Comparison of Topical 20% Azelaic Acid and 7.5% Dapsone in the Treatment of Mild-To-Moderate Papulopustular Rosacea

Rosacea is a chronic inflammatory skin disease, commonly affecting the central part of the face, characterized by erythema, flushing, telangiectasias, papules, and pustules. It may also involve sensations of burning, tingling, and occasionally fibrous changes.

This study aims to compare the efficacy, side effect profiles, and patient satisfaction of topical 20% azelaic acid and 7.5% dapsone in the treatment of mild-to-moderate papulopustular rosacea (Stage 2).

Ethics approval was obtained. A retrospective analysis was conducted on the medical records of 76 patients, including 44 in the azelaic acid group and 32 in the dapsone group, all diagnosed with mild-to-moderate papulopustular rosacea. These patients were treated with either topical azelaic acid or dapsone at the dermatology outpatient clinic between August 1, 2022 and December 31, 2022. Demographic characteristics, Investigator's Global Assessment scores, lesion counts, erythema scores, side effects, and patient satisfaction data were analyzed in the study.

No statistically significant differences were found between groups based on pretreatment IGA values, separate IGA scores (2-4), lesion counts, average erythema scores, or separate erythema scores (p > 0.05 for all). Within each group, comparisons of pre- and posttreatment IGA values, lesion counts, and erythema scores revealed statistically significant differences (p < 0.001 for all), indicating that both treatments were effective. When comparing the groups based on posttreatment IGA values, separate IGA scores (0-3), improvement percentages in IGA values, lesion counts, improvement percentages in lesion counts, average erythema scores, separate erythema scores (0-2), and improvement percentages in erythema scores, no significant differences were observed (p > 0.05 for all).

Topical dapsone is as effective as azelaic acid in treating mild-to-moderate papulopustular rosacea and is associated with fewer side effects, making it a safer option.