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Topical metronidazole: a new therapy for rosacea
1American Society of Hospital Pharmacists, Bethesda, MD 20814.
Clinical Pharmacy
|February 1, 1990
Summary
Topical metronidazole effectively treats rosacea by reducing inflammatory lesions and erythema. While its exact mechanism is debated, it offers a well-tolerated, palliative option for skin conditions.
Area of Science:
- Dermatology
- Pharmacology
- Microbiology
Background:
- Metronidazole is a synthetic nitroimidazole derivative with antibacterial and antiprotozoal properties.
- Topical metronidazole is available as an aqueous gel for dermatological applications.
- Its antimicrobial effects are attributed to polar reduction products that disrupt DNA.
Purpose of the Study:
- To review the chemistry, mechanism of action, pharmacokinetics, and adverse effects of topical metronidazole.
- To discuss its efficacy in treating rosacea and other dermatological conditions.
- To explore potential anti-inflammatory or immunosuppressive mechanisms in rosacea treatment.
Main Methods:
- Review of existing literature on topical metronidazole.
- Analysis of clinical studies evaluating its use in rosacea and other conditions.
- Assessment of reported pharmacokinetic data and adverse effects.
Main Results:
- Topical metronidazole (0.75% gel or 1% cream) improved inflammatory lesions in 68-96% of rosacea patients.
- The drug's mechanism in rosacea may involve anti-inflammatory/immunosuppressive actions, not solely bacterial suppression.
- Minimal systemic absorption, distribution, and elimination data are available for topical application.
Conclusions:
- Topical metronidazole is a palliative treatment for rosacea, with symptoms often recurring upon discontinuation.
- It has shown success in treating decubitus ulcers and certain dental conditions.
- The drug exhibits low toxicity, with local reactions like burning and stinging being the primary adverse effects, offering a valuable treatment option for rosacea.