Q&A: Informed patients, physicians improve rosacea care
The National Rosacea Society has released an updated version of its popular, free educational booklet “Understanding Rosacea,” which details the skin disorder and its treatment options.
A source for patients and physicians alike, the booklet includes photos to help identify signs and symptoms of rosacea, as well as potential causes and tips on management.
Healio spoke with John Wolf, MD, chairman of dermatology at Baylor College of Medicine, about the booklet and important updates to rosacea care.
Healio: Why is it important to have resources such as the “Understanding Rosacea” booklet and the National Rosacea Society available for your patients?
Wolf: Patients frequently have a poor understanding about rosacea. They do not understand what rosacea is, and they do not understand how important the long-term maintenance therapy can be. The National Rosacea Society deals with these important things that a patient needs to know. In the era of Dr. Google, it is increasingly important to have a trusted, reliable site where patients can go to find out more about the disease and its treatments.
Healio: What should patients know about the long-term nature of rosacea?
Wolf: It is a common disease, and it is a disease in which many patients are not receiving treatment. This is a chronic disease of unknown cause, and there is no cure. But patients need to know it can be controlled by activities on the part of the patient and therapies. One of the big problems with rosacea is that patients have been documented clearly as having poor compliance with therapy. So, we stress the importance of adherence to therapy and long-term compliance and management.
Healio: What precautions should patients take to prevent rosacea flares?
Wolf: I try to emphasize skin care. Patients with rosacea have sensitive skin. The three most common trigger factors are sunlight, heat and stress. They need to wear sunscreen every day, avoid hot baths and showers, and wash the face with cool water. I like to write on a prescription pad “no stress.” We laugh about it because we realize living a stress-free life is not possible, but you need to at least control the stress.
Healio: What are some of the main therapies used to combat rosacea?
Wolf: There are topical and systemic therapies. Topical therapies include metronidazole, azelaic acid and ivermectin. All of these are anti-inflammatory drugs.
Topical retinoids are also anti-inflammatory and help repair sunlight damage, and laser and light therapy helps particularly with the erythema, the red face.
Two new alpha blockers, brimonidine tartrate and oxymetazoline, are topical therapies that reduce redness as well.
Systemic therapies, which are aimed more toward papulopustular rosacea, include antibiotics in the tetracycline family. Now, when you think of antibiotics, you think to cure an infectious disease. But in these cases, we are using them to block inflammation.
Healio: What do physicians need to know in terms of managing rosacea for their patients?
Wolf: Physicians, especially non-dermatologists, need to know that if they are going to be managing rosacea, they need to be aware of the triggers.
They need to go over in their mind quickly if the patient has rosacea and what type of rosacea it is. They should be looking for erythema and pustules and know to check the nose for rhinophyma and the eyes for ocular rosacea.