Location
Philadelphia, PA
Start Date
1-5-2024 1:00 PM
End Date
1-5-2024 4:00 PM
Description
Rosacea is a chronic inflammatory skin condition that affects the face and presents in many forms, including pustules, papules, painful erythema, edema, and more. The pathogenesis of rosacea is largely undetermined, but general mechanisms include immune dysregulation, neurovascular reactivity, skin barrier dysfunction and demodex infestation, genetics, and certain environmental triggers. Rosacea is commonly exacerbated during pregnancy, but the lack of treatments that are safe for a developing fetus poses a problem for patients and their physicians. The go-to treatment for rosacea consists of a variety of topical and oral antibiotics and anti-inflammatory medications that are typically not recommended for use during pregnancy. Treatment for these patients may be overlooked by physicians at the time of pregnancy, but many of these patients suffer from emotional distress as a result of their rosacea.
A literature review was conducted in order to provide an update on which methods are the most safe and effective for pregnant patients. A search was performed on databases including PubMed and EMBASE using the keywords rosacea, pregnancy, treatment, holistic, edema, and osteopathic manipulative treatment (OMT). A total of 113 papers were extracted and screened to determine eligibility based on inclusion and exclusion criteria, and 24 papers were used for the purposes of the review.
Study participants were found to present with rosacea fulminans (RF) and rosacea-associated edema. Treatment options varied, including antibiotics, steroids, over-the-counter topical antiseptic, wet compresses, and osteopathic manipulative therapy. Of the patients who were pregnant, some complications were noted, including fever, malaise, gestational diabetes, ocular perforation, corneal transplant, required hormonal stimulation, fetal arrhythmia, oligohydramnios, and even intrauterine death. Some patients even elected for termination of pregnancy due to anxiety and depression as a result of their rosacea. It is expected that some of these complications were the result of chance, while others may have been due to the medications that were prescribed to patients for their rosacea during pregnancy.
The emotional distress these patients faced, as well as the physical harm to themselves and their babies, confirms the need for a more holistic approach to treating rosacea during pregnancy. It was concluded that a combination of pregnancy-safe over-the-counter or prescription drugs, in combination with osteopathic manipulative therapy or other holistic management, would be the most effective approach. A variety of oral and topical antibiotics, as well as steroids, were ascertained to be safe for use during pregnancy as long as the physician determines that the benefits will outweigh the potential harm. However, many of the prescription drugs used by the patients in this review are not considered safe for use during pregnancy and should be avoided. OMT serves as a unique, sustainable, and adjunctive treatment approach to pregnant patients with exacerbated skin disease that can be used to specifically reduce rosacea-associated edema. For patients who do not present with edema, other holistic management, including heating pads and blue light therapy, may be effective alternatives for rosacea treatment.
Embargo Period
7-11-2024
Included in
Treatment of rosacea during pregnancy: A literature review
Philadelphia, PA
Rosacea is a chronic inflammatory skin condition that affects the face and presents in many forms, including pustules, papules, painful erythema, edema, and more. The pathogenesis of rosacea is largely undetermined, but general mechanisms include immune dysregulation, neurovascular reactivity, skin barrier dysfunction and demodex infestation, genetics, and certain environmental triggers. Rosacea is commonly exacerbated during pregnancy, but the lack of treatments that are safe for a developing fetus poses a problem for patients and their physicians. The go-to treatment for rosacea consists of a variety of topical and oral antibiotics and anti-inflammatory medications that are typically not recommended for use during pregnancy. Treatment for these patients may be overlooked by physicians at the time of pregnancy, but many of these patients suffer from emotional distress as a result of their rosacea.
A literature review was conducted in order to provide an update on which methods are the most safe and effective for pregnant patients. A search was performed on databases including PubMed and EMBASE using the keywords rosacea, pregnancy, treatment, holistic, edema, and osteopathic manipulative treatment (OMT). A total of 113 papers were extracted and screened to determine eligibility based on inclusion and exclusion criteria, and 24 papers were used for the purposes of the review.
Study participants were found to present with rosacea fulminans (RF) and rosacea-associated edema. Treatment options varied, including antibiotics, steroids, over-the-counter topical antiseptic, wet compresses, and osteopathic manipulative therapy. Of the patients who were pregnant, some complications were noted, including fever, malaise, gestational diabetes, ocular perforation, corneal transplant, required hormonal stimulation, fetal arrhythmia, oligohydramnios, and even intrauterine death. Some patients even elected for termination of pregnancy due to anxiety and depression as a result of their rosacea. It is expected that some of these complications were the result of chance, while others may have been due to the medications that were prescribed to patients for their rosacea during pregnancy.
The emotional distress these patients faced, as well as the physical harm to themselves and their babies, confirms the need for a more holistic approach to treating rosacea during pregnancy. It was concluded that a combination of pregnancy-safe over-the-counter or prescription drugs, in combination with osteopathic manipulative therapy or other holistic management, would be the most effective approach. A variety of oral and topical antibiotics, as well as steroids, were ascertained to be safe for use during pregnancy as long as the physician determines that the benefits will outweigh the potential harm. However, many of the prescription drugs used by the patients in this review are not considered safe for use during pregnancy and should be avoided. OMT serves as a unique, sustainable, and adjunctive treatment approach to pregnant patients with exacerbated skin disease that can be used to specifically reduce rosacea-associated edema. For patients who do not present with edema, other holistic management, including heating pads and blue light therapy, may be effective alternatives for rosacea treatment.