Condition

Rosacea

Clinical trials and treatment information for Rosacea, a skin condition causing redness and visible blood vessels in the face.

415M
People Affected
60
Active Trials
16.6M
New Cases/Year
4,791
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Ivermectin (topical)
88% Effectiveness• 90% Confidence• 88% Safety• 6 trials• 5K participants
HIGH EvidenceExcellent ValueDose: Apply thinly once daily to affected areas
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Comparative Safety Scale(Higher is safer)

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88
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

12 weeks initial, then as needed or maintenance

Response Rate

75%

Remission Rate

45%

Number Needed to Treat (NNT)

4

Common Side Effects:

Skin irritation/burning/itching: 5%
Dry skin: 1%

Annual Cost of Care

Drug Cost

$2,500

Monitoring

$300

Side Effects

$50

Total Annual

$2,850

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$26,000/QALY

Cost per Remission

$6,333

Cost per Responder

$3,800

Treatment Outcomes
Primary Outcomes
Inflammatory Lesion Count22 lesions
-75% (-16.5 lesions)
Investigator's Global Assessment (IGA) ScoreIGA score: 3/5 (Moderate)
-60% (-1.8 points)
Erythema Severity (Clinician-assessed)Clinical Erythema Assessment (CEA) score: 3/4 (Moderate to Severe)
-40% (-1.2 points)
Secondary Benefits
Patient Assessment of Stinging/BurningVisual Analog Scale (VAS) score: 6/10
-58.3% (-3.5 points)
Quality of Life (Rosacea-specific)Rosacea Quality of Life Index score: 18/30 (Impaired)
-44.4% (-8 points)
Demodex Mite Density45 mites/cm²
-88.9% (-40 mites/cm²)
Common Side Effects
Skin irritation/burning/itching
+5%
Dry skin
+1%

Clinical Trial Phases:

Phase 3Phase 4
2
Doxycycline (low-dose)
85% Effectiveness• 90% Confidence• 70% Safety• 20 trials• 8K participants
HIGH EvidenceExcellent ValueDose: 20mg twice daily or 40mg once daily (modified release)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
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Chemo☢️
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70
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

3-6 months initial, then as needed or maintenance

Response Rate

68%

Remission Rate

35%

Number Needed to Treat (NNT)

5

Common Side Effects:

Nausea/diarrhea: 10%
Photosensitivity: 10%
Vaginal candidiasis: 3%

Annual Cost of Care

Drug Cost

$800

Monitoring

$300

Side Effects

$100

Total Annual

$1,200

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$11,353/QALY

Cost per Remission

$3,428

Cost per Responder

$1,765

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+85%
Response Rate
+68%
Remission Rate
+35%
Common Side Effects
Nausea/diarrhea
+10%
Photosensitivity
+10%
Vaginal candidiasis
+3%

Clinical Trial Phases:

Phase 3Phase 4
3
Vascular Laser / IPL Therapy
80% Effectiveness• 85% Confidence• 75% Safety• 1 trials• 5K participants
MODERATE EvidenceGood ValueDose: Varies by device and settings
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
75
DangerousModerateSafe

Time to Effect

Immediate, full effect in 2-4 weeks per session

Duration

3-5 sessions initially, then maintenance annually

Response Rate

80%

Remission Rate

%

Number Needed to Treat (NNT)

3

Common Side Effects:

Erythema/swelling: 100%
Purpura (bruising): 80%
Pigment changes: 5%
Blistering/crusting: 1%

Annual Cost of Care

Drug Cost

$0

Monitoring

$300

Side Effects

$100

Total Annual

$2,600

Cost-Effectiveness

GOOD

QALYs Gained

0.15

Cost per Responder

$3,250

Treatment Outcomes
Primary Outcomes
Erythema SeverityCEA score: 3/4 (Moderate Rosacea Erythema)
-50% (-1.5 points)
Telangiectasia SeverityGrade: 2/3 (Moderate Telangiectasia)
-60% (-1.2 grades)
Redness Index (Objective Measurement)Redness Index: 60 (arbitrary units)
-35% (-21 units)
Secondary Benefits
Rosacea Quality of Life (RosaQoL)RosaQoL score: 45/100 (Moderate impact)
-30% (-13.5 points)
Burning/Stinging Sensation SeverityVAS for burning: 6/10
-40% (-2.4 points)
Flushing SeverityFlushing Severity Scale: 3/4 (Moderate)
-33% (-1 point)
Common Side Effects
Erythema/swelling
+100%
Purpura (bruising)
+80%
Pigment changes
+5%
4
Azelaic Acid (topical)
75% Effectiveness• 85% Confidence• 85% Safety• 14 trials• 6K participants
HIGH EvidenceExcellent ValueDose: Apply twice daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
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Morphine💊
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85
DangerousModerateSafe

Time to Effect

4-8 weeks

Duration

12-16 weeks initial, then as needed or maintenance

Response Rate

65%

Remission Rate

35%

Number Needed to Treat (NNT)

5

Common Side Effects:

Burning/stinging/itching: 20%
Erythema: 5%
Dryness: 3%

Annual Cost of Care

Drug Cost

$1,500

Monitoring

$300

Side Effects

$100

Total Annual

$1,900

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$30,000/QALY

Cost per Remission

$5,428

Cost per Responder

$2,923

Treatment Outcomes
Primary Outcomes
Inflammatory Lesion Count (Papules and Pustules)25 lesions
-60% (-15 lesions)
Erythema Severity (Clinician's Erythema Assessment Scale)3.5 points (Moderate/Severe on a 0-4 scale)
-29% (-1.0 points)
Investigator Global Assessment (IGA)3.0 points (Moderate on a 0-4 scale)
-33% (-1.0 points)
Secondary Benefits
Patient-reported Burning/Stinging Severity5.0 points (on a 0-10 VAS scale)
-30% (-1.5 points)
Dermatology Life Quality Index (DLQI)12 points (Moderate Impact on a 0-30 scale)
-42% (-5 points)
Common Side Effects
Burning/stinging/itching
+20%
Erythema
+5%
Dryness
+3%

Clinical Trial Phases:

Phase 3Phase 4
5
Oxymetazoline (topical)
70% Effectiveness• 85% Confidence• 80% Safety• 2 trials• 1.5K participants
MODERATE EvidenceExcellent ValueDose: Pea-sized amount once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

Within 1 hour

Duration

Daily, as needed

Response Rate

58%

Remission Rate

%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

25

Common Side Effects:

Application site reactions (pain, erythema, pruritus): 5%
Rebound erythema: 5%

Annual Cost of Care

Drug Cost

$3,000

Monitoring

$300

Side Effects

$150

Total Annual

$3,450

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$16,929/QALY

Cost per Responder

$5,948

Treatment Outcomes
Primary Outcomes
Clinician's Erythema Assessment (CEA) Score3 (Moderate on 0-4 scale)
-50% (-1.5 points)
Subject's Global Assessment (SGA) Score3 (Moderate on 0-4 scale)
-50% (-1.5 points)
Overall Redness Intensity (Visual Analogue Scale)70 mm (on 0-100 mm scale)
-50% (-35 mm)
Secondary Benefits
Dermatology Life Quality Index (DLQI)12 points (DLQI score, range 0-30)
-33.33% (-4 points)
Patient Satisfaction with Appearance3 (Neutral on 1-5 satisfaction scale)
+50% (+1.5 points)
Self-perception of Facial Appearance Score4 (on 0-10 scale, 0=very poor, 10=excellent)
+50% (+2 points)
Common Side Effects
Application site reactions (pain, erythema, pruritus)
+5%
Rebound erythema
+5%

Clinical Trial Phases:

Phase 3Phase 4
6
Metronidazole (topical)
65% Effectiveness• 95% Confidence• 85% Safety• 9 trials• 10K participants
HIGH EvidenceExcellent ValueDose: Apply once or twice daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
85
DangerousModerateSafe

Time to Effect

3-6 weeks

Duration

9-12 weeks initial, then as needed or maintenance

Response Rate

58%

Remission Rate

25%

Number Needed to Treat (NNT)

6

Common Side Effects:

Dryness/irritation/burning: 10%
Erythema: 2%

Annual Cost of Care

Drug Cost

$500

Monitoring

$300

Side Effects

$50

Total Annual

$850

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$18,000/QALY

Cost per Remission

$3,400

Cost per Responder

$1,465

Treatment Outcomes
Primary Outcomes
Inflammatory Lesions (Papules/Pustules) Count18 lesions
-60% (-11 lesions)
Erythema Severity (0-4 scale)3 (moderate to severe)
-40% (-1.2 points)
Overall Disease Severity (IGA scale)3 (moderate)
-33.3% (-1.0 points)
Secondary Benefits
Burning/Stinging Sensation (0-4 scale)3 (moderate frequency/severity)
-50% (-1.5 points)
Dermatology Life Quality Index (DLQI)12/30 (moderate impact)
-33.3% (-4 points)
Patient Satisfaction Score (0-10 scale)4/10
+75% (+3 points)
Common Side Effects
Dryness/irritation/burning
+10%
Erythema
+2%

Clinical Trial Phases:

Phase 3Phase 4
7
Brimonidine (topical)
60% Effectiveness• 85% Confidence• 78% Safety• 9 trials• 2K participants
MODERATE EvidenceExcellent ValueDose: Pea-sized amount once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
78
DangerousModerateSafe

Time to Effect

Within 30 minutes

Duration

Daily, as needed

Response Rate

65%

Remission Rate

%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

15

Common Side Effects:

Rebound erythema: 10%
Flushing: 5%
Burning/pruritus: 3%

Annual Cost of Care

Drug Cost

$2,500

Monitoring

$300

Side Effects

$200

Total Annual

$3,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.07

ICER

$18,487/QALY

Cost per Responder

$4,615

Treatment Outcomes
Primary Outcomes
Clinician's Erythema Assessment (CEA) Score3 (moderate erythema) on 5-point scale (0-4)
-43.3% (-1.3 points)
Patient's Global Assessment (PGA) Score3 (moderate erythema) on 5-point scale (0-4)
-43.3% (-1.3 points)
Skin Redness (a* value on L*a*b* color space)15 units (typical for moderate erythema)
-15% (-2.25 units)
Secondary Benefits
Dermatology Life Quality Index (DLQI) Score15 (moderate impact) on 30-point scale (0-30)
-26.7% (-4 points)
Patient's Assessment of Facial Appearance (Likert Scale)3 (average) on 5-point scale (1=very poor, 5=excellent)
+33.3% (+1 point)
Common Side Effects
Rebound erythema
+10%
Flushing
+5%
Burning/pruritus
+3%

Clinical Trial Phases:

Phase 3Phase 4