Introduction
New,
exciting treatments for rosacea are on the horizon. Several
new topicals will become available, including SR101, which
SansRosa Pharmaceuticals has developed to reduce triggers
and to treat rosacea redness and flushing.
SR101
from SansRosa
SR101
is a new form of an alpha-2 adrenergic receptor agonist compound
that has been used for the treatment of certain eye disorders.
When applied topically, it eliminates skin redness rapidly
through a constrictor response, restoring facial skin to its
normal color. SR101 will be a topical, once-a-day, rapid-onset
product. The therapeutic potential of this compound has been
documented in initial pilot studies at the Mayo Clinic and
in placebo-controlled split-face studies. So far, the results
show great promise with no rebound dilation.
New
Topical Dapsone Cream for Treatment of Multiple Rosacea Symptoms
It
has long been recognized that oral dapsone (Jacobus Pharmaceutical
Company) is excellent for treating rosacea redness, facial
flushing, papules and pustules. However, the side effect profile
makes the risk/benefit ratio too high for most rosacea sufferers.
With new transdermal delivery systems, this insoluble medication
can be applied topically. Fujisawa has formulated this into
a rosacea-friendly cream to avoid irritation.
This
may also be the first topical to successfully treat rosacea
with coexisting acne without aggravating the underlying vascular
disorder. This is extremely important because most topical
anti-acne products are much too harsh for rosacea-sensitive
skin, resulting in increased facial redness and flushing.
Transdermal
Delivery Systems: Opening Up a New World of Rosacea Treatments
New
transdermal delivery systems also are changing the way we
can treat rosacea topically. Restoraderm (CollaGenex) is a
patented transdermal drug delivery system formulated with
lipids. It offers rapid penetration and absorption into the
stratum corneum of hydrophilic and hydrophobic medications.
A
new solvent microparticle (SMP) delivery system (Atrix Laboratories)
delivers highly insoluble drugs through the skin in a non-irritating,
time-released fashion. Since many medications that could help
treat rosacea redness and flushing are insoluble, they could
not be used in the past. The SMP technology first delivers
an unencapsulated drug followed by encapsulated microparticles
of the drug, providing delayed release of agents into the
dermal tissue for sustained 24-hour treatment.
Chemically
Modified Oral Antibiotics by Collagenex
Research
has shown that certain antibiotics can be chemically modified
to retain non-antibiotic properties and enhance their anti-inflammatory
actions. CollaGenex is developing various chemically modified
antibiotics termed IMPACS that inhibit inflammatory proteases
and cytokines.
Periostat
(CollaGenex) and Oracea (CollaGenex) have proven anti-inflammatory
actions in rosacea, but according to Klaus Theobald, M.D.,
a new, second-generation, chemically modified oral antibiotic
may change the face of rosacea. This antibiotic retains non-antimicrobial
actions at high doses and has already been tested on rosacea
sufferers in small multi-center studies with excellent results.
This
oral antibiotic derivative downregulates inducible nitric
oxide (a powerful dilator), VEGF (a powerful dilator with
strong angiogenic properties), and cell adhesion molecules
(gateways to dermal inflammation) — all substances proven
to play an intimate role in rosacea redness, flushing and
triggers.
Future
Rosacea Treatments
Several
biotechnology and pharmaceutical companies are racing to develop
the first topical biologic response modifier for skin redness
and flushing. Three of the most exciting agents that show
great promise in preliminary studies are focused on normalizing
dysfunctional smooth muscle cells in blood vessels of rosacea
skin.
These
include selective agonists of kinase enzymes in the smooth
muscle wall, intercellular gap junction blockers that stop
conducted dilation, and uncoupling G-proteins to prevent countless
dilator triggers from reaching the intercellular Ca++ stores
in smooth muscle cells of rosacea blood vessels.
About
the Author
Dr.
Geoffrey Nase, Ph.D., is a Rosacea Specialist and Consultant
for Rosacea Consulting Specialists LLC in Indianapolis, Indiana,
USA.
For
more information: www.drnase.com/
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