Rosacea is a chronic inflammatory dermatosis characterized by transient erythema, papules and/or pustules, telangiectasias, phimatous changes and such subjective symptoms as itching and burning. In 2017, a phenotypic approach to the diagnosis and classification of the disease was recommended by the American National Society for Rosacea. The treatment options for patients with rosacea have undergone some changes with recommendation update. The effective treatment of rosacea is achieved by using various combinations of drugs and techniques, however, one cannot ignore the provoking exogenous factors and comorbid conditions. Rosacea is considered a dermatological disorder but evidence is accumulating that there is a significant association between rosacea and systemic physical disease. In this review, we summarize new scientific data on the pathogenesis of the disease, in particular on the role of pro-inflammatory neuropeptides, the combination of a number of somatic pathologies with rosacea severity. The data of Russian and foreign literature on the rosacea treatment with an emphasis on local therapy taking into account specific subtypes of dermatosis as well as drugs used both for monotherapy and combination are described. The role of azelaic acid in topical therapy of rosacea and its combination with other therapeutic regimens, efficacy, and safety in various disease subtypes are discussed.