ABSTRACT

Retinoids have been used in the management of rosacea since the 1980s with therapeutic benefits stemming from their anti-inflammatory and sebum-reducing actions. Systemic retinoids also play a role in management of rosacea subtypes that are traditionally more difficult to treat, including phymatous, ocular, granulomatous, and fulminant disease. Rosacea is more frequently diagnosed in those with lighter skin phototypes, although it is not known whether this is concealment by cutaneous melanin pigment or a reduced risk of rosacea in darker skin types. Rosacea flares can be triggered by extremes of temperatures, hot or spicy foods, and alcohol, which contribute to neurogenic inflammation via activation of receptors on primary sensory neurons and keratinocytes. Topical retinoids, including tretinoin, adapalene, and tazarotene creams and gels, may have a role in the management of papulopustular rosacea; however, use is limited by their irritant potential which may exacerbate erythema.