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Last Updated: 5/30/2013  

Rosacea

Diagnosis
  • More common in fair-skinned individuals with light-colored eyes, especially of European descent.

  • Skin disorder of the central face frequently associated with ocular symptoms of dryness and other ocular symptoms.

  • Classify into one of several subtypes: erythematotelangiectatic, papulopustular, phymatous, or ocular rosacea.

  • A number of other facial eruptions must be excluded including acne, steroid-induced acneiform eruptions, perioral dermatitis, systemic lupus erythematosus, and several other skin conditions.

Therapy
  • Recommend certain cleansers, sunscreens, emollients, and hats to help prevent rosacea flares.

  • Begin drug therapy with topical regimens, including topical antibiotics, immunomodulators, or retinoids for mild rosacea.

  • Begin treatment of moderate to severe rosacea with oral treatment regimens or a combination of both topical and oral regimens. Choose a first-line oral medication for rosacea such as tetracycline, doxycycline, minocycline, or erythromycin.

  • Treat ocular rosacea with oral medications such as oral tetracycline, doxycycline, or minocycline.

  • Consider dermatologic laser therapy for background erythema and telangiectasia.

DOI: 10.7326/d614
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
Sidney B. Smith, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Jeffrey B. Smith, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. William W. Huang, MD, MPH has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Editor in Chief, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Richard B. Lynn, MD, FACP, Editor, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
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