TY  - JOUR
T1  - Rozasede topikal tedavi seçenekleri: güncel bir derleme
TT  - Topical treatment options in rosacea: A current review
AU  - Yoldaş, Ayşe Hande
PY  - 2026
DA  - June
Y2  - 2026
DO  - 10.54270/atljm.2026.112
JF  - Atlas Journal of Medicine
JO  - ATLJM
PB  - Atlas Üniversitesi
WT  - DergiPark
SN  - 3023-6878
SP  - 150
EP  - 156
VL  - 6
IS  - 2
LA  - tr
AB  - Amaç: 2020–2026 yılları arasındaki güncel kanıtları değerlendirmek ve rozasede fenotip temelli tedavi stratejilerini, bireyselleştirilmiş ve klinik pratiğe uygulanabilir yaklaşımlar çerçevesinde özetlemek. Gereç ve Yöntem: 2020–2026 yılları arasında yayımlanan güncel klinik kılavuzlar, randomize kontrollü çalışmalar ve sistematik analizler incelendi. Tedavi seçenekleri baskın klinik özellikler, hastalık şiddeti ve hasta ile ilişkili faktörler doğrultusunda değerlendirildi. Bulgular: Katı alt tip sınıflamasından ziyade, spesifik klinik bulguları hedefleyen fenotip temelli yönetim yaklaşımı önerilmektedir. Papülopüstüler rozasede topikal ivermektin, azelaik asit ve metronidazol ilk basamak tedavilerdir. Düşük doz modifiye salınımlı oral doksisiklin daha düşük nüks oranları ile sürdürülebilir antiinflamatuvar etkinlik göstermektedir. Minosiklin akut inflamatuvar lezyonların azaltılmasında yüksek etkinlik göstermektedir. Eritematotelanjiektatik tabloda topikal vazokonstriktörler hızlı semptom kontrolü sağlarken, oral beta blokerler flushing ve persistan eritemi azaltabilmektedir. Enerji temelli cihazlar eritemde belirgin azalma sağlamaktadır. Orta-ağır hastalıkta kombinasyon yaklaşımları daha üstün sonuçlar göstermektedir. Oküler rozase yönetiminde topikal antimikrobiyaller, oral antibiyotikler ve ışık temelli tedaviler yüksek yanıt oranlarına sahiptir. Düşük doz izotretinoin dirençli papülopüstüler hastalıkta yüksek etkinlik göstermektedir. Mikroenkapsüle benzoil peroksit, kalsitonin gen ilişkili peptid yolak inhibitörleri ve intradermal botulinum toksin gibi yeni tedaviler belirli fenotiplerde umut verici sonuçlar sunmaktadır. Sonuç: Güncel kanıtlar, rozasede baskın klinik özellikler ve hasta özelliklerine göre bireyselleştirilmiş fenotip temelli tedavi seçiminin etkinlik, tolere edilebilirlik ve uzun dönem hastalık kontrolünü optimize ettiğini desteklemektedir.
KW  - rozase
KW  - papulopüstüler rozase
KW  - eritematotelenjiektatik rozase
KW  - oküler rozase
N2  - Aim: To evaluate current evidence from 2020 to 2026 and summarize phenotype-based treatment strategies for rosacea, focusing on individualized and clinically practical management approaches. Materials and Methods: Clinical guidelines, randomized controlled trials, and systematic analyses published between 2020 and 2026 were reviewed. Treatment options were evaluated according to dominant clinical features, disease severity, and patient-related factors. Results: Phenotype-based management targeting specific clinical manifestations is favored over rigid subtype classification. For papulopustular disease, topical ivermectin, azelaic acid, and metronidazole remain first-line therapies, while low-dose oral doxycycline provides sustained anti-inflammatory control with reduced relapse rates. Minocycline demonstrates strong efficacy in acute inflammatory lesions. In erythematotelangiectatic presentations, topical vasoconstrictors offer rapid erythema reduction, and oral beta-blockers may improve flushing. Energy-based devices significantly reduce persistent erythema. Combination therapies improve outcomes in moderate-to-severe cases. Ocular involvement responds well to topical antimicrobials, oral antibiotics, and light-based therapies. Low-dose isotretinoin remains effective for severe recalcitrant disease. Emerging treatments, including microencapsulated benzoyl peroxide, calcitonin gene-related peptide pathway inhibitors, and intradermal botulinum toxin, show promising results in selected phenotypes. Conclusion: Recent evidence supports individualized, phenotype-driven treatment strategies in rosacea. Tailoring therapy according to dominant clinical features and patient-specific factors optimizes efficacy, tolerability, and long-term disease control.
CR  - Sharma A, Kroumpouzos G, Kassir M, Galadari H, Goren A, Grabbe S, Goldust M. Rosacea management: A comprehensive review. J Cosmet Dermatol. 2022 May;21(5):1895-1904.
CR  - Wilkin J. K., “Rosacea: Pathophysiology and Treatment,” Archives of Dermatology. 1994; 130(3): 359–362.
CR  - Scheinfeld N, Berk T. A review of the diagnosis and treatment of rosacea. Postgrad Med. 2010 Jan;122(1):139-43.
CR  - Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, Powell F; National Rosacea Society Expert Committee. Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol. 2004 Jun;50(6):907-12.
CR  - Scharschmidt TC, Yost JM, Truong SV, Steinhoff M, Wang KC, Berger TG. Neurogenic rosacea: a distinct clinical subtype requiring a modified approach to treatment. Arch Dermatol. 2011 Jan;147(1):123-6.
CR  - van Zuuren EJ, Fedorowicz Z, Tan J, van der Linden MMD, Arents BWM, Carter B, Charland L. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol. 2019 Jul;181(1):65-79.
CR  - van Zuuren EJ, Arents BWM, van der Linden MMD, Vermeulen S, Fedorowicz Z, Tan J. Rosacea: New Concepts in Classification and Treatment. Am J Clin Dermatol. 2021 Jul;22(4):457-465.
CR  - Clanner-Engelshofen BM, Bernhard D, Dargatz S, Flaig MJ, Gieler U, Kinberger M, Klövekorn W, Kuna AC, Läuchli S, Lehmann P, Nast A, Pleyer U, Schaller M, Schöfer H, Steinhoff M, Schwennesen T, Werner RN, Zierhut M, Reinholz M. S2k guideline: Rosacea. J Dtsch Dermatol Ges. 2022 Aug;20(8):1147-1165.
CR  - Forton FM, De Maertelaer V. Rosacea and demodicosis: little-known diagnostic signs and symptoms. Acta Derm Venereol. 2019;99(1):47–52.
CR  - Holmes AD, Steinhoff M. Integrative concepts of rosacea pathophysiology, clinical presentation and new therapeutics. Exp Dermatol. 2017 Aug;26(8):659-667.
CR  - Kang CN, Shah M, Tan J. Rosacea: An Update in Diagnosis, Classification and Management. Skin Therapy Lett. 2021 Jul;26(4):1-8.
CR  - Dall’Oglio F, Nasca MR, Micali G. Emerging topical drugs for the treatment of rosacea. Expert Opin Emerg Drugs. 2021 Mar;26(1):27-38.
CR  - Nielsen PG. Treatment of rosacea with 1% metronidazole cream. A double blind study. Br J Dermatol. 1983; Mar;108(3):327-32.
CR  - Geng RSQ, Sood S, Hua N, Chen J, Sibbald RG, Sibbald C. Efficacy of Treatments in Reducing Inflammatory Lesion Count in Rosacea: A Systematic Review. J Cutan Med Surg. 2024 Jul-Aug;28(4):352-359.
CR  - Bjerke R, Fyrand O, Graupe K. Double-blind comparison of azelaic acid 20% cream and its vehicle in treatment of papulo-pustular rosacea. 1999;79(6):456-459.
CR  - Mostafa FF, El Harras MA, Gomaa SM, Al Mokadem S, Nassar AA, Abdel Gawad EH. Comparative study of some treatment modalities of rosacea. J Eur Acad Dermatol Venereol. 2009;23(1):22-28.
CR  - Paiva-Santos AC, Gonçalves T, Peixoto D, Pires PC, Velsankar K, Jha NK, Chavda VP, Mohammad IS, Cefali LC, Mazzola PG, Mascarenhas-Melo F, Veiga F. Rosacea Topical Treatment and Care: From Traditional to New Drug Delivery Systems. Mol Pharm. 2023 Aug 7;20(8):3804-3828.
CR  - Leyer A, Rieg G, Müller M et al. Ivermectin zur Behandlung der Skabies norwegica bei AIDS Patienten. Ein neues Therapiekonzept – dargestellt an 2 Fallbeispielen. AIDS-FORSCHUNG (AIFO). 1994; 9: 608.
CR  - Stein L, Kircik L, Fowler J, et al. Efficacy and safety of ivermectin 1% cream in treatment of papulopustular rosacea: results of two randomized, double-blind, vehicle-controlled pivotal studies. J Drugs Dermatol. 2014;
13(3): 316-323.
CR  - Nakatsuji T, Cheng JY, Butcher A, Shafiq F, Osuoji O, Gallo RL, Hata TR. Topical Ivermectin Treatment of Rosacea Changes the Bacterial Microbiome of the Skin. J Invest Dermatol. 2025 May;145(5):1226-1228.e5.
CR  - Torok HM, Webster G, Dunlap FE, Egan N, Jarratt M, Stewart D. Combination sodium sulfacetamide 10% and sulfur 5% cream with sunscreens versus metronidazole 0.75% cream for rosacea. Cutis. 2005;75(6):357-363.
CR  - Alamri A, Alsamadani AH, Alraddadi RA, Kalantan M, Khafaji R, Bashrahil B, Bogari H, Kadasa A, Jfri A. Efficacy and safety of topical minocycline preparations for papulopustular rosacea: a systematic review and metaanalysis. Front Med (Lausanne). 2025 Apr 1;12:1517825.
CR  - Raoufinejad K, Mansouri P, Rajabi M et al. Efficacy and safety of permethrin 5 % topical gel vs. placebo for rosacea: a double-blind randomized controlled clinical trial. J Eur Acad Dermatol Venereol. 2016; 30: 2105–17.
CR  - Wollina U. Recent advances in the understanding and management of rosacea. F1000Prime Rep. 2014; 6: 50
CR  - Schmitdt E., Reimer S., Kruse N., et al., “The IL‐8 Release From Human Keratinocytes, Mediated by Anti‐Bodies to Bullous Pemphigoid Autoantigen 180, Is Inhibited by Dapsone,” Clinical and Experimental Immunology 124
(2001): 157–162.
CR  - Hasanbeyzade S. Comparison of Topical 20% Azelaic Acid and 7.5% Dapsone in the Treatment of Mild-To-Moderate Papulopustular Rosacea. J Cosmet Dermatol. 2025 May;24(5):e70212.
CR  - Choe J, Barbieri JS. Emerging Medical Therapies in Rosacea: A Narrative Review. Dermatol Ther (Heidelb). 2023 Dec;13(12):2933-2949.
CR  - Piwnica D, Rosignoli C, de Ménonville ST et al. Vasoconstriction and antiinflammatory properties of the selective α-adrenergic receptor agonist brimonidine. J Dermatol Sci 2014;75: 49–54.
CR  - Radermecker M, Foley P, Sullivan J, Armour K, Baker C, Ferguson A, et al. Pharmaceutical management of rosacea—An Australian/New Zealand Medical Dermatology consensus narrative. Dermatol Ther. 2024;37:e9678447.
CR  - Moore A, Kempers S, Murakawa G et al. Long-term safety and efficacy of once-daily topical brimonidine tartrate gel 0.5 % for the treatment of moderate to severe facial erythema of rosacea: results of a 1-year openlabel study. J Drugs Dermatol 2014; 13: 56–61.
CR  - 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, doubleblind,
and vehicle-controlled pivotal studies. J Drugs Dermatol 2013; 12: 650–6.
CR  - Del Rosso J, Baldwin H, Bhatia N, Chavda R, York JP, Harper J, Hougeir FG, Jackson JM, Noor O, Rodriguez DA, Schlesinger T, Weiss J. A Review of the Diagnostic and Therapeutic Gaps in Rosacea Management: Consensus Opinion. Dermatol Ther (Heidelb). 2024 Feb;14(2):271-284.
CR  - Bandyopadhyay D. Topical antibacterials in dermatology. Indian J Dermatol. 2021;66:117–125.
CR  - Bhatia ND, Werschler WP, Baldwin H, Sugarman J, Green LJ, Levy-Hacham O, Nov O, Ram V, Stein Gold L. Efficacy and Safety of Microencapsulated Benzoyl Peroxide Cream, 5%, in Rosacea: Results From Two Phase III,
Randomized, Vehicle-Controlled Trials. J Clin Aesthet Dermatol. 2023 Aug;16(8):34-40.
CR  - Jiang X, Lai W, Gao X, Zeng W, Tao J, Li Y, Yu N, Li J, Lu Q, Xiao R, Xiong Y, Yang J, Zhang L, Chen J, Chen XE, Sun N, Tao S, Xu N, Zhou Y, Ye J, Zhang F, Yang E. Efficacy and safety of supramolecular salicylic acid in the treatment of papulopustular rosacea: a multicentre randomized, doubleblind, placebo-controlled superiority study. Clin Exp Dermatol. 2025 Nov 25;50(12):2410-2417.
CR  - Gao X, Xiang W. Efficacy of Widely Used Topical Drugs for Rosacea: A Systematic Review and Meta-Analysis. Actas Dermosifiliogr. 2025 Sep;116(8):863-875.
CR  - Husein-ElAhmed H, Steinhoff M. Efficacy of topical ivermectin and impact on quality of life in patients with papulopustular rosacea: a systematic review and meta-analysis. Dermatol Ther. 2020;33(1):e13203.
CR  - Frampton JE, Wagstaff AJ. Azelaic acid 15% gel: in the treatment of papulopustular rosacea. Am J Clin Dermatol. 2004;5(1):57-64.
CR  - Koca R, Altinyazar HC, Ankarali H et al. A comparison of metronidazole 1 % cream and pimecrolimus 1 % cream in the treatment of patients with papulopustular rosacea: a randomized open-label clinical trial. Clin Exp Dermatol 2010; 35: 251–6.
CR  - El-Heis S, Buckley DA. Rosacea-like eruption due to topical pimecrolimus. Dermatol Online J. 2015 May 18;21(5):13030/qt7kd1048m.
UR  - https://doi.org/10.54270/atljm.2026.112
L1  - https://dergipark.org.tr/tr/download/article-file/5760416
ER  -