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Jrizzle

Anyone know of any roscea treatments?

I was on accutane last year and my face got really red, just my face like a reaction to the medicine. The doctor said that was normal. My neck back all over were white though I never understood it. Now I think its roscea. I'm going to the derm the 26th of this month to find out. But I would like to do a little studying up before this. If anyone can help me I would be great. And btw its just red nothing else. Like sun burnt red all the time ](*,)

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Sorry this is so long, the link gives a server error. I subscribe to an online medical journal. Here is a study they reported on rosacea treatment. I hope it helps.

A Comparison of 15% Azelaic Acid Gel and 0.75% Metronidazole Gel in the Topical Treatment of Papulopustular Rosacea: Results of a Randomized Trial

Elewski BE, Fleischer AB, Pariser DM

Archives of Dermatology. 2003;139(11):1444-1450

In this randomized clinical trial, Elewski and colleagues compared the efficacy and tolerability of 15% azelaic acid gel (Finacea) with the standard topical preparation of 0.75% metronidazole gel (MetroGel) for the treatment of papulopustular (stage 2) rosacea. This multicenter US study enrolled 251 patients with papulopustular rosacea to receive 15 weeks of topical monotherapy (n = 127 in the metronidazole gel twice-daily group vs n = 124 in the azelaic acid gel twice-daily group). Outcome measures included change in inflammatory lesion count, change in erythema and telangiectasia severity, and global-assessment scores (investigator and patient ratings).

Both treatment groups showed comparable demographics and rosacea severity. A majority of patients were white (93%-94%) and female (66%-68%). After 15 weeks of treatment, patients in the azelaic acid group showed a greater percentage decrease in inflammatory lesions (-72.7% vs -55.8%, respectively; P < .001), and erythema severity (56% improved vs 42% improved, respectively; P < .02). Both the investigator's global assessment and overall assessment of improvement (investigator and patient) showed superior results in the azelaic acid gel group. Not surprisingly, telangiectatic vessels failed to improve in either group. Of interest, improvement (erythema and lesion count variables) reached a plateau in the metronidazole gel group after 8 weeks of treatment but continued to improve throughout the 15-week treatment period in the azelaic acid group.

Both gels were well tolerated, with no significant adverse effects reported. Nevertheless, most patients reported some degree of local skin irritation (ie, burning, stinging, itching, dry skin) in the azelaic acid and metronidazole treatment groups (85% and 95%, respectively). Both gels showed comparable "cosmetic acceptability."

Comment

This randomized, controlled comparison trial showed slightly superior results in patients receiving 15% azelaic acid gel monotherapy vs 0.75% metronidazole gel. Perhaps the most impressive feature of azelaic acid gel is that it seems to yield progressive improvement for at least 15 weeks, in contrast to metronidazole, whose efficacy appeared (in this study) to plateau at 8 weeks. As with all rosacea therapies, the mechanism of action of azelaic acid is unclear. This dicarboxylic acid compound is thought to exert anti-inflammatory effects, and shows modest comedolytic and antibacterial activity in the treatment of acne vulgaris. Since rosacea features no comedones and has not been linked to any bacterial pathogens, azelaic acid may improve papulopustular rosacea mainly through its anti-inflammatory actions.

Finacea is formulated in a gel vehicle in order to optimize bioavailability of the active agent (azelaic acid). Nevertheless, it should be kept in mind that some individuals with rosacea may not tolerate this formulation -- a drawback hinted at by the high rate of local skin irritation seen in the above study with both Finacea and MetroGel. Azelaic acid is also available in a cream vehicle (Azelex or Finevin cream), and these formulations may be better tolerated in patients with sensitive skin.

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