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Azelaic acid and Metronidazole

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I already have used Azelex effectively on my forehead to treat

acne.. and was wondering if I should try it for my cea. I

already use noritate, which is like the only thing I'm currently

using that I find to be helpful with minimal side effects. Is it

possible to use azelex in conjunction with Noritate?

Adam

cea effectively treated with azelaic acid

Azelaic acid 20% cream is an effective and safe alternative to

metronidazole 0.75% cream for the treatment of chronic rosacea,

according to this double-blind, randomized study from Vancouver.

The study also found higher patient satisfaction with the results

of azelaic acid treatment.

STUDY DESIGN

The investigator enrolled 40 patients (age ³21; 29 women) at a

university-based skin care center. Patients had rosacea

characterized by persistent symmetrical erythema affecting the

cheeks. Those who were using or had used other medications for

rosacea had to undergo washout periods of 21 days (for topical

metronidazole) to 1 year (for tretinoin or isotretinoin).

Thirty-seven patients completed the study; those who discontinued

did so for reasons not related to the study treatment.

Study medications were randomly assigned to either side of the

face and applied twice daily for 15 weeks. This study design

permitted each patient to serve as his or her own control; its

disadvantage, according to the author, is the risk of crossover

contamination. To reduce this risk, patients were taught how to

prevent crossover contamination when applying the medication.

RESULTS

Both treatments achieved a similar improvement in skin dryness

and burning. A greater reduction in erythema occurred with

azelaic acid (25.5%) than with metronidazole (18.7%). Neither

treatment had a significant effect on telangiectasia or itching.

At week 15, the investigator's rating of global improvement was

marginally better for azelaic acid than for metronidazole.

Patients, however, were consistently more satisfied with azelaic

acid. Fifty-seven percent said it was more effective than

previous medications; only 21% found metronidazole so effective.

A trace amount of transient stinging on application of azelaic

acid did not reduce patients' overall satisfaction with the

treatment.

source

J Am Acad Dermatol

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

(6) 1999;40:961-5.

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