Topical metronidazole maintains remissions of rosacea

Mark V. Dahl, H. Irving Katz, Gerald G. Krueger, Larry E. Millikan, Richard B. Odom, Frank Parker, John E. Wolf, Raza Aly, Charlene Bayles, Brenda Reusser, Melissa Weidner, Edward Coleman, Robert Patrignelli, Michael R. Tuley, Michael O. Baker, James H. Herndon, Janusz M. Czemielewski, Joe Willis

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

Background: Rosacea is a chronic skin disease that requires long-term therapy. Oral antibiotics and topical metronidazole successfully treat rosacea. Because long-term use of systemic antibiotics carries risks for systemic complications and adverse reactions, topical treatments are preferred. Objective: To determine if the use of topical metronidazole gel (Metrogel) could prevent relapse of moderate to severe rosacea. Design: A combination of oral tetracycline and topical metronidazole gel was used to treat 113 subjects with rosacea (open portion of the study). Successfully treated subjects (n = 88) entered a randomized, double-blind, placebo- controlled study applying either 0.75% topical metronidazole gel (active agent) or topical metronidazole vehicle gel (placebo) twice daily (blinded portion of the study). Setting: Subjects were enrolled at 6 separate sites in large cities at sites associated with major medical centers. Subjects: One hundred thirteen subjects with at least 6 inflammatory papules and pustules, moderate to severe facial erythema, and telangiectasia entered the open phase of the study. Eighty-eight subjects responded to treatment with systemic tetracycline and topical metronidazole gel as measured by at least a 70% reduction in the number of inflammatory lesions. These subjects were randomized to receive 1 of 2 treatments: either 0.75% metronidazole gel or placebo gel. Interventions: Subjects were evaluated monthly for up to 6 months to determine relapse rates. Main Outcomes Measures: Inflammatory papules and pustules were counted at each visit. Relapse was determined by the appearance of a clinically significant increase in the number of papules and pustules. Prominence of telangiectases and dryness (roughness and scaling) were also observed. Results: In the open phase, treatment with tetracycline and metronidazole gel eliminated all papules and pustules in 67 subjects (59%). The faces of 104 subjects (92%) displayed fewer papules and pustules after treatment, and 82 subjects (73%) exhibited less erythema. In the randomized double-blind phase, the use of topical metronidazole significantly prolonged the disease-free interval and minimized recurrence compared with subjects treated with the vehicle. Eighteen (42%) of 43 subjects applying the vehicle experienced relapse, compared with 9 (23%) of 39 subjects applying metronidazole gel (P

Original languageEnglish (US)
Pages (from-to)679-683
Number of pages5
JournalArchives of Dermatology
Volume134
Issue number6
DOIs
StatePublished - 1998
Externally publishedYes

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Rosacea
Metronidazole
Gels
Recurrence
Tetracycline
Telangiectasis
Placebos
Erythema
Therapeutics
Anti-Bacterial Agents
Skin Diseases
Chronic Disease
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Dermatology

Cite this

Dahl, M. V., Katz, H. I., Krueger, G. G., Millikan, L. E., Odom, R. B., Parker, F., ... Willis, J. (1998). Topical metronidazole maintains remissions of rosacea. Archives of Dermatology, 134(6), 679-683. https://doi.org/10.1001/archderm.134.6.679

Topical metronidazole maintains remissions of rosacea. / Dahl, Mark V.; Katz, H. Irving; Krueger, Gerald G.; Millikan, Larry E.; Odom, Richard B.; Parker, Frank; Wolf, John E.; Aly, Raza; Bayles, Charlene; Reusser, Brenda; Weidner, Melissa; Coleman, Edward; Patrignelli, Robert; Tuley, Michael R.; Baker, Michael O.; Herndon, James H.; Czemielewski, Janusz M.; Willis, Joe.

In: Archives of Dermatology, Vol. 134, No. 6, 1998, p. 679-683.

Research output: Contribution to journalArticle

Dahl, MV, Katz, HI, Krueger, GG, Millikan, LE, Odom, RB, Parker, F, Wolf, JE, Aly, R, Bayles, C, Reusser, B, Weidner, M, Coleman, E, Patrignelli, R, Tuley, MR, Baker, MO, Herndon, JH, Czemielewski, JM & Willis, J 1998, 'Topical metronidazole maintains remissions of rosacea', Archives of Dermatology, vol. 134, no. 6, pp. 679-683. https://doi.org/10.1001/archderm.134.6.679
Dahl, Mark V. ; Katz, H. Irving ; Krueger, Gerald G. ; Millikan, Larry E. ; Odom, Richard B. ; Parker, Frank ; Wolf, John E. ; Aly, Raza ; Bayles, Charlene ; Reusser, Brenda ; Weidner, Melissa ; Coleman, Edward ; Patrignelli, Robert ; Tuley, Michael R. ; Baker, Michael O. ; Herndon, James H. ; Czemielewski, Janusz M. ; Willis, Joe. / Topical metronidazole maintains remissions of rosacea. In: Archives of Dermatology. 1998 ; Vol. 134, No. 6. pp. 679-683.
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abstract = "Background: Rosacea is a chronic skin disease that requires long-term therapy. Oral antibiotics and topical metronidazole successfully treat rosacea. Because long-term use of systemic antibiotics carries risks for systemic complications and adverse reactions, topical treatments are preferred. Objective: To determine if the use of topical metronidazole gel (Metrogel) could prevent relapse of moderate to severe rosacea. Design: A combination of oral tetracycline and topical metronidazole gel was used to treat 113 subjects with rosacea (open portion of the study). Successfully treated subjects (n = 88) entered a randomized, double-blind, placebo- controlled study applying either 0.75{\%} topical metronidazole gel (active agent) or topical metronidazole vehicle gel (placebo) twice daily (blinded portion of the study). Setting: Subjects were enrolled at 6 separate sites in large cities at sites associated with major medical centers. Subjects: One hundred thirteen subjects with at least 6 inflammatory papules and pustules, moderate to severe facial erythema, and telangiectasia entered the open phase of the study. Eighty-eight subjects responded to treatment with systemic tetracycline and topical metronidazole gel as measured by at least a 70{\%} reduction in the number of inflammatory lesions. These subjects were randomized to receive 1 of 2 treatments: either 0.75{\%} metronidazole gel or placebo gel. Interventions: Subjects were evaluated monthly for up to 6 months to determine relapse rates. Main Outcomes Measures: Inflammatory papules and pustules were counted at each visit. Relapse was determined by the appearance of a clinically significant increase in the number of papules and pustules. Prominence of telangiectases and dryness (roughness and scaling) were also observed. Results: In the open phase, treatment with tetracycline and metronidazole gel eliminated all papules and pustules in 67 subjects (59{\%}). The faces of 104 subjects (92{\%}) displayed fewer papules and pustules after treatment, and 82 subjects (73{\%}) exhibited less erythema. In the randomized double-blind phase, the use of topical metronidazole significantly prolonged the disease-free interval and minimized recurrence compared with subjects treated with the vehicle. Eighteen (42{\%}) of 43 subjects applying the vehicle experienced relapse, compared with 9 (23{\%}) of 39 subjects applying metronidazole gel (P",
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