2018;19(4):489–503.CrossRefPubMed
18.
go back to reference Schaller M, Almeida LMC, Bewley A, et al. Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019 panel. Br J Dermatol. 2020;182(5):1269–76.CrossRefPubMed Schaller M, Almeida LMC, Bewley A, et al. Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019 panel. Br J Dermatol. 2020;182(5):1269–76.CrossRefPubMed
19.
go back to reference Fowler J Jr., Jackson M, Moore A, et al. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. 2013;12(6):650–6. Fowler J Jr., Jackson M, Moore A, et al. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. 2013;12(6):650–6.
20.
go back to reference Draelos ZD, Gold MH, Weiss RA, et al. Efficacy and safety of oxymetazoline cream 1.0% for treatment of persistent facial erythema associated with rosacea: findings from the 52-week open label REVEAL trial. J Am Acad Dermatol. 2018;78(6):1156–63. Draelos ZD, Gold MH, Weiss RA, et al. Efficacy and safety of oxymetazoline cream 1.0% for treatment of persistent facial erythema associated with rosacea: findings from the 52-week open label REVEAL trial. J Am Acad Dermatol. 2018;78(6):1156–63.
21.
go back to reference Pfeffer I, Borelli C, Zierhut M, et al. Treatment of ocular rosacea with 40 mg doxycycline in a slow release form. J Dtsch Dermatol Ges. 2011;9(11):904–7.PubMed Pfeffer I, Borelli C, Zierhut M, et al. Treatment of ocular rosacea with 40 mg doxycycline in a slow release form. J Dtsch Dermatol Ges. 2011;9(11):904–7.PubMed
22.
go back to reference Rodgers JL, Jones J, Bolleddu SI, et al. Cardiovascular risks associated with gender and aging. J Cardiovasc Dev Dis. 2019;6(2):19.PubMedPubMedCentral Rodgers JL, Jones J, Bolleddu SI, et al. Cardiovascular risks associated with gender and aging. J Cardiovasc Dev Dis. 2019;6(2):19.PubMedPubMedCentral
23.
go back to reference Dumurgier J, Tzourio C. Epidemiology of neurological diseases in older adults. Rev Neurol (Paris). 2020;176(9):642–8.CrossRefPubMed Dumurgier J, Tzourio C. Epidemiology of neurological diseases in older adults. Rev Neurol (Paris). 2020;176(9):642–8.CrossRefPubMed
25.
go back to reference Petrova NN, Khvostikova DA. Prevalence, structure, and risk factors for mental disorders in older adults. Adv Gerontol. 2021;34(1):152–9.PubMed Petrova NN, Khvostikova DA. Prevalence, structure, and risk factors for mental disorders in older adults. Adv Gerontol. 2021;34(1):152–9.PubMed
26.
go back to reference Delara M, Murray L, Jafari B, et al. Prevalence and factors associated with polypharmacy: a systematic review and meta-analysis. BMC Geriatr. 2022;22(1):601.CrossRefPubMedPubMedCentral Delara M, Murray L, Jafari B, et al. Prevalence and factors associated with polypharmacy: a systematic review and meta-analysis. BMC Geriatr. 2022;22(1):601.CrossRefPubMedPubMedCentral
27.
go back to reference Bowling CB, Lee A, Williamson JD. Blood pressure control among older adults with hypertension: narrative review and introduction of a framework for improving care. Am J Hypertens. 2021;34(3):258–66.CrossRefPubMedPubMedCentral Bowling CB, Lee A, Williamson JD. Blood pressure control among older adults with hypertension: narrative review and introduction of a framework for improving care. Am J Hypertens. 2021;34(3):258–66.CrossRefPubMedPubMedCentral
28.
go back to reference Haber R, El Gemayel M. Comorbidities in rosacea: a systematic review and update. J Am Acad Dermatol. 2018;78(4):786–92 e8. Haber R, El Gemayel M. Comorbidities in rosacea: a systematic review and update. J Am Acad Dermatol. 2018;78(4):786–92 e8.
29.
go back to reference Gold LS, Papp K, Lynde C, et al. Treatment of rosacea with concomitant use of topical ivermectin 1% cream and brimonidine 0.33% gel: a randomized, vehicle-controlled study. J Drugs Dermatol. 2017;16(9):909–16.PubMed Gold LS, Papp K, Lynde C, et al. Treatment of rosacea with concomitant use of topical ivermectin 1% cream and brimonidine 0.33% gel: a randomized, vehicle-controlled study. J Drugs Dermatol. 2017;16(9):909–16.PubMed
30.
go back to reference Marchitto MC, Chien AL. Mast cell stabilizers in the treatment of rosacea: a review of existing and emerging therapies. Dermatol Ther (Heidelb). 2021;11(5):1541–9.CrossRefPubMedPubMedCentral Marchitto MC, Chien AL. Mast cell stabilizers in the treatment of rosacea: a review of existing and emerging therapies. Dermatol Ther (Heidelb). 2021;11(5):1541–9.CrossRefPubMedPubMedCentral
31.
go back to reference Martins AM, Marto JM, Johnson JL, et al. A review of systemic minocycline side effects and topical minocycline as a safer alternative for treating acne and rosacea. Antibiotics (Basel). 2021;10(7):757.CrossRefPubMedPubMedCentral Martins AM, Marto JM, Johnson JL, et al. A review of systemic minocycline side effects and topical minocycline as a safer alternative for treating acne and rosacea. Antibiotics (Basel). 2021;10(7):757.CrossRefPubMedPubMedCentral
32.
go back to reference Tsai J, Chien AL, Kim N, et al. Topical timolol 0.5% gel-forming solution for erythema in rosacea: a quantitative, split-face, randomized, and rater-masked pilot clinical trial. J Am Acad Dermatol. 2021;85(4):1044-6. Tsai J, Chien AL, Kim N, et al. Topical timolol 0.5% gel-forming solution for erythema in rosacea: a quantitative, split-face, randomized, and rater-masked pilot clinical trial. J Am Acad Dermatol. 2021;85(4):1044-6.
33.
go back to reference Wang B, Huang Y, Tang Y, et al. Paroxetine is an effective treatment for refractory erythema of rosacea: primary results from the Prospective Rosacea Refractory Erythema Randomized Clinical Trial. J Am Acad Dermatol. 2023;88(6):1300–7.CrossRefPubMed Wang B, Huang Y, Tang Y, et al. Paroxetine is an effective treatment for refractory erythema of rosacea: primary results from the Prospective Rosacea Refractory Erythema Randomized Clinical Trial. J Am Acad Dermatol. 2023;88(6):1300–7.CrossRefPubMed
Metadata
Title
Take a personalised approach when treating older adults with rosacea
Authors
Michael B. Brown
Sheridan M. Hoy
Publication date
12-03-2025
Publisher
Springer International Publishing
Published in
Drugs & Therapy Perspectives
Print ISSN: 1172-0360
Electronic ISSN: 1179-1977
DOI
https://doi.org/10.1007/s40267-025-01147-3