From the Guidelines
Compounded creams for rosacea are customized topical medications prepared by pharmacists that combine multiple active ingredients, such as metronidazole, to address the specific symptoms and severity of a patient's rosacea. These creams typically contain a combination of anti-inflammatory agents, antibiotics, and other ingredients such as niacinamide or azelaic acid. The advantage of compounded creams is their ability to be tailored to individual needs, potentially combining treatments that would otherwise require multiple separate products. According to a recent review of the current treatment landscape for rosacea, metronidazole has been a mainstay of topical rosacea therapy for several decades, with formulations of 0.75% and 1.0% being well studied in more than 500 patients 1. Common formulations might include metronidazole 1% with niacinamide 4%, or ivermectin 1% with azelaic acid 15%. These creams are typically applied once or twice daily to affected areas for several weeks to months. Patients should be aware that compounded medications aren't FDA-approved as combined formulations, though individual ingredients may be. They work by reducing inflammation, controlling skin microbes that may trigger flares, strengthening the skin barrier, and reducing redness and pustules associated with rosacea. Key benefits of compounded creams include:
- Customization to individual patient needs
- Potential for combining treatments that would otherwise require multiple separate products
- Reduction of inflammation and control of skin microbes
- Strengthening of the skin barrier and reduction of redness and pustules associated with rosacea, as supported by studies on metronidazole 1.
From the Research
Definition of Compounded Creams for Rosacea
- Compounded creams for rosacea are customized topical formulations prepared by a pharmacist to address the specific needs of a patient with rosacea.
- These creams can combine various ingredients, such as azelaic acid, metronidazole, and sulfacetamide/sulfur, in concentrations tailored to the individual's skin type and condition 2, 3, 4, 5.
- The goal of compounded creams is to reduce symptoms of rosacea, including erythema, papules, pustules, and telangiectasias, while minimizing potential side effects and improving skin tolerability.
Key Ingredients in Compounded Creams for Rosacea
- Azelaic acid: a topical agent effective in reducing inflammatory lesions and erythema 2, 3, 4, 5.
- Metronidazole: an antibiotic commonly used in topical formulations to treat rosacea, particularly for its anti-inflammatory properties 2, 3, 4, 6, 5.
- Sulfacetamide/sulfur: a combination of ingredients used to reduce sebum production, inflammation, and bacterial growth on the skin 2, 3, 4, 5.