A double-blind study of 1% metronidazole cream versus systemic oxytetracycline therapy for rosacea

Nielsen, P. Gamborg

doi:10.1111/j.1365-2133.1983.tb03993.x

Cited by 85 publications

(36 citation statements)

References 3 publications

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“…Since no change occurred in telangiectasia and rhinophyma, we thought that permethrin 5% cream and metronidazole 0.75% gel had no effect on telangiectasia and rhinophyma and, therefore, did not make any statistical analysis of telangiectasia and rhinophyma scores. Our finding that metronidazole 0.75% gel did not have any effect on telangiectasia and rhinophyma was consistent with the results of previous studies [4, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29]. …”

Section: Discussionsupporting

confidence: 83%

Permethrin 5% Cream versus Metronidazole 0.75% Gel for the Treatment of Papulopustular Rosacea

et al. 2002

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Background: Permethrin 5% cream used against human ectoparasites suggests that it may be effective in papulopustular rosacea. Methods: This study included 63 patients diagnosed as having papulopustular rosacea based on the clinical and histological findings. Patients were randomly assigned into permethrin (n = 23), metronidazole (n = 20) and placebo (n = 20) groups. Scores of erythema, telangiectasia, edema and rhinophyma and the numbers of papules, pustules, inflammatory nodules and Demodex folliculorum were determined. Twenty-three patients were given permethrin 5% cream (Zalvor 5% skin cream^®), 20 patients metronidazole 0.75% gel (Roza gel^®) and 20 patients placebo cream (Basis cream^®), in packages looking identical to those of metronidazole and permethrin creams, and were recommended to apply them to their faces twice a day. All patients were also given SPF 20 cream for protection against sunlight. Two months of treatment were planned, and the patients were invited to the clinic for fortnightly controls. Scores of erythema, telangiectasia, edema and rhinophyma and the numbers of papules, pustules, inflammatory nodules and D. folliculorum were recorded at each visit. The mean scores of erythema and the mean numbers of papules, pustules and D. folliculorum were determined at baseline and on days 15, 30, 45 and 60. Side effects were also detected. Results: The effect of permethrin 5% cream on D. folliculorum was superior to that of metronidazole 0.75% gel. The effect of permethrin 5% cream on erythema and papules was found to be more effective than placebo and as effective as metronidazole 0.75% gel. However, it had no effect on telangiectasia, rhinophyma and pustules. Conclusion: It can be concluded that the application of permethrin 5% cream twice daily for 2 months can be as effective and reliable as metronidazole in the treatment of rosacea and a greater benefit can be gained when it is combined with other systemic and/or topical treatments.

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Section: Discussionsupporting

confidence: 83%

Permethrin 5% Cream versus Metronidazole 0.75% Gel for the Treatment of Papulopustular Rosacea

et al. 2002

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“…Metronidazole also reduced erythema scores significantly compared with placebo in patients with rosacea [66]. Topical metronidazole therapy was as effective as oral tetracycline in reducing the number of inflammatory lesions and the degree of erythema in patients with mild to severe rosacea treated for 8–9 weeks [71]. Metronidazole gel was more effective than placebo in maintaining remission in patients with rosacea [72].…”

Section: Topical Therapymentioning

confidence: 99%

Rosacea: An Update

Buechner¹

2005

Dermatology

119

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Rosacea is a common chronic cutaneous disorder of unknown etiology which occurs most commonly in middle-aged individuals. Cutaneous manifestations include transient or persistent facial erythema, telangiectasia, edema, papules and pustules that are usually confined to the central portion of the face. The National Rosacea Society’s Expert Committee on the Classification and Staging of Rosacea identified four subtypes of rosacea: erythematotelangiectatic, papulopustular, phymatous and ocular. Recently, a standard grading system for assessing gradations of the severity of rosacea has been reported. Little is known about the cause of rosacea. Genetic, environmental, vascular, inflammatory factors and microorganisms such as Demodex folliculorum and Helicobacter pylori have been considered. Topical metronidazole and azelaic acid have been demonstrated to be effective treatments for rosacea. Severer or persistent cases may be treated with oral metronidazole, tetracyclines or isotretinoin.

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“…70) It is therefore considered that the potential for drug related systemic side effects following topical application of metronidazole is extremely low. 8,61,64) In our study, we did not observe any systemic side effects in any of patients following 6 weeks of treatment, indicating that the metronidazole was not absorbed through the skin sufficient to cause systemic side effects, which is a desired condition for topically applied drugs.…”

Section: Discussionmentioning

confidence: 83%

“…6,7) Topical application of metronidazole was shown to be as effective as systemic antibiotic therapy. 8,9) Metronidazole is particularly effective against papules and pustules and is a well-tolerated alternative to oral antibacterials. The exact mechanism by which topical metronidazole reduces inflammatory lesions and erythema in rosacea is unknown; it is suggested that its anti-inflammatory effect may be due to its antioxidant action.…”

mentioning

confidence: 99%

Preparation and Evaluation of Topical Microemulsion System Containing Metronidazole for Remission in Rosacea

et al. 2012

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The aim of this study was to prepare a topical water-in-oil type microemulsion containing metronidazole and to compare its effectiveness with a commercial gel product in the treatment of rosacea. A pseudoternary phase diagram (K m 2 : 1) was constructed using lecithin/butanol/isopropyl myristate/water. The microemulsion was chosen from the microemulsion region in the phase diagram. The formulation was a water-in-oil type microemulsion (droplet size: 11.6 nm, viscosity: 457.3 mPa·s, conductivity: 1.5 µs/cm, turbidity: 6.89 NTU) and the addition of the metronidazole did not alter the properties of the system. The release experiment showed that the release rate of metronidazole from the commercial gel product was higher than that of the microemulsion. Stability experiments showed that the metronidazole microemulsion remained stable for at least 6 months; none of the characteristic properties of the microemulsion had changed, the system retained its clarity and there was no sign that crystallization of metronidazole has occurred. Microemulsion was compared to a gel product in a randomized, double-blind, baseline-controlled, split-face clinical trial for the treatment of patients. After the 6-week treatment period there was a statistically significant difference in reduction of the main symptoms of rosacea. Of the patients treated with the microemulsion, 17% experienced complete relief from inflammatory lesions, and 50% from erythema. The microemulsion resulted in complete relief in 38% of the patients with telangiectasia while the commercial product did not provide any relief of telangiectasia symptoms. In conclusion, the microemulsion containing metronidazole was found to be more effective in reducing the symptoms of rosacea compared to the commercial gel product. Key words microemulsion; metronidazole; rosaceaRosacea is a chronic skin disorder of unknown etiology that is more common in women than men.

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A double-blind study of 1% metronidazole cream versus systemic oxytetracycline therapy for rosacea

Cited by 85 publications

References 3 publications

Permethrin 5% Cream versus Metronidazole 0.75% Gel for the Treatment of Papulopustular Rosacea

Permethrin 5% Cream versus Metronidazole 0.75% Gel for the Treatment of Papulopustular Rosacea

Rosacea: An Update

Preparation and Evaluation of Topical Microemulsion System Containing Metronidazole for Remission in Rosacea

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