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Topical Treatment for Rosacea

There are 3 main forms of topical treatment that are used for rosacea.

1) Topical Metronidazole:
In Rosacea it reduces the inflammatory papules and pustules and has little or no effect on the flushing or vascular component of the disease. It has been shown to reduce the papules and pustules by about 65% over a nine-week course. The Metrogel formulation may have increased penetration into the skin but may also cause some stinging. Topical treatment is one way of avoiding oral antibiotics but in very inflammed cases oral treatment may be required initially.

Brands available:
• Metrogel 0.75%
• Metrocream 0.75%
• Metrolotion 0.75%
• Noritate 1%
• Rosasol 1% plus sunscreen

2) Sodium Sulfacetamide:
Sodium Sulfacetamide is a sulfonamide antibiotic that competes with para-aminbenzoic acid. Sulfur has a keratolytic action, and is believed to an anti-inflammatory effect.

Brands available:
• Klaron®
• Sulfacet-R®
• Novacet®

3) Azelaic Acid:
It is of benefit in reducing pigment formation in the skin by its anti-tyrosinase action in hyperactive melanocytes. It therefore is useful in the treatment of melasma. The activity against Proprionibacteria acnes and Staphyloccocus epidermidis makes it active in the treatment of acne and rosacea. It appears to inhibit bacterial protein synthesis. It has mild anti-comodone action. The anti-inflammatory properties are a result of its oxy radical scavenging action.

Brands available:
• Azelex® 20% cream 30, 50 gms (Allergan)
• Skinoren® (Shering AG)
• Finnevin® (Berlex)