Table 2.
Supplementation and topical treatment recommendations for Rosacea
| Vitamin or mineral | Recommendation | Grade and level of evidence |
|---|---|---|
| Vitamin A |
Oral isotretinoin is safe and can be recommended for recalcitrant cases of rosacea and papulopustular rosacea No recommendations to measure or monitor serum vitamin A levels |
Grade A, level 1b |
| Insufficient evidence to recommend topical adapalene for rosacea | Grade B, level 2b | |
| Vitamin B3 |
Insufficient evidence for supplementation recommendation No recommendations to measure or monitor serum vitamin B3 levels |
Grade D, level 5 |
| Topical 1-methylnicotinamide is a safe alternative to conventional treatment for rosacea, and can be recommended | Grade D, level 5 | |
| Topical NADH is a safe alternative to conventional treatment for rosacea, and can be recommended | Grade D, level 5 | |
| Vitamin B12 |
Insufficient evidence for supplementation recommendation No recommendations to measure or monitor serum vitamin B12 levels |
Grade D, level 5 |
| Intramuscular B12 (hydroxycobalmin) is a safe alternative to conventional treatment and can be used to treat persistent rosacea | Grade D, level 5 | |
| Vitamin D |
Insufficient evidence for supplementation recommendation No recommendations to measure or monitor serum vitamin D levels |
Grade D, level 5y |
| Vitamin K |
Insufficient evidence for supplementation recommendation No recommendations to measure or monitor serum vitamin K levels |
Grade B, level 2b |
| Topical Vitamin K is safe and can be recommended for steroid-induced rosacea, however standard treatment approaches should be attempted first | Grade B, level 2b | |
| Omega-3 FAs |
Supplementation is safe and recommended for ocular rosacea patients or rosacea patients with dry eye symptoms No recommendations to measure or monitor serum omega-3 FAs levels |
Grade B, level 2b |
| Zinc |
Insufficient evidence for supplementation recommendation No recommendations to measure or monitor serum zinc levels |
Grade B, level 2b |
| Topical zinc sulfate is safe and can be recommended for rosacea in mild cases and could be combined with other standard oral therapies such as azithromycin, doxycycline, and others | Grade B, level 2b |
NADH Nicotinamide Adenine Dinucleotide (Hydrogen), FAs Fatty acids