YAFI Online Programming // Disease State Management and Drug Therapy


Understanding the Patient Journey, Offering Insightful Help

Educational Objectives

After participating in this activity, pharmacists will be able to:

  • Discuss rosacea's pathophysiology and four subtypes
  • Identify recent changes in available medications to treat rosacea
  • Distinguish each FDA-approved product by the symptoms it addresses
  • Maximize the pharmacist's role in identifying OTC products, referring patients for prescription strength medication, and counseling patients about both

After participating in this activity pharmacy technicians will be able to:

  • Discuss the basic facts about rosacea
  • Acquire reputable sources for patients who have rosacea to find information
  • Differentiate between over-the-counter and prescription drugs for rosacea
  • Infer when to refer patients to the pharmacist for recommendations or referral

Session Offered

Release Date: May 15, 2020

Expiration Date: May 14, 2021

Course Fee


Session Codes

18YC15-VXP82 -Pharmacist

18YC15-TVK26-Pharmacy Technician

Accreditation Hours

2.0 hours of CE


Rosacea, a common skin condition among the fair-skinned, can affect individuals of all skin types. While often characterized by signs of facial flushing and redness, inflammatory papules and pustules, telangiectasia, and facial edema, rosacea’s symptom severity varies greatly among individuals. Symptoms are classified into four different subtypes according to predominant findings; symptoms may wax and wane, with exacerbations likely upon exposure to triggers. Research has not completely elucidated rosacea's pathophysiology, so understanding this inflammatory disorder and the various mediators involved with triggering flares is necessary to educate patients properly and develop appropriate treatment plans that address all symptoms. Management strategies must be tailored to individual patient symptoms, and often, employ periods of trial and error. Clinicians must also consider rosacea's psychological and psychosocial impact. Pharmacists can promote realistic expectations, suggest rosacea-friendly skin products, and advise patients to seek help if they don't see improvement within a certain timeframe. This activity discusses rosacea's incidence and etiology; its impact on quality of life; available treatments; and appropriate treatment for predominant symptoms.

Accreditation Statements

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and pharmacy technicians are eligible to participate in this application-based activity and will receive up to 0.2 CEU (2 contact hours) for completing the activity, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor on- line system and your participation will be recorded with CPE Monitor within 72 hours of submission


Grant funding: Supported by an unrestricted educational grant from Galderma

Cost: Free

Initial Release Date: May 15, 2020

Expiration Date: May 14, 2021

To obtain CPE credit, visit the UConn Online CE Center

Use your NABP E-profile ID and the session code 18YC15-VXP82 for pharmacists or 18YC15-TVK26 for pharmacy technicians to access the online quiz and evaluation.

First- time users must pre-register in the Online CE Center. Test results will be displayed immediately and your participation will be recorded with CPE Mon- itor within 72 hours of completing the requirements.

For questions concerning the online CPE activities, email joanne.nault@uconn.edu


Mary M. Bridgeman, Pharm.D., BCPS, BCGP is a Clinical Associate Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey

Faculty Disclosure

Dr. Bridgeman has no actual or potential conflicts of interest associated with this article.

Disclosure of Discussions of Off-label and Investigational Drug Use

This activity may contain discussion of off label/unapproved use of drugs. The content and views presented in this educational program are those of the faculty and do not necessarily represent those of the University of Connecticut School of Pharmacy. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.



Rosacea is a remarkably common chronic, progressive inflammatory condition estimated to affect up to 10% of the American population, or more than 16 million Americans.1 Beyond a topical skin affliction, rosacea impairs patients’ quality of life and may signal an elevated risk for certain other systemic medical comorbidities. This condition, most common in fair-skinned adults, tends to develop in midlife and often has a genetic component. Its onset is insidious, and its symptoms are so general that clinicians often confuse them with other skin problems like acne, sun damage, or actinic keratosis. This makes it very difficult to determine rosacea's exact incidence, although most experts agree that it is far more common than previously believed.2,3 Affecting primarily the face, rosacea is not easily hidden, and creates tremendous emotional and physical discomfort for patients experiencing moderate-to-severe symptoms.


Full List of References

1. National Rosacea Society. If You Have Rosacea, You’re Not Alone. Available at https://www.rosacea.org/patients/index.php. Accessed April 20, 2018.
2. Oge LK, Muncie HL, Phillips-Savoy AR. Rosacea: Diagnosis and Treatment. Am Fam Physician. 2015;92(3)L:187-198.
3. National Rosacea Society. New Survey Defines Impact of Rosacea In Social Situations. Winter 2017. Available
at https://www.rosacea.org/rr/new-survey-definesimpact-rosacea-social-situations. Accessed April 20, 2018.
4. Asai Y, Tan J, Baibergenova A, et al. Canadian Clinical Practice Guidelines for Rosacea. J Cutan Med Surg.
5. Mikkelsen CS, Holmgren HR, Kjeliman P, et al. Rosacea: a clinical review. Derm Reports. 2016;8:1-5.
6. Alinia H, Moradi Tuchayi S, Farhangian ME, et al. Rosacea patients seeking advice: qualitative analysis of patients'
posts on a rosacea support forum. J Dermatolog Treat. 2016;27:99-102.
7. National Rosacea Society. Rosacea prevalence map. Available from: https://www.rosacea.org/press/prevalencemap. Accessed April 21, 2018.
8. Moustafa F, Lewallen RS, Feldman, SR. The psychological impact of rosacea and the influence of current management options. J Am Acad Dermatol. 2014;71:973-980.
9. Aksoy B, Altaykan-Hapa A, Egemen D, et al. The impact of rosacea on quality of life: effects of demographic and clinical characteristics and various treatment modalities. Br J Dermatol. 2010;163:719-725.
10. van der Linden MM, van Rappard DC, Daams JG, et al. Health-related quality of life in patients with cutaneous
rosacea: a systematic review. Acta Derm Venereol. 2015;95:395-400.
11. Bohm D, Schwanitz P, Stock Gissendanner S, et al. Symptom severity and psychological sequelae in rosacea: results of a survey. Psychol Health Med. 2014;19:586-591.
12. American Academy of Dermatology. Rosacea: Overview & Symptoms. Available at https://www.aad.org/public/diseases/acne-androsacea/rosacea#overview. Accessed April 20, 2018.
13. National Rosacea Society. Survey shows rosacea disrupts work for patients with severe symptoms. Fall 2000. Available at https://www.rosacea.org/rr/2000/fall/article_3.php. Accessed April 20, 2018.
14. National Rosacea Society. Rosacea often affects patients’ social lives, new survey finds. Summer
2005. Available at https://www.rosacea.org/rr/2005/summer/article_3.php. Accessed April 20, 2018.
15. Egeberg A, Hansen PR, Gislason GH, Thyssen JP. Exploring the association between rosacea and
Parkinson Disease: A Danish Nationwide Cohort Study. JAMA Neurol. 2016;73:529-534.
16. Egeberg A, Hansen PR, Gislason GH, Thyssen JP. Patients with rosacea have increased risk of dementia. Ann Neurol. 2016;79:921-928.
17. Facts about rosacea: A survey of rosacea patients results of the Rosacea Research and Development Institute
Member Survey on Rosacea. January 21, 2016. Available at http://eyedoc2020.blogspot.com/2016/01/facts-aboutrosacea-survey-of-rosacea.html?view=classic&m=1. Accessed April 21, 2018.
18. Drake L. New research on comorbidities extends scientific knowledge. Rosacea Review. Summer 2016. Available at
http://www.rosacea.org/rr/2016/summer/new-researchcomorbidities-extends-scientific-knowledge. Accessed April 22, 2018.
19. Huynh TT. Burden of disease: the psychosocial impact of rosacea on a patient’s quality of life. Am Health Drug Benefits. 2013;6:348-354.
20. Steinhoff M, Schmelz M, Schauber J. Facial Erythema of Rosacea - Aetiology, Different Pathophysiologies
and Treatment Options. Acta Derm Venereol. 2016;96:579-586.
21. National Rosacea Society. New survey suggests eye irritation from rosacea often goes untreated. Fall 2016. Available at https://www.rosacea.org/rr/new-survey-suggests-eyeirritation-rosacea-often-goes-untreated. Accessed April 28, 2018.
22. Wilkin J, Dahl M, Detmar M, et al. Standard grading system for rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. J Am Acad Dermatol. 2004;50:907-912.
23. Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2018;78:148-155.
24. National Rosacea Society. Survey shows rosacea patients often use more than one medical therapy. Summer 2016. Available from: https://www.rosacea.org/rr/2016/summer/surveyshows-rosacea-patients-often-use-more-one-medical-therapy. Accessed April 29, 2018.
25. Mayba JN, Gooderham MJ. A Guide to Topical Vehicle Formulations. J Cutan Med Surg. 2018;22(2):207-212.
26. Finacea (azelaic acid) package insert. Whippany, NJ: Bayer HealthCare, 2016.
27. Metrogel (metronidazole) package insert. Forth Worth, TX: Galderma Laboratories, 2011.
28. Mirvaso (brimonidine) package insert. Forth Worth, TX: Galderma Laboratories, 2016.
29. Rhofade (oxymetazoline hydrochloride) package insert. Irvine, CA: Allergan, 2017.
30. Soolantra (ivermectin) package insert. Forth Worth, TX: Galderma Laboratories, 2014.
31. Oracea (doxyxylcin) package insert. Forth Worth, TX: Galderma Laboratories, 2014.
32. Wehausen B, Hill DE, Feldman SR. Most people with psoriasis or rosacea are not being treated: a large population study. Dermatol Online J. 2016;22.
33. Del Rosso JQ, Tanghetti EA, Baldwin HE, Rodriguez DA, Ferrusi IL. The burden of illness of erythematotelangiectatic rosacea and papulopustular rosacea: Findings from a web-based Survey. J Clin Aesthet Dermatol. 2017;10:17-31.
34. National Rosacea Society. Flare-ups strike often, survey says. Fall 2008. Available at https://www.rosacea.org/rr/2008/fall/article_4.php. Accessed April 29, 2018.
35. National Rosacea Society. Tips for tracking rosacea triggers. Available from: https://www.rosacea.org/rr/2015/summer/tips.php. Accessed April 29, 2018.
36. Draelos ZD. Cosmeceuticals for rosacea. Clin Dermatol. 2017;35:213-217.
37. Lynde C. Moisturizers for the treatment of inflammatory skin conditions. J Drugs Dermatol. 2008;7:1038-1043.
38. Subramanyan K. Role of mild cleansing in the management of patient skin. Dermatol Ther. 2004;17(Suppl 1):26-34.
39. Spoendlin J, Voegel JJ, Jick SS, Meier CR. Antihypertensive drugs and the risk of incident rosacea. Br J Dermatol. 2014;171(1):130-136.
40. Wu J. Treatment of rosacea with herbal ingredients. J Drugs Dermatol. 2006;5(1):29-32.
41. Draelos ZD. Cosmeceuticals for rosacea. Clin Dermatol. 2017;35(2):213-217.
42. McAleer MA, Powell FC. Complementary and alternative medicine usage in rosacea. Br J Dermatol. 2008;158(5):1139-1141.
43. Eichenfield LF, Tom WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71:116-132.
44. Grimalt R, Mengeaud V, Cambazard F. The steroidsparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology. 2007;214:61-67.
45. Ng SY, Begum S, Chong SY. Does order of application of emollient and topical corticosteroids make a difference in the severity of atopic eczema in children? Pediatr Dermatol. 2016;33:160-164.
46. Smoker A, Voegeli D. Topical steroid or emollient — which to apply first? A critical review of the science and debate. Dermatol Nurs (Lond) 2014;13:14-26.
47. Jappe U, Schäfer T, Schnuch A, et al. Contact allergy in patients with rosacea: a clinic-based, prospective epidemiological study. J Eur Acad Dermatol Venereol. 2008;22:1208-1214.