Use of beta-blockers for rosacea-associated facial erythema and flushing: A systematic review and update on proposed mode of action.

BACKGROUND: Flushing and erythema are frequent skin symptoms in rosacea. Because their adequate treatment remains a clinical challenge, new treatment options are explored, such as oral ß-blockers. OBJECTIVES: To evaluate the efficacy of oral ß-blockers for rosacea-associated facial flushing and erythema. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were systematically searched, including studies providing original data on the efficacy of oral ß-blockers in rosacea patients with facial flushing and/or persistent erythema. Risk of bias was assessed using the Cochrane Risk of Bias tool, Newcastle-Ottawa scale, and Quality in Prognosis Studies tool. RESULTS: Nine studies evaluating the use of carvedilol, propranolol, nadolol, and ß-blockers in general were included. Articles studying carvedilol and propranolol showed a large reduction of erythema and flushing during treatment with a rapid onset of symptom control. Bradycardia and hypotension were the most commonly described adverse events. LIMITATIONS: Most studies had a retrospective design with a small sample size, and outcome measurement was often subjective. CONCLUSIONS: Oral ß-blockers could be an effective treatment option for patients with rosacea with facial erythema and flushing that does not respond to conventional therapy. Larger prospective trials with objective outcome assessment are needed to validate the promising results of these studies.

Anatomical site variation of water content in human skin measured by the Epsilon: A pilot study.

BACKGROUND: This pilot study aimed to investigate the anatomical site variation of water content of the stratum corneum (SC) on the body by measuring skin capacitance with the Epsilon, a new generation corneometer with multiple sensors. Secondly, values of the Epsilon were compared to values measured by conventional single sensor corneometers. METHODS: The hydration status of SC was measured in 15 healthy Caucasian volunteers with the Epsilon at five body sites (cheek, lower forearm, mid-calf, lower back and abdomen). Transepidermal water loss (TEWL) was measured with the Aquaflux to get more insight into the condition of the skin barrier. A literature search was performed to compare Epsilon values with conventional corneometers. RESULTS: The tested anatomical locations showed significant differences in water content (P < 0.001) with large interindividual variations; highest values were found in the cheek (11.64ε) and lowest values in the mid-calf (4.43ε). No correlation between water content and TEWL was found. In general, Epsilon values were lower compared to values of conventional corneometers, with a similar trend. CONCLUSION: This pilot study showed significant variations in water content at different skin locations measured by the Epsilon. Moreover, the Epsilon measured consistent lower values compared to single sensor corneometers. Further validation of the device is recommended.