Rosacea Review - Newsletter of the National Rosacea SocietyRosacea Review - Newsletter of the National Rosacea Society

The Importance of Adhering to Therapy

It may be tempting for rosacea patients to stop treatment once their signs and symptoms have cleared up. But studies show that when used consistently according to directions, long-term medical therapy can slow or halt the progression of the disease and help maintain remission.

“The best results are achieved when patients and their doctors work together to identify appropriate therapy and monitor its progress,” said Dr. Hilary Baldwin, associate professor of dermatology at Rutgers Robert Wood Johnson Medical School. Because each individual case is different, selecting treatments that address a patient’s unique set of signs and symptoms can increase the likelihood of a patient achieving success.

In a long-term efficacy and safety study of topical oxymetazoline, about a third of patients using the treatment daily saw a two grade or greater improvement in their facial redness after six months compared to the start of the trial, meaning that their redness went from severe to mild, or from mild to clear.1 What’s more, at the end of one year, 11.2% reported two-grade improvement compared to their prestudy condition before they even applied the treatment in the morning, indicating that daily therapy may modify the disease over time.2

In another study, patients with moderate to severe papulopustular rosacea were treated with low-dose oral doxycycline and topical metronidazole.3 After 12 weeks, 50.9% had a two-grade improvement in their rosacea symptoms. The investigators then enrolled 130 of the patients into two groups for the second part of the study: 65 continued to take low-dose oral doxycycline alone, and 65 took a placebo pill.

After 40 weeks, half as many of those who continued with oral doxycycline had a relapse compared to the placebo group (9 vs. 18). Relapse also occurred more quickly among the placebo group, with 10 having a relapse within the first four weeks compared to only four in the active treatment group.

“Managing rosacea isn’t a single visit to the doctor, but an ongoing process, and for some patients it may take weeks or months to see improvement,” Dr. Baldwin said. “But patients are not alone. Fortunately, with today’s increasingly sophisticated tools, individuals partnering with their physicians can lead normal lives that are not adversely impacted by rosacea.”


1. Draelos ZD, Gold MH, Weiss RA, et al. Efficacy and safety of oxymetazoline cream 1.0% for treatment of persistent facial erythema associated with rosacea: findings from the 52-week open label REVEAL trial. J Am Acad Dermatol 2018 Jun; 78(6): 1156-1163.

2. Gallo RL, Baldwin H, Stein Gold L, Harper J. Update on facial erythema in rosacea. J Drugs Dermatol 2021; 20(8): 861-864.

3. Del Rosso R, Brantman S, Baldwin H. Long-term inflammatory rosacea manage- ment with subantibiotic dose oral doxycycline 40 mg modified release capsules once daily. Dermatol Ther 2021; el15180.