High Point, N.C. — A new classification system, new treatments and new versions of old standbys mark how knowledge of rosacea has evolved over the past five years.

While rosacea was once considered to be one disease, a new algorithm divides it into groups, or classifications, says Zoe Diana Draelos, M.D., a dermatologist and researcher in High Point, N.C.

"The different types of classifications help you better understand whether it should be treated topically or orally," Dr. Draelos says.

Scientists have also optimized the use of azelaic acid for the treatment of rosacea by putting it in a new vehicle. The new version of this therapy allows for better skin penetration, which correlates with improved inflammation reduction.

"Yet another drug that was studied in rosacea, but has not yet been approved for the treatment of the skin disease, is topical dapsone," she says. "Used off-label, it is effective in the inflammatory phase of rosacea, where you have the acne."

Dermatologists, according to Dr. Draelos, are also having success using modalities such as intense pulsed light (IPL) laser therapy to treat rosacea.

"We are learning that rosacea is probably multiple diseases with the same presentation. Even though we do not have ways of predicting which medicines will work best in which patients, we now have more treatment options, so that we can customize treatment more for the specifics of the patient," Dr. Draelos tells Dermatology Times.

Disclosure: Dr. Draelos conducts research for major rosacea medication manufacturers Allergan, Intendis and Galderma.