Efficacy of Topical Azelaic Acid (AzA) Gel 15% Plus Oral Doxycycline 40 mg Versus Metronidazole Gel 1% Plus Oral Doxycycline 40 mg in Mild-to-Moderate Papulopustular Rosacea
June 2010 | Volume 9 | Issue 6 | Original Article | 607 | Copyright © June 2010
James Q. Del Rosso DO FAOCD, Suzanne Bruce MD, Michael Jarratt MD, Alan Menter MD, Gerald Staedtler
Rosacea is a leading reason why people seek the care of a dermatologist, accounting for nearly 7 million office visits annually. Pharmacologic
treatments include both topical and oral medications, which are increasingly being used in combination, especially at the
outset of therapy. This exploratory study assesses the safety, effectiveness and speed of onset of two common topical agents for
the treatment of rosacea—azelaic acid gel (AzA) 15% and metronidazole gel 1%—used in conjunction with anti-inflammatory dose
doxycycline (40 mg once daily).
Men and women (n=207) with mild-to-moderate papulopustular rosacea were enrolled and randomized to receive either AzA gel 15%
twice daily plus doxycycline 40 mg once daily (AzA group) or metronidazole gel 1% once daily plus doxycycline 40 mg once daily
(Metro group) for 12 weeks. Both regimens were safe, efficacious and well tolerated. Efficacy parameters revealed a possible trend
toward greater and earlier benefit with the AzA-based regimen than with the metronidazole-based regimen. These findings warrant
further investigation in a sufficiently powered study.