Rosacea Treatments in the 20th and 21st Centuries
Summary
Prior to 1992 rosacea was considered a rare disease. The number of treatments available has increased during the last decade partly due to a tidal wave of people diagnosed with the condition. This article looks at the various treatments and identifies a possible reason why the number of patients and treatments has increased in the 21st Century.
References to rosacea before 1980 are relatively few and seem to focus on relatively severe cases.
In 1904, there is a description of cabinet-maker, who was admitted to Ward 37A, of the Edinburgh Royal Infirmary. He had had rosacea for at least six years. In 1901 his nose started to enlarge and the condition progressed rapidly. His nose was red, coarse in appearance and studded over, especially on the right side, with excrescences, set with gaping openings of enlarged sebaceous glands.
In the 1980's there seemed to be a greater awareness of the condition and it seemed to be more topical and newsworthy.
In 1982, there was an article about sun damage to the skin and describes rosacea in men as the red bulbous nose. It said 'Another result (of sun injury), and one very common in men, is rosacea: the red, often bulbous, nose. "W. C. Fields had a dandy,"
In 1982 there was a newspaper article suggesting that alcohol induced blushing may identify people with a propensity for alcohol addiction and that these people are more apt to develop rosacea in later life.
In 1982, a drug that has various names (e.g. Accutane and Roaccutane) and is Isotretinoin was released by Hoffmann-La Roche and was used for treatment of Rosacea. Numerous side effects have been reported, including depression, suicide, hair loss, severe birth defects etc. This drug is also mentioned in a 2003 treatment.
In 1982 a doctor with a column in a newspaper described two treatments for Rosacea, one is cryotherapy (freezing the skin) to reduce the redness, another is treatment with antibiotics.
In 1992 the National Rosacea Society was formed, and in the 90's there was a tidal wave of people being diagnosed with the condition now suffered by over 14 million Americans and millions of others worldwide.
It is suggested that there was increased awareness of the condition in 1992 when Bill Clinton (a celebrity sufferer) became President of the United States of America. This awareness was possibly responsible for the tidal wave of sufferers seeing dermatologists, as previously they had ignored the condition.
Bill Clinton had previously won the Arkansas gubernatorial election in 1982, which may explain a surge in interest in this year.
In 1995 Pulsed-light equipment for Rosacea Treatment received FDA-approval.
In 1998 metronidazole was approved by the FDA (MetroGel)
In 2001, there are references to "Skin Rejuvenation for Sun Damage, Rosacea using Intense Pulsed Light (IPL) Therapy"
In 2002 there is an article in the Dermatological Times, 'Laser offers relief in diminishing rosacea'.
In 2002, the classification of Rosacea also changed. Prior to this year rosacea was classified according to four phases:-
Pre-rosacea, where these is flushing and blushing, sometimes with a stinging sensation
The Vascular phase where there is persistent redness and swelling associated with multiple telangiectasias.
The Inflammatory phase where papules and pustules (pimples and severer pimples) develop on these red areas. This had sometimes been called adult acne.
The Phymatous phase where there is thickening, coarsening, and overgrowth of inflamed tissues, typically causing the red bulbous nose seen on W.C. Fields and J.P. Morgan.
In this year, ' The National Rosacea Society' identified 4 distinct subtypes of Rosacea, which were then further classified according to severity of symptoms, e.g. mild, moderate, or severe.
In 2003, Finacea gel was approved for topical (applied to the skin) use as a treatment for the inflammatory pimples of mild to moderate rosacea. It is a form of azelaic acid, which had been approved as a treatment for acne in 1996.
In 2004 there was an observational study involving a small series of patients with rosacea. It found Intense pulsed light with maintenance therapy using metronidazole cream improved vascular lesions significantly
In 2005, the FDA approved Aczone (dapsone) Gel, 5% for the topical treatment of acne vulgaris in patients aged 12 years and over.
In 2006, the U.S. Food and Drug Administration (FDA) approved the use of a specific type of doxycycline for the treatment of rosacea.
Prior to 1992 rosacea was considered a rare disease. The number of treatments available has increased during the last decade partly due to a tidal wave of people diagnosed with the condition. This article looks at the various treatments and identifies a possible reason why the number of patients and treatments has increased in the 21st Century.
References to rosacea before 1980 are relatively few and seem to focus on relatively severe cases.
In 1904, there is a description of cabinet-maker, who was admitted to Ward 37A, of the Edinburgh Royal Infirmary. He had had rosacea for at least six years. In 1901 his nose started to enlarge and the condition progressed rapidly. His nose was red, coarse in appearance and studded over, especially on the right side, with excrescences, set with gaping openings of enlarged sebaceous glands.
In the 1980's there seemed to be a greater awareness of the condition and it seemed to be more topical and newsworthy.
In 1982, there was an article about sun damage to the skin and describes rosacea in men as the red bulbous nose. It said 'Another result (of sun injury), and one very common in men, is rosacea: the red, often bulbous, nose. "W. C. Fields had a dandy,"
In 1982 there was a newspaper article suggesting that alcohol induced blushing may identify people with a propensity for alcohol addiction and that these people are more apt to develop rosacea in later life.
In 1982, a drug that has various names (e.g. Accutane and Roaccutane) and is Isotretinoin was released by Hoffmann-La Roche and was used for treatment of Rosacea. Numerous side effects have been reported, including depression, suicide, hair loss, severe birth defects etc. This drug is also mentioned in a 2003 treatment.
In 1982 a doctor with a column in a newspaper described two treatments for Rosacea, one is cryotherapy (freezing the skin) to reduce the redness, another is treatment with antibiotics.
In 1992 the National Rosacea Society was formed, and in the 90's there was a tidal wave of people being diagnosed with the condition now suffered by over 14 million Americans and millions of others worldwide.
It is suggested that there was increased awareness of the condition in 1992 when Bill Clinton (a celebrity sufferer) became President of the United States of America. This awareness was possibly responsible for the tidal wave of sufferers seeing dermatologists, as previously they had ignored the condition.
Bill Clinton had previously won the Arkansas gubernatorial election in 1982, which may explain a surge in interest in this year.
In 1995 Pulsed-light equipment for Rosacea Treatment received FDA-approval.
In 1998 metronidazole was approved by the FDA (MetroGel)
In 2001, there are references to "Skin Rejuvenation for Sun Damage, Rosacea using Intense Pulsed Light (IPL) Therapy"
In 2002 there is an article in the Dermatological Times, 'Laser offers relief in diminishing rosacea'.
In 2002, the classification of Rosacea also changed. Prior to this year rosacea was classified according to four phases:-
Pre-rosacea, where these is flushing and blushing, sometimes with a stinging sensation
The Vascular phase where there is persistent redness and swelling associated with multiple telangiectasias.
The Inflammatory phase where papules and pustules (pimples and severer pimples) develop on these red areas. This had sometimes been called adult acne.
The Phymatous phase where there is thickening, coarsening, and overgrowth of inflamed tissues, typically causing the red bulbous nose seen on W.C. Fields and J.P. Morgan.
In this year, ' The National Rosacea Society' identified 4 distinct subtypes of Rosacea, which were then further classified according to severity of symptoms, e.g. mild, moderate, or severe.
In 2003, Finacea gel was approved for topical (applied to the skin) use as a treatment for the inflammatory pimples of mild to moderate rosacea. It is a form of azelaic acid, which had been approved as a treatment for acne in 1996.
In 2004 there was an observational study involving a small series of patients with rosacea. It found Intense pulsed light with maintenance therapy using metronidazole cream improved vascular lesions significantly
In 2005, the FDA approved Aczone (dapsone) Gel, 5% for the topical treatment of acne vulgaris in patients aged 12 years and over.
In 2006, the U.S. Food and Drug Administration (FDA) approved the use of a specific type of doxycycline for the treatment of rosacea.
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