This is the most thorough evidence review of rosacea treatments available: 152 studies covering 20,944 people, each conclusion formally rated for how certain it is. High-certainty evidence backs topical brimonidine for persistent redness, and azelaic acid and ivermectin for papules and pustules. Doxycycline 40 mg and isotretinoin have moderate-to-high certainty behind them. When a review of this size and rigour reaches a high-certainty verdict, further trials are unlikely to change it much.
van Zuuren EJ, Fedorowicz Z, Tan J, et al. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol. 2019;181(1):65-79.
Read the full study ↗