What is the role of metronidazole and retinoids in the treatment of rosacea?

Updated: Aug 14, 2018
  • Author: Agnieszka Kupiec Banasikowska, MD; Chief Editor: William D James, MD  more...
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Answer

Topical metronidazole is commonly used as a first-line agent. Topical azelaic acid, sulfacetamide products, and topical acne medications are also commonly used. Topical and oral antibiotics are also very effective, and for oral rosacea, they are usually considered as a first-line therapy.  In many cases, oral and topical antibiotics are used in combination; the oral treatment may be eventually withdrawn and the topical treatment is used alone as maintenance therapy. However, in patients with ocular involvement, oral therapy needs to be maintained. In patients who require a systemic antibiotic, evidence suggests that the newer regimen of 20-50 mg q12h of doxycycline is as effective as the older regimen of 100 mg of doxycycline [18] For many patients, this could represent a significant cost reduction.

Retinoids are advocated by some authorities. [19, 20, 21]


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