Efficacy of Systemic Metronidazole in the Treatment of Rosacea

Han, Seok Hyun; Suh, Ho Seok; Choi, Yu Sung

Abstract

BACKGROUND
Recent studies have revealed that several factors including Demodex mites induce an excessive immune response and that the skin lesions seen in patients with rosacea may develop as a result of excessive inflammation. Therefore, acaricidal and anti-inflammatory treatments such as systemic metronidazole have been shown to be efficacious for rosacea.
OBJECTIVE
This study aimed to evaluate the efficacy of systemic metronidazole in the treatment of rosacea.
METHODS
A group of 39 patients diagnosed with rosacea who visited the Department of Dermatology of Ulsan University Hospital from April 2014 to July 2015 was investigated in this single-center retrospective study. Patients were treated with metronidazole 250 mg 3 times daily for 3 weeks. The response was evaluated using serial photographs of the patients. According to clinical improvement, patients were classified into an effective group and a failure group.
RESULTS
After treatment, 29 patients (74.4%) responded to systemic metronidazole treatment. Fourteen patients (48.3%) in the effective group were well controlled without recurrence for 20.1 weeks. Patients in the effective group showed a higher detection rate of Demodex mites and proportion of the papulopustular rosacea subtype than patients in the failure group.
CONCLUSION
The results of this study showed that systemic metronidazole was a tolerable and effective option for the treatment of patients with papulopustular rosacea with Demodex mites. Moreover, the early treatment of inflammatory lesions leads to an improved prognosis.