Greater understanding of the pathophysiology of rosacea is leading to the emergence of newer therapies to address the chronic condition, say leading dermatologists who frequently treat the condition.
"People with rosacea tend to have more demodex mites on the skin, but we all have those," says Joseph F. Fowler, Jr., M.D., FAAD, a dermatologist in Louisville, Ky. and a Clinical Professor of Dermatology at the University of Louisville and Assistant Clinical Professor in the Division of Occupational Medicine at the University of Kentucky.
The approval by the Food and Drug Administration of ivermectin represents an advance in topical treatment of a chronic and inflammatory condition, according to Dr. Fowler.
"It appears to be at least as effective as our standard treatments," explains Dr. Fowler. "In addition to killing the demodex mites, ivermectin has an anti-inflammatory effect. What we don't know is if the product is working
because it is killing the demodex mites, or is it because of an anti-inflammatory effect on the skin, or is it because of both?"
Experience with ivermectin is still early, but data from various clinical trials suggest the topical therapy is well-tolerated, safe, and as or more effective in decreasing inflammatory lesions compared to other topical therapies like azelaic acid or metronidazole, says Hilary Baldwin, M.D., a board-certified dermatologist in private practice in Brooklyn, N.Y. and an Associate Professor at the State University of New York, Downstate in Brooklyn, N.Y.
"It will likely be my first choice of topical therapy for rosacea," says Dr. Baldwin. "It is offering really good response."