A recent survey by the National Rosacea Society revealed that while patients were satisfied with their current therapies, older patients were more likely to use older treatments, signaling a need to revisit management plans.
Scientific understanding of rosacea has grown over the past few years, with updated standard classifications based on phenotypes1 and standard management options as determined by an expert consensus panel.2 However, a recent survey administered by the National Rosacea Society (NRS) found 53.9% of patients aged 60 years or older were still using topical metronidazole, the first prescription therapy developed for rosacea, and 42% of this age group has never changed their treatment regimen vs the 81% of patients younger than 60 years who have made changes.3 This stark contrast highlights the need for dermatologists to revisit management plans for their older patients with rosacea.
The NRS survey consisted of questions regarding current treatments, treatment satisfaction, health care access, and patient demographics. A total of 1714 participants with rosacea completed the survey. Of these participants, 56% said their skin was clear or almost clear on most days, and 30% indicated that they considered their rosacea to be mild. Comparatively, only 12% said their rosacea was moderate and 1% said it was severe.
The Table details the all of the products used by participants at the time of survey completion. In keeping with a multimodal approach to rosacea care, patients could select more than one option. While 51.2% of survey respondents used metronidazole cream/gel, patients aged 60 years and older were more likely to use this particular product than those younger than 60 years (53.9% vs 40.5%, respectively). A larger difference in percentage was seen in patients who used ivermectin; in total, 20.7% of participants younger than 60 years reported current use in comparison with only 9.1% of older patients. Also notable was 21.7% of respondents using over-the-counter products.
The survey also asked participants about their recent visits to see a dermatologist. Approximately 56% reported seeing a dermatologist within the past year, and another 18% had a health care visit within the past 3 years. Interestingly, roughly 15% of responses tried teledermatology to seek dermatologic care and would do so again in the future. Another 40% said they would consider teledermatology for future care access. Though not significant, these numbers imply a need for patients with rosacea to be in contact with their dermatologist on a regular basis.
Overall, patients were generally satisfied with their treatment results. On a scale of 1 to 5 (5 = most satisfied), the weighted average satisfaction score for each treatment product was 3.5 or higher. No treatment scored below a 3. Of patients who changed treatment plans, 28% noted it was because they were not satisfied with results from the former product, 23% said their health care provider initiated the change, and 9% said their product was no longer covered by their medical insurance. Discontinued or previously used therapies included topical metronidazole (56%), oral doxycycline tablets or extended release capsules (an approximately combined 40%), and azelaic acid foam (22%).
“These finds suggest that older patients should talk with their doctors about newer therapeutic options. Today’s approach to rosacea treatment is different than in the past,” said Linda Stein Gold, MD, director of dermatology clinical research at the Henry Ford Health System in Detroit, MI, in a NRS press release.3 With newer therapeutic options available, dermatologists can create an individualized treatment plan to achieve more optimal patient outcomes.
1. Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee.
J Am Acad Dermatol. 2018;78(1):148-155. doi:10.1016/j.jaad.2017.08.037
2. Thiboutot D, Anderson R, Cook-Bolden F, et al. Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2020;82(6):1501-1510. doi:10.1016/j.jaad.2020.01.007
3. Huff A. New rosacea survey shows most patients are satisfied with therapy, but more awareness of treatment options is needed. News release. National Rosacea Society. October 5, 2020. Accessed October 30, 2020. https://www.rosacea.org/press/2020/october/new-rosacea-survey-shows-most-patients-satisfied-with-therapy