From the Guidelines
Metronidazole is a suitable alternative treatment option for retinol in treating rosacea, particularly for reducing inflammatory lesions and perilesional erythema. According to a recent review of the current treatment landscape for rosacea, metronidazole 0.75% and 1.0% formulations have been well studied in more than 500 patients and have demonstrated efficacy in reducing inflammatory lesions and erythema associated with rosacea 1. The study found that metronidazole produced a 65% decrease in inflammatory lesion counts compared with a 15% reduction for vehicle, with improvement noted as early as 3 weeks 1. Key benefits of metronidazole include:
- Effective in reducing inflammatory lesions and perilesional erythema
- Available in two strengths: 0.75% and 1.0%
- Can be used once daily, with both strengths being equally effective 1
- Long-term efficacy and safety have been confirmed in a 6-month double-blind placebo-controlled study 1 Other potential alternatives, such as azelaic acid, sodium sulfacetamide/sulfur preparations, or ivermectin cream, may also be considered, but metronidazole offers a well-studied and effective option for treating rosacea, especially for patients who experience irritation with retinol.
From the FDA Drug Label
After the skin is thoroughly washed and patted dry, a thin film of AZELEX® Cream should be gently but thoroughly massaged into the affected areas twice daily, in the morning and evening. The duration of use of AZELEX® Cream can vary from person to person and depends on the severity of the acne. Azelaic acid is an alternative treatment option for rosacea.
- It can be applied as a thin film to the affected areas twice daily.
- The duration of use may vary depending on the severity of the condition 2.
From the Research
Alternative Treatment Options for Retinol in Rosacea
- Azelaic acid is a potential alternative treatment option for retinol in rosacea, as it is a standard topical treatment agent for rosacea 3, 4, 5.
- Metronidazole is another alternative treatment option for retinol in rosacea, as it is a primary agent for the topical treatment of rosacea 3, 6, 4, 5.
- Sodium sulfacetamide-sulfur is also an alternative treatment option for retinol in rosacea, as it is one of the primary agents for the topical treatment of rosacea 3, 4, 5.
- Other alternative treatment options for retinol in rosacea include benzoyl peroxide, clindamycin, calcineurin inhibitors, and permethrin, although their roles in the management of rosacea are variable 3, 5.
- Topical brimonidine, oxymetazoline, ivermectin, tacrolimus, pimecrolimus, and botulinum toxin are new additions to the therapeutic armamentarium for rosacea, and may be considered as alternative treatment options for retinol 4.