Funding sources No external funding.
Effective and evidence-based management strategies for rosacea: summary of a Cochrane systematic review
Article first published online: 15 SEP 2011
© 2011 The Authors. BJD © 2011 British Association of Dermatologists 2011
British Journal of Dermatology
Volume 165, Issue 4, pages 760–781, October 2011
How to Cite
van Zuuren, E.J., Kramer, S.F., Carter, B.R., Graber, M.A. and Fedorowicz, Z. (2011), Effective and evidence-based management strategies for rosacea: summary of a Cochrane systematic review. British Journal of Dermatology, 165: 760–781. doi: 10.1111/j.1365-2133.2011.10473.x
Conflicts of interest None declared.
Footnote This paper is based on a Cochrane review published in Issue 3, March 2011 of The Cochrane Library 2011 (see http://www.CochraneLibrary.net for further information). Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms. The Cochrane Library should be consulted for the most recent version of this review.
- Issue published online: 27 SEP 2011
- Article first published online: 15 SEP 2011
- Accepted manuscript online: 21 JUN 2011 07:34AM EST
- Accepted for publication 3 June 2011
Rosacea is a common chronic skin disease affecting the face. There are numerous treatment options, but it is unclear which are the most effective. The aim of this review was to assess the evidence for the efficacy and safety of treatments for rosacea. Searches included the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index, and Ongoing Trials Registers (updated February 2011). Randomized controlled trials in people with moderate to severe rosacea were included. Fifty-eight trials, including 27 from the original review, comprising 6633 participants were included in this updated review. Interventions included topical metronidazole, oral antibiotics, topical azelaic cream or gel, topical benzoyl peroxide and/or combined with topical antibiotics, sulphacetamide/sulphur, and others. There was some evidence that topical metronidazole and azelaic acid were more effective than placebo. Two trials indicated that doxycycline 40 mg was more effective than placebo. There was no statistically significant difference in effectiveness between doxycycline 40 mg and 100 mg but there were fewer adverse effects. One study reported that ciclosporin ophthalmic emulsion was significantly more effective than artificial tears for treating ocular rosacea. Although the majority of included studies were assessed as being at high or unclear risk of bias, there was some evidence to support the effectiveness of topical metronidazole, azelaic acid and doxycycline (40 mg) in the treatment of moderate to severe rosacea, and ciclosporin 0·05% ophthalmic emulsion for ocular rosacea. Further well-designed, adequately powered randomized controlled trials are required.