. 2021 Feb 16;13(1):121–128. doi: 10.1159/000511984

Table 1.

Overview of off-label treatments suggested for rosacea in recent literature^a

Management option	Subtype	Quality of Evidence^b
*Topical* Artemether emulsion [1]	PPR	C

Crotamiton [2] (+ benzyl benzoate) [3]	ETR PPR	C

Dapsone gel 5% [4, 5]	PPR	C

1% 4-ethoxybenzaldehyde	ETR	C

Gluthathione-C4 (0.1%), beta-glycyrrhetinic (0.5%), and azelaic acid (10%) [6]		C

Honevo (Kanuka Honey) [7]	ETR PPR	C

Hydroxypropyl chitosan and potassium azeloyl diglycinate (5%) [8]	ETR	C

Liposomal polyvinylpyrrolidone-iodine hydrogel [9]	ETR PPR	C

Liposomal sodium copper chlorophyllin complex [10]	ETR	C

1-Methylnicotinamide [11]	ETR PPR	C

Permethrin gel [12, 13, 14]	ETR PPR	B

Pimecrolimus 1%^c [15, 16, 17, 18, 19]	ETR PPR	B

Praziquantel [20]	ETR PPR	C

Serine protease inhibitor [21]	PPR	C

Tacrolimus 0.1%^c [22]	ETR	C

Timolol maleate 0.5% [23]	ETR PPR	C

Tranexamic acid [24–27]	ETR	C

*Oral* Phosphodiesterase type 4 inhibitor (apremilast) [28]	ETR PPR	C

Escherichia coli Nissle 1917 + regular topical therapy for rosacea [29] Hydroxychloroquine [30, 31]	PPR ETR PPR	C C

Rifaximin [32-37]	PPR	B

Thalidomide [38] (+ pimecrolimus) [19]	ETR PPR	C

Turmeric polyherbal formulation [39]	ETR	C

*Devices and surgical interventions* (Abo/Inco) Botulinumtoxin A [40–44]	ETR	B

Dual-frequency ultrasound [45]	ETR PPR	C

Coupled blue and red light-emitting diodes therapy [46]	PPR	C

Interleukin-17 blockade [47]	PPR	C

Long-pulsed 1,064-nm neodynium:yttrium-aluminum-garnet laser [48]	PPR	C

Microfocused ultrasound [49]	ETR	C

Microneedling radiofrequency [50]	ETR	C

Photodynamic therapy + (methyl) aminolevulinate [51,52]	ETR PPR	C

PPR, papulopustular rosacea; ETR, erythematotelangiectatic rosacea.

Table with references is available as online supplementary material.

Quality of evidence (A, B, or C): A: Randomized controlled trials; B: Systematic review/meta-analysis of lower-quality clinical trials or studies with limitations and inconsistent findings; lower-quality clinical trial; cohort study; case-control study; C: Consensus guidelines; usual practice; expert opinion; case series; limited trial data.

May also cause rosacea-like eruption in the face.