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Rosacea: Common Questions and Answers

Winfred Frazier, MD, MPH
Raquel K. Zemtsov, MD, MPH
Yufei Ge, MD, MS

American Family Physician. 2024;109(6):533-542.

Author disclosure: No relevant financial relationships.

This clinical content conforms to AAFP criteria for CME.

Rosacea is a chronic inflammatory skin disease of the central face, affecting 5% of the population. The exact etiology is unknown. A diagnosis is made based on the updated 2017 National Rosacea Society Expert Committee guidelines, including fixed erythema, phymatous changes of skin thickening due to sebaceous gland hyperplasia and fibrosis, papules, pustules, telangiectasia, and flushing. Delays in an accurate diagnosis and treatment may occur in skin of color due to difficulty visualizing erythema and telangiectasia. The daily use of sunscreen, moisturizers, and mild skin cleansers and avoidance of triggers are essential aspects of maintenance treatment. Effective topical treatment options include alpha-adrenergic receptor agonists for flushing and ivermectin, metronidazole, and azelaic acid for papules and pustules. Systemic treatments include nonselective beta blockers for flushing, low-dose doxycycline, and isotretinoin for papules and pustules. Rosacea can significantly affect a patient's emotional health and quality of life. A referral for care is recommended for fixed phymatous changes and ocular rosacea. (Am Fam Physician. 2024;109(6):533-542. Copyright © 2024 American Academy of Family Physicians.)

WINFRED FRAZIER, MD, MPH, FAAFP, is the associate program director and director of scholarly activity of the UPMC St. Margaret Family Medicine Residency Program, Pittsburgh, Pa., and medical director of the UPMC St. Margaret New Kensington Family Health Center, New Kensington, Pa.

RAQUEL K. ZEMTSOV, MD, MPH, is a resident physician in the UPMC St. Margaret Family Medicine Residency Program.

YUFEI GE, MD, MS, is the assistant medical director of the UPMC St. Margaret Lawrenceville Family Health Center, Pittsburgh, Pa., and director of didactic education of the UPMC St. Margaret Family Medicine Residency Program.

Address correspondence to Winfred Frazier, MD, MPH, FAAFP, UPMC St. Margaret, 1072 5th Ave., New Kensington, PA 15068 (frazierwt2@upmc.edu). Reprints are not available from the authors.

Author disclosure: No relevant financial relationships.

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