Use of topical metronidazole in moderate to severe rosacea

Rosacea is a chronic condition requiring long-term therapy for control and maintenance. Numerous controlled studies have shown that metronidazole 0.75% in combination with oral antibiotics significantly reduces the number of papules and pustules and erythema severity scores in patients with severe disease. Topical metronidazole 0.75% also maintains long-term remissions after oral tetracycline has been discontinued. Although original studies involving topical metronidazole 0.75% used a twice-daily regimen, subsequent work has shown that this formulation used once daily is as effective as 1% metronidazole.