Pathogenetic justification of combination therapy for rosacea

Aim: to evaluate an effect of combination therapy (1% ivermectin cream, troxerutin [i.e., an angioprotective agent] and intravenous laser blood irradiation) on vascular condition and inflammation in patients with erythematotelangiectatic and papulopustular subtypes of rosacea. Patients and Methods: 90 patients with clinically diagnosed erythematotelangiectatic and papulopustular subtypes of rosacea were enrolled in the study. They were randomized into 3 groups (n=30 each). The Group I received ivermectin monotherapy (1% cream) on cleansed facial skin once a day in the evening for 12 weeks. The Group II applied 1% ivermectin cream according to the same regimen and received troxerutin per os (1 300 mg capsule 3 times a day for 90 days). As for the Group III, patients received ivermectin and troxerutin according to the abovementioned regimens along with intravenous laser blood irradiation (ILBI). At the baseline and at Week 12, rosacea severity was assessed according to the Rosacea Diagnostic Evaluation Score (RDES). Additionally, microcirculation and blood coagulation system were evaluated. To assess safety, adverse reactions were recorded. Results: at the baseline, patients demonstrated comparable rosacea symptom severity as per the RDES. After 12 weeks of therapy, a significant decrease in a RDES index was reported in all groups. The Group III demonstrated the most pronounced decrease. According to microcirculation evaluation data, endothelial function indicators recovered in these patients as compared with their baseline values, as well as with Groups I and II. A thrombodynamics test revealed a similar trend. All groups tolerated the therapy well. No adverse reactions were reported. Conclusion: combined use of 1% ivermectin cream, troxerutin (an angioprotective agent) and ILBI is a pathogenetically justified highly efficient and safe therapeutic method in patients with erythematotelangiectatic and papulopustular subtypes of rosacea. Keywords: rosacea, angiopathy, inflammation, ivermectin, troxerutin, angioprotective agent, intravenous laser blood irradiation. For citation: Pirugina E.A., Perlamutrov Yu.N. Pathogenetic justification of combination therapy for rosacea. RMJ. 2025;3:51–55. DOI: 10.32364/2225-2282-2025-3-10