J Am Acad Dermatol 40:6 Pt 1 961-5, 1999 Jun
BACKGROUND: Although it is important for physicians to have sufficientclinical data on which to base treatment decisions, little comparativedata exist regarding newer treatment modalities for rosacea. OBJECTIVE: The goal of the study was to compare the efficacy and safetyof topical azelaic acid 20% cream and topical metronidazole 0.75% creamin the treatment of patients with papulopustular rosacea. Parameters ofpatient satisfaction to treatment were also assessed.
METHODS: Forty patients with the clinical manifestation of symmetricfacial rosacea were investigated in this single-center, double-blind,randomized, contralateral split-face comparison clinical trial.
RESULTS: After 15 weeks of treatment, both azelaic acid andmetronidazole induced significant, albeit equal reductions in thenumber of inflammatory lesions (pustules and papules). A significantlyhigher physician rating of global improvement was achieved with azelaicacid. Changes in the rosacea signs and symptoms of dryness, burning,telangiectasia, and itching were equal between treatments. Areduction in erythema tended toward significance with azelaic acid atweek 15. A trace amount of stinging on application was noted withazelaic acid; however, such discomfort did not appear to concernpatients because their overall impression of azelaic acid was superiorto that of metronidazole.
CONCLUSION: Azelaic acid 20% cream provides an effective and safealternative to metronidazole 0.75% cream with the added benefit ofincreased patient satisfaction.
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