More tinkering at the edges of rosacea research. This study found that applying azelaic acid 15% (finacea) to healthy skin was more irritating than metrogel (metronidazole 0.75%). There seems to be no shortage of papers that look at combinations of the available rosacea topicals.
Another relevant study from 1999 ;
“Azelaic acid (Azelex) is a new topical agent that has been approved by the U.S. Food and Drug Administration for the treatment of acne. It is available in a 20 percent cream base and appears to be safe and well tolerated. A randomized, double-blinded study showed that azelaic acid was as effective as topical metronidazole in the treatment of pustular and papular forms of rosacea and had comparable side effects”. Maddin S. A comparison of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea. Journal of the American Academy of Dermatology 1999;40(6 pt 1):961-5.
Journal of Drugs in Dermatology. 2005 Nov-Dec;4(6):727-31.
Cumulative irritation potential of metronidazole gel compared to azelaic acid gel after repeated applications to healthy skin.
Ziel K, Yelverton CB, Balkrishnan R, Feldman SR.
Center for Dermatology Research, Department of Dermatology, Wake Forest, Winston-Salem, NC, USA.
BACKGROUND: Metronidazole 0.75% gel and azelaic acid 15% gel are commonly used to treat rosacea. Irritation is a common side effect.
OBJECTIVE: To assess the cumulative irritation potential of metronidazole 0.75% gel and azelaic acid 15% gel.
METHODS: Metronidazole 0.75% gel, azelaic acid 15% gel, and a white petrolatum negative control were applied under occlusive conditions to the upper back of a total of 33 healthy subjects. There were twelve 24-hour applications (4 times a week) and three 72-hour applications on weekends during a 3-week period. Skin reactions (erythema score +/- other local reaction) were assessed within 15 to 30 minutes of removal of the products.
RESULTS: The mean cumulative irritancy index of metronidazole 0.75% gel was significantly lower than that of azelaic acid 15% gel and not significantly higher than the negative control product. There was increasing cumulative irritancy with azelaic acid; no cumulative irritancy was seen for either metronidazole or white petrolatum.
CONCLUSION: Metronidazole 0.75% gel is less irritating in sustained use than azelaic acid 15% gel.
Has any one tried AROPAX?. I suffered severe rosacea on nose and cheeks until I was placed on this drug. Its main use is as an antidepresant. I take 10mg. (1/2 tablet daily in the morning). Rosacea effective 85% in my case with slight blushing some nights. I also use Rozex in the evening. My days are blush free. D.C.
I have used Metrogel for a year and had no luck with my rosacea.
I think many people will find Rozex a less irritating alternative to metrogel. I found metrogel to be very astringent, whilst Rozex (also a metronidazole gel) has a more mild base.
I don’t find finacea too irritating but it does feel like it itches or burns slightly when first applied but this tends to settle down, particularly after moisturising.
I had a serious skin reaction to Metrogel. My face developed a crust on any area the drug touched. It was awful. I now use Finacea and it was irritating at first but that went away.