Skip to main content
SpringerLink
Log in

Rosacea Therapy

  • Chapter
  • First Online:
Plewig and Kligman´s Acne and Rosacea

  • 1563 Accesses

Abstract

Avoidance of rosacea trigger factors and appropriate skin care such as sunscreens and moisturizing agents are important first steps for rosacea treatment and prevention. Pharmacologic interventions range from topical to systemic medications, with the ideal medication choice dependent on the symptoms and severity of each individual patient. The endoplasmic reticulum (ER) stress model of rosacea pathogenesis (see Chap. 8) sheds new light on preventive and therapeutic interventions controlling this chronic skin disease. This chapter shows that prophylactic measures and pharmacological interventions synergize in attenuating enhanced ER stress of rosacea skin.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  • Akamatsu H, Komura J, Asada Y, et al. Inhibitory effect of azelaic acid on neutrophil functions: a possible cause for its efficacy in treating pathogenetically unrelated diseases. Arch Dermatol Res. 1991;283:162–6.

    CAS  PubMed  Google Scholar 

  • Akamatsu H, Asada M, Komura J, et al. Effect of doxycycline on the generation of reactive oxygen species: a possible mechanism of action of acne therapy with doxycycline. Acta Derm Venereol. 1992;72:178–9.

    CAS  PubMed  Google Scholar 

  • Akhyani M, Ehsani AH, Ghiasi M, Jafari AK. Comparison of efficacy of azithromycin vs. doxycycline in the treatment of rosacea: a randomized open clinical trial. Int J Dermatol. 2008;47:284–8.

    CAS  PubMed  Google Scholar 

  • Alikhan A, Kurek L, Feldman SR. The role of tetracyclines in rosacea. Am J Clin Dermatol. 2010;11:79–87.

    PubMed  Google Scholar 

  • Anderson MS, Nadkarni A, Cardwell LA, et al. Spotlight on brimonidine topical gel 0.33% for facial erythema of rosacea: safety, efficacy, and patient acceptability. Patient Prefer Adherence. 2017;11:1143–50.

    PubMed  PubMed Central  Google Scholar 

  • Arman A, Demirseren DD, Takmaz T. Treatment of ocular rosacea: comparative study of topical cyclosporine and oral doxycycline. Int J Ophthalmol. 2015;8:544–9.

    PubMed  PubMed Central  Google Scholar 

  • Bakar O, Demirçay Z, Yuksel M, et al. The effect of azithromycin on reactive oxygen species in rosacea. Clin Exp Dermatol. 2007;32:197–200.

    CAS  PubMed  Google Scholar 

  • Balakirski G, Baron JM, Megahed M. Morbus Morbihan als Sonderform der Rosazea: Einblick in die Pathogenese und neue Therapieoptionen. Hautarzt. 2013;64:884–6.

    CAS  PubMed  Google Scholar 

  • Bassi A, Campolmi P, Dindelli M, et al. Laser surgery in rhinophyma. G Ital Dermatol Venereol. 2016;151:9–16.

    PubMed  Google Scholar 

  • Borovaya A, Dombrowski Y, Zwicker S, et al. Isotretinoin therapy changes the expression of antimicrobial peptides in acne vulgaris. Arch Dermatol Res. 2014;306:689–700.

    CAS  PubMed  Google Scholar 

  • Castro ML, Franco GC, Branco-de-Almeida LS, et al. Downregulation of proteinase-activated receptor-2, interleukin-17, and other proinflammatory genes by subantimicrobial doxycycline dose in a rat periodontitis model. J Periodontol. 2016;87:203–10.

    CAS  PubMed  Google Scholar 

  • Chakraborty S, Elvezio V, Kaczocha M, et al. Presynaptic inhibition of transient receptor potential vanilloid type 1 (TRPV1) receptors by noradrenaline in nociceptive neurons. J Physiol. 2017;595:2639–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Ci X, Li H, Yu Q, et al. Avermectin exerts anti-inflammatory effect by downregulating the nuclear transcription factor kappa-B and mitogen-activated protein kinase activation pathway. Fundam Clin Pharmacol. 2009;23:449–55.

    CAS  PubMed  Google Scholar 

  • Coda AB, Hata T, Miller J, et al. Cathelicidin, kallikrein 5, and serine protease activity is inhibited during treatment of rosacea with azelaic acid 15% gel. J Am Acad Dermatol. 2013;69:570–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Crispin MK, Hruza GJ, Kilmer SL. Lasers and energy-based devices in men. Dermatol Surg. 2017;43(Suppl 2):S176–84.

    CAS  PubMed  Google Scholar 

  • Deeks ED. Ivermectin: a review in rosacea. Am J Clin Dermatol. 2015;16:447–52.

    PubMed  Google Scholar 

  • Del Rosso JQ. Topical α-agonist therapy for persistent facial erythema of rosacea and the addition of oximetazoline to the treatment armamentarium: where are we now? J Clin Aesthet Dermatol. 2017;10:28–32.

    PubMed  PubMed Central  Google Scholar 

  • Del Rosso JQ, Webster GF, Jackson M, et al. Two randomized phase III clinical trials evaluating anti-inflammatory dose doxycycline (40-mg doxycycline, USP capsules) administered once daily for treatment of rosacea. J Am Acad Dermatol. 2007;56:791–802.

    PubMed  Google Scholar 

  • Del Rosso JQ, Thiboutot D, Gallo R, et al. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 3: a status report on systemic therapies. Cutis. 2014a;93:18–28.

    PubMed  Google Scholar 

  • Del Rosso JQ, Thiboutot D, Gallo R, et al. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 5: a guide on the management of rosacea. Cutis. 2014b;93:134–8.

    PubMed  Google Scholar 

  • Di Nardo A, Holmes AD, Muto Y, et al. Improved clinical outcome and biomarkers in adults with papulopustular rosacea treated with doxycycline modified-release capsules in a randomized trial. J Am Acad Dermatol. 2016;74:1086–92.

    PubMed  Google Scholar 

  • Dispenza MC, Wolpert EB, Gilliland KL, et al. Systemic isotretinoin therapy normalizes exaggerated TLR-2-mediated innate immune responses in acne patients. J Invest Dermatol. 2012;132:2198–205.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Doan S, Gabison E, Chiambaretta F, et al. Efficacy of azithromycin 1.5% eye drops in childhood ocular rosacea with phlyctenular blepharokeratoconjunctivitis. J Ophthalmic Inflamm Infect. 2013;3:38.

    PubMed  PubMed Central  Google Scholar 

  • Draelos ZD. Noxious sensory perceptions in patients with mild to moderate rosacea treated with azelaic acid 15% gel. Cutis. 2004;74:257–60.

    PubMed  Google Scholar 

  • El-Heis S, Buckley DA. Rosacea-like eruption due to topical pimecrolimus. Dermatol Online J. 2015;21:5.

    Google Scholar 

  • Fowler JF Jr. Combined effect of anti-inflammatory dose doxycycline (40-mg doxycycline, usp monohydrate controlled-release capsules) and metronidazole topical gel 1% in the treatment of rosacea. J Drugs Dermatol. 2007;6:641–5.

    PubMed  Google Scholar 

  • Fowler J, Jarratt M, Moore A, et al. Once-daily topical brimonidine tartrate gel 0.5% is a novel treatment for moderate to severe facial erythema of rosacea: results of two multicentre, randomized and vehicle-controlled studies. Br J Dermatol. 2012;166:633–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Fowler J Jr, Jackson M, Moore A, et al. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. 2013;2:650–6.

    Google Scholar 

  • Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2018;78:148–55.

    PubMed  Google Scholar 

  • Goetze S, Hiernickel C, Elsner P. Phototoxicity of doxycycline: a systematic review on clinical manifestations, frequency, cofactors, and prevention. Skin Pharmacol Physiol. 2017;30:76–80.

    CAS  PubMed  Google Scholar 

  • Gold LS, Papp K, Lynde C, et al. Treatment of rosacea with concomitant use of topical ivermectin 1% cream and brimonidine 0.33% gel: a randomized, vehicle-controlled study. J Drugs Dermatol. 2017;16:909–16.

    CAS  PubMed  Google Scholar 

  • Gollnick H, Blume-Peytavi U, Szabó EL, et al. Systemisches Isotretinoin in der Behandlung der Rosazea—Doxycyclin- und plazebokontrollierte, randomisierte Studie. J Dtsch Dermatol Ges. 2010;8:505–15.

    PubMed  Google Scholar 

  • Gonser LI, Gonser CE, Deuter C, et al. Systemic therapy of ocular and cutaneous rosacea in children. J Eur Acad Dermatol Venereol. 2017;31:1732–8.

    CAS  PubMed  Google Scholar 

  • Hofmann MA, Lehmann P. Physikalische Methoden zur Behandlung der Rosazea. J Dtsch Dermatol Ges. 2016;14(Suppl 6):38–43.

    PubMed  Google Scholar 

  • Holmes AD, Waite KA, Chen MC, et al. Dermatological adverse events associated with topical brimonidine gel 0.33% in subjects with erythema of rosacea: a retrospective review of clinical studies. J Clin Aesthet Dermatol. 2015;8:29–35.

    PubMed  PubMed Central  Google Scholar 

  • Hoover RM, Erramouspe J. Role of topical oxymetazoline for management of erythematotelangiectatic rosacea. Ann Pharmacother. 2018;52:263–7.

    CAS  PubMed  Google Scholar 

  • Hoyt JC, Ballering J, Numanami H, et al. Doxycycline modulates nitric oxide production in murine lung epithelial cells. J Immunol. 2006;176:567–72.

    CAS  PubMed  Google Scholar 

  • Hsu CC, Lee JY. Carvedilol for the treatment of refractory facial flushing and persistent erythema of rosacea. Arch Dermatol. 2011;147:1258–60.

    PubMed  Google Scholar 

  • Hu SW, Robinson M, Meehan SA, Cohen DE. Morbihan disease. Dermatol Online J. 2012;18:27.

    PubMed  Google Scholar 

  • Ilkovitch D, Pomerantz RG. Brimonidine effective but may lead to significant rebound erythema. J Am Acad Dermatol. 2014;70:e109–10.

    PubMed  Google Scholar 

  • Iovieno A, Lambiase A, Micera A, et al. In vivo characterization of doxycycline effects on tear metalloproteinases in patients with chronic blepharitis. Eur J Ophthalmol. 2009;19:708–16.

    PubMed  Google Scholar 

  • Jackson JM, Knuckles M, Minni JP, et al. The role of brimonidine tartrate gel in the treatment of rosacea. Clin Cosmet Investig Dermatol. 2015;8:529–38.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Jang YH, Sim JH, Kang HY, et al. Immunohistochemical expression of matrix metalloproteinases in the granulomatous rosacea compared with the non-granulomatous rosacea. J Eur Acad Dermatol Venereol. 2011;25:544–8.

    CAS  PubMed  Google Scholar 

  • Jones DA. Rosacea, reactive oxygen species, and azelaic acid. J Clin Aesthet Dermatol. 2009;2:26–30.

    PubMed  PubMed Central  Google Scholar 

  • Kanada KN, Nakatsuji T, Gallo RL. Doxycycline indirectly inhibits proteolytic activation of tryptic kallikrein-related peptidases and activation of cathelicidin. J Invest Dermatol. 2012;132:1435–42.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kim MB, Kim GW, Park HJ, et al. Pimecrolimus 1% cream for the treatment of rosacea. J Dermatol. 2011a;38:1135–9.

    CAS  PubMed  Google Scholar 

  • Kim JH, Oh YS, Choi EH. Oral azithromycin for treatment of intractable rosacea. J Korean Med Sci. 2011b;26:694–69.

    PubMed  PubMed Central  Google Scholar 

  • Kim M, Kim J, Jeong SW, et al. Inhibition of mast cell infiltration in an LL-37-induced rosacea mouse model using topical brimonidine tartrate 0.33% gel. Exp Dermatol. 2017;26:1143–5.

    CAS  PubMed  Google Scholar 

  • Korting HC, Schöllmann C. Tetracycline actions relevant to rosacea treatment. Skin Pharmacol Physiol. 2009a;22:287–94.

    CAS  PubMed  Google Scholar 

  • Korting HC, Schöllmann C. Current topical and systemic approaches to treatment of rosacea. J Eur Acad Dermatol Venereol. 2009b;23:876–82.

    CAS  PubMed  Google Scholar 

  • Layton AM, Schaller M, Homey B, et al. Brimonidine gel 0.33% rapidly improves patient-reported outcomes by controlling facial erythema of rosacea: a randomized, double-blind, vehicle-controlled study. J Eur Acad Dermatol Venereol. 2015;29:2405–10.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Liu PT, Krutzik SR, Kim J, Modlin RL. Cutting edge: all-trans retinoic acid down-regulates TLR2 expression and function. J Immunol. 2005;174:2467–70.

    CAS  PubMed  Google Scholar 

  • Liu RH, Smith MK, Basta SA, Farmer ER. Azelaic acid in the treatment of papulopustular rosacea: a systematic review of randomized controlled trials. Arch Dermatol. 2006;142:1047–52.

    CAS  PubMed  Google Scholar 

  • Longo CM, Adam AP, Wladis EJ. Rosacea and the eye: a recent review. Expert Rev Ophthalmol. 2018;13:57–64.

    CAS  Google Scholar 

  • Lowe NJ. Use of topical metronidazole in moderate to severe rosacea. Adv Ther. 2003;20:177–90.

    CAS  PubMed  Google Scholar 

  • Lowe E, Lim S. Paradoxical erythema reaction of long-term topical brimonidine gel for the treatment of facial erythema of rosacea. J Drugs Dermatol. 2016;15:763–5.

    PubMed  Google Scholar 

  • Maddin S. A comparison of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea. J Am Acad Dermatol. 1999;40:961–5.

    CAS  PubMed  Google Scholar 

  • Mantelli F, Di Zazzo A, Sacchetti M, et al. Topical azithromycin as a novel treatment for ocular rosacea. Ocul Immunol Inflamm. 2013;21:371–7.

    CAS  PubMed  Google Scholar 

  • Melnik BC. Endoplasmic reticulum stress: key promoter of rosacea pathogenesis. Exp Dermatol. 2014;23:868–73.

    CAS  PubMed  Google Scholar 

  • Melnik BC. Rosacea: the blessing of the Celts—an approach to pathogenesis through translational research. Acta Derm Venereol. 2016;96:147–56.

    CAS  PubMed  Google Scholar 

  • Micali G, Gerber PA, Lacarrubba F, Schäfer G. Improving treatment of erythematotelangiectatic rosacea with laser and/or topical therapy through enhanced discrimination of its clinical features. J Clin Aesthet Dermatol. 2016;9:30–9.

    PubMed  PubMed Central  Google Scholar 

  • Mizoguchi S, Iwanishi H, Arita R, et al. Ocular surface inflammation impairs structure and function of meibomian gland. Exp Eye Res. 2017;163:78–84.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Modi S, Harting M, Rosen T. Azithromycin as an alternative rosacea therapy when tetracyclines prove problematic. J Drugs Dermatol. 2008;7:898–9.

    PubMed  Google Scholar 

  • Monk E, Shalita A, Siegel DM. Clinical applications of non-antimicrobial tetracyclines in dermatology. Pharmacol Res. 2011;63:130–45.

    CAS  PubMed  Google Scholar 

  • Morizane S, Yamasaki K, Kabigting FD, Gallo RL. Kallikrein expression and cathelicidin processing are independently controlled in keratinocytes by calcium, vitamin D(3), and retinoic acid. J Invest Dermatol. 2010;130:1297–306.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Narayanan S, Hünerbein A, Getie M, et al. Scavenging properties of metronidazole on free oxygen radicals in a skin lipid model system. J Pharm Pharmacol. 2007;59:1125–30.

    CAS  PubMed  Google Scholar 

  • Nikolowski J, Plewig G. Orale Behandlung der Rosazea mit 13-cis-Retinsäure. Hautarzt. 1981;32:575–84.

    CAS  PubMed  Google Scholar 

  • Ong HS, Patel KV, Dart JK, Praestegaard M. Topical cyclosporin A as a steroid-sparing agent for ocular rosacea. Acta Ophthalmol. 2017;95:e158–9.

    CAS  PubMed  Google Scholar 

  • Patel NU, Shukla S, Zaki J, Feldman SR. Oxymetazoline hydrochloride cream for facial erythema associated with rosacea. Expert Rev Clin Pharmacol. 2017;10:1049–54.

    CAS  PubMed  Google Scholar 

  • Pfeffer I, Borelli C, Zierhut M, Schaller M. Behandlung der Ophthalmo-Rosazea mit 40 mg Doxycyclin in teilretardierter Form. J Dtsch Dermatol Ges. 2011;9:904–7.

    PubMed  Google Scholar 

  • Pietschke K, Schaller M. Long-term management of distinct facial flushing and persistent erythema of rosacea by treatment with carvedilol. J Dermatolog Treat. 2018;29:310–3.

    CAS  PubMed  Google Scholar 

  • Rademaker M. Very low-dose isotretinoin in mild to moderate papulopustular rosacea; a retrospective review of 52 patients. Australas J Dermatol. 2018;59:26–30.

    PubMed  Google Scholar 

  • Reinholz M, Tietze JK, Kilian K, et al. Rosacea—S1 guideline. J Dtsch Dermatol Ges. 2013;11:768–80.

    PubMed  Google Scholar 

  • Sanchez J, Somolinos AL, Almodóvar PI, et al. A randomized, double-blind, placebo-controlled trial of the combined effect of doxycycline hyclate 20-mg tablets and metronidazole 0.75% topical lotion in the treatment of rosacea. J Am Acad Dermatol. 2005;53:791–7.

    PubMed  Google Scholar 

  • Santos CX, Tanaka LY, Wosniak J, Laurindo FR. Mechanisms and implications of reactive oxygen species generation during the unfolded protein response: roles of endoplasmic reticulum oxidoreductases, mitochondrial electron transport, and NADPH oxidase. Antioxid Redox Signal. 2009;11:2409–27.

    CAS  PubMed  Google Scholar 

  • Schaller M, Dirschka T, Kemény L, et al. Superior efficacy with ivermectin 1% cream compared to metronidazole 0.75% cream contributes to a better quality of life in patients with severe papulopustular rosacea: a subanalysis of the randomized, investigator-blinded ATTRACT study. Dermatol Ther (Heidelb). 2016;6:427–36.

    Google Scholar 

  • Schaller M, Gonser L, Belge K, et al. Dual anti-inflammatory and anti-parasitic action of topical ivermectin 1% in papulopustular rosacea. J Eur Acad Dermatol Venereol. 2017;31:1907–11.

    CAS  PubMed  Google Scholar 

  • Schechter BA, Katz RS, Friedman LS. Efficacy of topical cyclosporine for the treatment of ocular rosacea. Adv Ther. 2009;26:651–9.

    CAS  PubMed  Google Scholar 

  • Schweinzer K, Kofler L, Spott C, et al. Surgical treatment of rhinophyma: experience from a German cohort of 70 patients. Eur J Dermatol. 2017;27:281–5.

    PubMed  Google Scholar 

  • Siddiqui K, Stein Gold L, Gill J. The efficacy, safety, and tolerability of ivermectin compared with current topical treatments for the inflammatory lesions of rosacea: a network meta-analysis. Springerplus. 2016;5:1151.

    PubMed  PubMed Central  Google Scholar 

  • Sobolewska B, Doycheva D, Deuter C, et al. Treatment of ocular rosacea with once-daily low-dose doxycycline. Cornea. 2014;33:257–60.

    PubMed  Google Scholar 

  • Steinhoff M, Schmelz M, Schauber J. Facial erythema of rosacea—aetiology, different pathophysiologies and treatment options. Acta Derm Venereol. 2016a;96:579–86.

    CAS  PubMed  Google Scholar 

  • Steinhoff M, Vocanson M, Voegel JJ, et al. Topical ivermectin 10 mg/g and oral doxycycline 40 mg modified-release: current evidence on the complementary use of anti-inflammatory rosacea treatments. Adv Ther. 2016b;33:1481–501.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Strand M, Bergqvist G, Griffith S, Bergqvist E. The effect of recurrent pulsed dye laser treatments in rosacea patients. J Cosmet Laser Ther. 2017;19:160–4.

    PubMed  Google Scholar 

  • Taieb A, Ortonne JP, Ruzicka T, et al. Superiority of ivermectin 1% cream over metronidazole 0.75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial. Br J Dermatol. 2015;172:1103–10.

    CAS  PubMed  Google Scholar 

  • Teraki Y, Hitomi K, Sato Y, Izaki S. Tacrolimus-induced rosacea-like dermatitis: a clinical analysis of 16 cases associated with tacrolimus ointment application. Dermatology. 2012;224:309–14.

    CAS  PubMed  Google Scholar 

  • Thibaut de Ménonville S, Rosignoli C, Soares E, et al. Topical treatment of rosacea with ivermectin inhibits gene expression of cathelicidin innate immune mediators, LL-37 and KLK5, in reconstructed and ex vivo skin models. Dermatol Ther (Heidelb). 2017;7:213–25.

    Google Scholar 

  • Thiboutot DM, Fleischer AB, Del Rosso JQ, Rich P. A multicenter study of topical azelaic acid 15% gel in combination with oral doxycycline as initial therapy and azelaic acid 15% gel as maintenance monotherapy. J Drugs Dermatol. 2009;8:639–48.

    PubMed  Google Scholar 

  • Tong LX, Moore AY. Brimonidine tartrate for the treatment of facial flushing and erythema in rosacea. Expert Rev Clin Pharmacol. 2014;7:567–77.

    CAS  PubMed  Google Scholar 

  • Two AM, Wu W, Gallo RL, Hata TR. Rosacea: part II. Topical and systemic therapies in the treatment of rosacea. J Am Acad Dermatol. 2015;72:761–70.

    PubMed  Google Scholar 

  • van der Linden MMD, van Ratingen AR, van Rappard DC, et al. DOMINO, doxycycline 40 mg vs. minocycline 100 mg in the treatment of rosacea: a randomized, single-blinded, noninferiority trial, comparing efficacy and safety. Br J Dermatol. 2017;176:1465–74.

    PubMed  Google Scholar 

  • van Zuuren EJ, Fedorowicz Z, Carter B, et al. Interventions for rosacea. Cochrane Database Syst Rev. 2015;(4):CD003262.

    Google Scholar 

  • Webster G, Schaller M. Ocular rosacea: a dermatologic perspective. J Am Acad Dermatol. 2013;69(6 Suppl 1):S42–3.

    PubMed  Google Scholar 

  • Wirth PJ, Henderson Berg MH, Sadick N. Real-world efficacy of azelaic acid 15% gel for the reduction of inflammatory lesions of rosacea. Skin Therapy Lett. 2017;22:5–7.

    CAS  PubMed  Google Scholar 

  • Wolf JE Jr, Del Rosso JQ. The CLEAR trial: results of a large community-based study of metronidazole gel in rosacea. Cutis. 2007;79:73–80.

    PubMed  Google Scholar 

  • Wolf JE Jr, Kerrouche N, Arsonnaud S. Efficacy and safety of once-daily metronidazole 1% gel compared with twice-daily azelaic acid 15% gel in the treatment of rosacea. Cutis. 2006;77(4 Suppl):3–11.

    PubMed  Google Scholar 

  • Yamasaki K, Kanada K, Macleod DT, et al. TLR2 expression is increased in rosacea and stimulates enhanced serine protease production by keratinocytes. J Invest Dermatol. 2011;131:688–97.

    CAS  PubMed  Google Scholar 

  • Zhang X, Song Y, Xiong H, et al. Inhibitory effects of ivermectin on nitric oxide and prostaglandin E2 production in LPS-stimulated RAW 264.7 macrophages. Int Immunopharmacol. 2009;9:354–9.

    CAS  PubMed  Google Scholar 

  • Zhang L, Su Z, Zhang Z, et al. Effects of azithromycin on gene expression profiles of proinflammatory and anti-inflammatory mediators in the eyelid margin and conjunctiva of patients with meibomian gland disease. JAMA Ophthalmol. 2015;133:1117–23.

    PubMed  PubMed Central  Google Scholar 

  • Zip CM. Innovative use of topical metronidazole. Dermatol Clin. 2010;28:525–34.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology and Allergy, Ludwig-Maximilian-University Munich, Munich, Germany

    Gerd Plewig

  2. Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany

    Bodo Melnik

  3. Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany

    WenChieh Chen

Authors
  1. Gerd Plewig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bodo Melnik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. WenChieh Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Plewig, G., Melnik, B., Chen, W. (2019). Rosacea Therapy. In: Plewig and Kligman´s Acne and Rosacea. Springer, Cham. https://doi.org/10.1007/978-3-319-49274-2_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-49274-2_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49273-5

  • Online ISBN: 978-3-319-49274-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation