Rosacea and treatment with retinoids: a systematic review and meta-analysis

Background: Rosacea is a common inflammatory disease. Four clinical rosacea subtypes have been described, with the papulo-pustular being the most common. At present, the only FDA-approved treatment for papulo-pustular rosacea is low-dose doxycycline. Retinoids, in particular isotretinoin, have shown...

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Main Authors: Alberto Sticchi, Flavio Fiorito, Shaniko Kaleci, Alessia Paganelli, Marco Manfredini, Caterina Longo
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Therapeutic Advances in Chronic Disease
Online Access:https://doi.org/10.1177/20406223251339964
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author Alberto Sticchi
Flavio Fiorito
Shaniko Kaleci
Alessia Paganelli
Marco Manfredini
Caterina Longo
author_facet Alberto Sticchi
Flavio Fiorito
Shaniko Kaleci
Alessia Paganelli
Marco Manfredini
Caterina Longo
author_sort Alberto Sticchi
collection DOAJ
description Background: Rosacea is a common inflammatory disease. Four clinical rosacea subtypes have been described, with the papulo-pustular being the most common. At present, the only FDA-approved treatment for papulo-pustular rosacea is low-dose doxycycline. Retinoids, in particular isotretinoin, have shown for decades positive outcomes in the treatment of rosacea, but due to the lack of robust evidence, they are still considered an off-label treatment for this condition. Objectives: Summarize the current evidence in the literature regarding the role of topical and systemic retinoids in the treatment of papulo-pustular rosacea. Design: Systematic review and meta-analysis. Data source and methods: A systematic MEDLINE, EMBASE, and Cochrane search of relevant publications on this topic was carried out. Randomized and non-randomized studies regarding topical and systemic retinoid treatment for rosacea were included. We excluded not relevant studies, case reports, reviews, and non-English language studies. We have used RoB2 and ROBINS-1 tool for assessing risk of bias in randomized and non-randomized trials, respectively. Results: Due to the heterogeneity in study design and outcomes reporting, the standardization of our results is limited, but the findings from this systematic review with meta-analysis indicate that retinoids, particularly isotretinoin, are a promising treatment option for papulopustular rosacea, with a favorable tolerability and safety profile. On the other hand, available data for topical retinoid therapy are less definitive and more contradictory, with only two randomized studies reporting opposite outcomes. Conclusion: Retinoids may be a valid treatment option for rosacea, but larger, randomized controlled trials are needed to establish standardized dosing regimens and long-term safety profiles.
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spelling doaj-art-609f067ab7e040598454ee03633d09f92025-08-20T02:00:54ZengSAGE PublishingTherapeutic Advances in Chronic Disease2040-62312025-05-011610.1177/20406223251339964Rosacea and treatment with retinoids: a systematic review and meta-analysisAlberto SticchiFlavio FioritoShaniko KaleciAlessia PaganelliMarco ManfrediniCaterina LongoBackground: Rosacea is a common inflammatory disease. Four clinical rosacea subtypes have been described, with the papulo-pustular being the most common. At present, the only FDA-approved treatment for papulo-pustular rosacea is low-dose doxycycline. Retinoids, in particular isotretinoin, have shown for decades positive outcomes in the treatment of rosacea, but due to the lack of robust evidence, they are still considered an off-label treatment for this condition. Objectives: Summarize the current evidence in the literature regarding the role of topical and systemic retinoids in the treatment of papulo-pustular rosacea. Design: Systematic review and meta-analysis. Data source and methods: A systematic MEDLINE, EMBASE, and Cochrane search of relevant publications on this topic was carried out. Randomized and non-randomized studies regarding topical and systemic retinoid treatment for rosacea were included. We excluded not relevant studies, case reports, reviews, and non-English language studies. We have used RoB2 and ROBINS-1 tool for assessing risk of bias in randomized and non-randomized trials, respectively. Results: Due to the heterogeneity in study design and outcomes reporting, the standardization of our results is limited, but the findings from this systematic review with meta-analysis indicate that retinoids, particularly isotretinoin, are a promising treatment option for papulopustular rosacea, with a favorable tolerability and safety profile. On the other hand, available data for topical retinoid therapy are less definitive and more contradictory, with only two randomized studies reporting opposite outcomes. Conclusion: Retinoids may be a valid treatment option for rosacea, but larger, randomized controlled trials are needed to establish standardized dosing regimens and long-term safety profiles.https://doi.org/10.1177/20406223251339964
spellingShingle Alberto Sticchi
Flavio Fiorito
Shaniko Kaleci
Alessia Paganelli
Marco Manfredini
Caterina Longo
Rosacea and treatment with retinoids: a systematic review and meta-analysis
Therapeutic Advances in Chronic Disease
title Rosacea and treatment with retinoids: a systematic review and meta-analysis
title_full Rosacea and treatment with retinoids: a systematic review and meta-analysis
title_fullStr Rosacea and treatment with retinoids: a systematic review and meta-analysis
title_full_unstemmed Rosacea and treatment with retinoids: a systematic review and meta-analysis
title_short Rosacea and treatment with retinoids: a systematic review and meta-analysis
title_sort rosacea and treatment with retinoids a systematic review and meta analysis
url https://doi.org/10.1177/20406223251339964
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