Evidence of barrier deficiency in rosacea and the importance of integrating OTC skincare products into treatment regimens

ABSTRACT

Background: Rosacea, an inflammatory skin disease that leads to an impaired skin barrier function, commonly involves the face. Symptoms of rosacea can be bothersome and include pain, stinging, burning, itching, and facial flushing. This review explored skin barrier impairment in rosacea and reduced symptomatology when using over the counter (OTC) skincare products.

Methods: Nine dermatologists (the panel) completed a survey on OTC products they recommend for rosacea. The survey results were summarized, presented, and discussed during the online meeting, together with the results of a literature review. The outcome of these discussions, coupled with the panel's expert opinion and experience, is shown in the current review.

Results: Addressing barrier dysfunction by use of moisturizer and cleanser formulations that restore skin hydration, normalize skin pH, restore the microbiome, and skin lipids can assist in improving rosacea signs and symptoms. The panel's consensus was that in addition to the use of prescription medications, skincare recommendations are a crucial part of successful rosacea therapy. In addition to occlusives and humectants, barrier restoring ingredients such as ceramides, hyaluronic acid, and niacinamide were considered beneficial. Equally important was the absence of potentially irritating substances.

Conclusions: The use of OTC products can improve rosacea symptomatology and signs. As adjuncts, these products are recommended before and during prescription therapy and as part of a maintenance regimen.

J Drugs Dermatol. 2021;20(4):384-392. doi:10.36849/JDD.5861

Hilary Baldwin MD, Andrew F. Alexis MD MPH, Anneke Andriessen PhD, Diane S. Berson MD FAAD, Patricia Farris MD FAAD, Julie Harper MD, Edward Lain MD FAAD, Shari Marchbein MD, Linda Stein Gold MD, Jerry Tan MD FRCPC