The Foundation of (Rosacea) Treatment

Rosacea is a very common problem, and we focus on it this Rosacea Awareness Month. Many more people have rosacea than come to a dermatologist for its treatment. Diagnosing rosacea and its various subtypes is not all that difficult, at least not for dermatologists for whom rosacea is our bread and butter. And we have great treatments for rosacea, including effective topical and oral treatments. Despite all that, treating rosacea can be challenging.

In this issue of The Dermatologist, we explore rosacea management. An interview with Dr Hilary Baldwin on page 38 describes key issues in rosacea management, not the least of which is the importance of treatment adherence. Although making the diagnosis of rosacea may not be tough and excellent treatments are available, getting patients to use those treatments regularly—and as long as needed for management of a chronic disease—is a high hurdle.

Dr Baldwin describes several things we can do to promote adherence, including using the simplest regimen possible, avoiding tolerability issues, utilizing affordable products, and paying attention to cosmetic elegance. In addition, we need to make sure patients trust us, and we need to find ways to hold them accountable for using the medication. To get patients well, it is not enough to make the right diagnosis and prescribe the right treatment; we also need to do our part to get patients to use the treatment effectively. In our cover story on page 43, “Tips for Physicians to Increase Adherence to Rosacea Therapy,” Dr Julie Harper focuses on this key issue. Our relationships with our patients are the foundation of treatment adherence.

Will new treatments in the pipeline make rosacea management more successful? I do not know whether new treatments will solve the problem of resistant rosacea if that resistance is due to poor adherence to treatment. Adherence is the foundation; without it, neither old nor new treatments are going to solve patients’ skin problems.