Targeted rosacea therapies can lead to facial skin free of redness and blemishes, but only if these two key elements are also in place: the patient’s commitment to consistent adherence to the treatment plan and the patience to let it work. The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to educate the public on this conspicuous, life-disruptive facial disorder affecting 16 million Americans, and urge those who may have it to see a dermatologist for diagnosis and therapy tailored to their individual case.
“Patients play a vital role in managing their rosacea,” said Dr. Steven Feldman, professor of dermatology, pathology, and social sciences and health policy at Wake Forest University School of Medicine. “The combination of signs and symptoms in any individual is often unique, and while physicians take the lead in designing an appropriate treatment plan, sufferers bear equal responsibility for their part: being diligent and patient in using their medication.”
Rosacea is a complex disorder with a broad range of potential manifestations. Although it can develop in many ways, rosacea typically first appears after age 30 as a transient redness on the cheeks, nose, chin or forehead that might be mistaken for a sunburn. The redness tends to worsen and grow more persistent over time, and small visible blood vessels may appear. Without treatment, bumps and pimples often develop, and burning and stinging are common. In severe cases, the nose may become enlarged from excess tissue, and in many rosacea patients the eyes are also affected, feeling irritated and appearing watery or bloodshot.
Fortunately, research has uncovered increasingly sophisticated therapies that address the specific signs and symptoms of rosacea, known as phenotypes, and a unique treatment plan precisely tailored for each individual case may be devised from this menu of medicines. However, depending on the phenotypes present and their severity, the timelines to remission may vary.
In a recent survey, the NRS asked rosacea patients how long they gave a new product or treatment to work before giving up on it.1 Over 75% said within a month, and more than half said two weeks or less. In contrast, dermatologists recommend sticking with a new therapy for at least 12 weeks before evaluating its effectiveness. One study showed that 28% of rosacea patients took time off from their treatment regimen, but Dr. Feldman noted that actual nonadherence rates may be higher. Reasons for quitting treatment or using it incorrectly may include believing signs and symptoms had resolved, affordability and insurance issues, and believing the medicine was ineffective, he said.2
Dr. Feldman stressed that the patients must be proactive in partnering with their physicians, and this involves managing their own behavior to establish consistent routines.
“Adherence is important through the whole course of therapy, but patients have to make a concerted effort to use the treatment faithfully in the first week or two especially. In this way they get into the habit of using the medicine, and they’ll see the benefits of the drug,” he said. “Also, it’s easy to convince yourself to do something for one week rather than eight, so just telling yourself, ‘This week I’m going to do a really good job of taking my medicine’ can be a big step forward.”
Often older patients who are accustomed to taking a variety of medicines already have organizational tools like pill cases and calendar reminders, he noted.
“Patience and consistency are imperative,” he said. “It can be a vicious cycle – if patients don’t use therapy well, it may be slow to work, and physicians may therefore believe the therapy is inappropriate or ineffective.”
1. National Rosacea Society. Patients Need Patience: Give Rosacea Therapy Time. https://www.rosacea.org/blog/2022/december/patients-need-patience-give-rosacea-therapy-time Published Dec. 13, 2022.
2. Kuo S, Huang KE, Davis SA, Feldman SR. The rosacea patient journey: a novel approach to conceptualizing patient experiences. Cutis 2015;95:37-43.