Rosacea Medical Therapies: Lotions, Topical & Oral Medicines, and Pr – Dr. Bailey Pores and skin Care

A Dermatologist’s Method to Rosacea Therapy

Many rosacea sufferers go to a dermatologist in search of reduction from persistent redness, pimples, and visual, ‘damaged’ facial capillaries. After over 35 years of efficiently treating rosacea in my dermatology observe—and managing my very own rosacea—I am right here to share my holistic strategy to successfully carry rosacea below management. I’ll cowl how I take advantage of prescription lotions, topical and oral medicines, beauty procedures, why prescription therapies typically fail with out correct skincare, and even how way of life adjustments may also help you obtain clearer, calmer pores and skin.

Your skincare routine will make or break getting management of your rosacea. – Dr. Bailey

This information is a part of my rosacea collection that teaches you in regards to the varieties, signs and indicators of rosacea, how I management rosacea with a easy skincare routine, anti-aging growing older skincare, and my holistic strategy that features the perfect weight loss plan and way of life selections for lowering physiologic irritation that may result in pores and skin irritation, together with rosacea.

It’s vital to notice that this info is for academic functions solely and represents my opinions. When you suppose that one thing you learn right here could also be useful for you, it is advisable to talk about it along with your treating dermatologist.

Ought to You Use Antibiotics to Deal with Your Cussed Rosacea?

As a result of it’s essential, I need to instantly tackle the usage of antibiotics to deal with rosacea. For my part solely use them if you’re already doing the 4 major, confirmed steps to manage rosacea:

4 Steps to Management Rosacea With out Antibiotics:

1. a superb rosacea fighting skin care routine (see learn how to mix medicines into the routine below)
2. keep away from skincare merchandise that trigger rosacea
3. management way of life triggers
4. use efficient topical prescription care to manage rosacea (extra below)

Oral antibiotics are invaluable as a final resort when all else fails and rosacea is uncontrolled.

Why Skincare is A part of Your Medical Therapy Success

Professional-tip: By no means depend upon a prescription alone to manage this cussed, continual, and at occasions unrelenting pores and skin drawback. Add a rosacea-healing skincare routine to prescriptions and acquire sustainable management of your rosacea. – Dermatologist Dr. Bailey

The Lacking Hyperlink – Improve Therapy Efficacy

Many individuals really feel annoyed as a result of their docs prescribe therapies however do not clarify learn how to look after delicate, rosacea-prone pores and skin. I regularly see sufferers utilizing merchandise that irritate their pores and skin, successfully canceling out the advantages of their treatment. That is why I emphasize integrating the perfect medical therapies with a supportive skincare routine, an important step typically missed. My strategy ensures you be taught to care in your delicate complexion, so your therapies actually have an opportunity to work.

4-Step Full Skincare Routine to Combat Rosacea

I at all times construct a rosacea-healing skincare routine for my sufferers, contemplating it each preventative and therapeutic. The objective is to manage rosacea and maintain it in remission. I developed this routine, which I name Complete Skin Care Routine, primarily based on my a long time of expertise and it completely integrates prescription topical medicines:

It is designed to provide your pores and skin the whole lot it wants in 4 important steps, forming the inspiration of my Rosacea Therapy Skincare Kit, which incorporates all of the appropriate merchandise you’ll want:

1. Cleanse: Cleanse pores and skin with out over drying the delicate pores and skin barrier whereas additionally discouraging the Pityrosporum yeast that thrives on rosacea-prone pores and skin. My suggestion:

Right: Calm rosacea irritation and reload the pores and skin’s antioxidant reserve:

Hydrate: Shield pores and skin barrier with a wealthy, but light supporting moisturizer comparable to my Daily Hydrating Moisturizing Face Cream.

Shield: Stop UV-triggered rosacea flare-ups utilizing a mineral-based, broad-spectrum sunscreen like Sheer Strength Pure Physical Matte Tinted Facial Sunscreen, SPF 50.

Antibiotics, when wanted to realize management of a rosacea flare up, are used briefly after which tapered off.

A extremely good skincare routine is very vital for rosacea, a situation simply triggered by harsh cleansers, insufficient moisturizer use, and even the slightest quantity of UV publicity.

I will clarify how I add prescription merchandise to a routine comparable to this.

For an entire, in-depth breakdown of every skincare step, together with detailed product choice, substances to keep away from, pores and skin varieties, and anti-aging issues please learn my step by step guide for treating Rosacea.

I additionally train my rosacea sufferers to identify and avoid their rosacea triggers. That is actually vital for controlling rosacea. I prefer to say that an occasional set off could also be OK however do not do them all of sudden, comparable to go on a sunny seaside trip, play excessive seaside volleyball, whereas ingesting a pitcher of margaritas, and consuming spicy fish tacos. Your rosacea will flare!

One Equipment – All of the Merchandise to Deal with Your Rosacea

My Rosacea Therapy Skin Care Kit takes the guesswork out of making a rosacea-friendly skincare routine. It has all of the merchandise you’ll want in your rosacea skincare routine:

[product handle=”rosacea-therapy-kit,extremely-gentle-foaming-facial-cleanser,calming-zinc-bar-soap,green-tea-skin-therapy-cream,daily-moisturizing-face-cream,sheer-strength-pure-physical-sunscreen”]

Topical Prescription Medicines for Rosacea

What are the perfect topical medicated prescription merchandise that I discover work for my dermatology sufferers? I will begin with medicated cleansers after which checklist the leave-on medicated prescription lotions to deal with rosacea.

Medicated Facial Cleansers

Sodium Sulfacetamide and Sulfur Antibiotic Cleanser

Utilization

There’s just about only one prescription facial cleanser that I’ve discovered helpful for rosacea and it is sodium sulfacetamide and sulfur [17].

Take a “Drug Vacation”

As a result of sodium sulfacetamide is an antibiotic, I like to make use of it when wanted then take a ‘drug vacation’ to forestall antibiotic resistance. I do that by switching my affected person’s complexion over to Calming Zinc Soap, fortified with 2% pyrithione zinc, which isn’t an antibiotic, and works to discourage pores and skin microbes by a broad mechanism of motion that doesn’t create resistant microbes.

The way it Works

Sodium sulfacetamide is a sulfa antibiotic. It really works in opposition to a broad vary of pores and skin micro organism. When sulfur is added, it really works even higher and has efficacy in opposition to micro organism, fungi/yeast and a few parasites (suppose probably Demodex mites in the case of rosacea). We do not know the reason for rosacea, nor why antibiotics like sodium sulfacetamide work to deal with rosacea, however they’re a mainstay of rosacea remedy, each for topical and oral therapy.

Issues

This antibiotic cannot be utilized by people who find themselves allergic to sulfa medication. The sulfur additionally smells and may be drying however I typically discover this cleanser is properly tolerated.

Topical Go away-On Prescription and Medicated Lotions

 

Topical Antibiotic Foams and Cream Prescriptions

I take into account the gathering of topical antibiotics variations on a theme. I attempt to match the product to the affected person’s preferences for the way it feels on their pores and skin, what their insurance coverage covers, and the way properly it really works for his or her distinctive case of rosacea. As soon as the pores and skin is evident, I prefer to get them off antibiotics for a ‘drug vacation’ in order that we do not unbalance their pores and skin microbiome or create resistant micro organism.

Metronidazole Topical Cream and Gel Prescription Antibiotic

• prescription antibiotic that has been used topically to deal with rosacea for many years
• properly tolerated
• relying on the energy and the particular product it’s utilized a few times a day

Different Topical Antibiotics

There are different antibiotics used topically to deal with rosacea together with clindamycin, erythromycin and minocycline. Clindamycin has additionally been mixed with benzoyl peroxide and used for rosacea. These merchandise are available in lotions, lotions, gels and options. They’re merchandise used to deal with different situations like zits and they also get tried on rosacea when docs and sufferers are annoyed.

We do not absolutely perceive why antimicrobial therapy works for rosacea. Philosophically and scientifically, I desire to do the antimicrobial inhabitants discount with non-antibiotic substances comparable to pyrithione zinc and benzoyl peroxide to keep away from creating antibiotic resistant microbes – Dr. Bailey

Different Medicated Prescription Face Lotions for Rosacea

Ivermectin Cream – Soolantra

Ivermectin cream [8] is a sport changer in rosacea therapy, nevertheless the therapy is ongoing and costly, and I’ve used the off-label permethrin cream efficiently as a substitute – see extra on this under.

Ivermectin is the primary actually good prescription drugs that is come alongside for this irritating pores and skin drawback throughout the course of my 40+ years in drugs. At present, the one model of ivermectin cream is Soolantra, and it is costly.

Why Does Ivermectin Assist Rosacea

Ivermectin is a standard and anti-parasitic drugs [16] created within the Seventies. It has been utilized in people and animals to kill parasites comparable to worms. There’s nothing new or attractive about ivermectin however the concept of making use of it to the face to kill Demodex mites is sensible – and worthwhile for the pharmaceutical firm that makes it.

Demodex mites are identified to overpopulate the pores and skin of rosacea sufferers. Decreasing their numbers typically improves rosacea. – Dr. Bailey

Ongoing and Costly Therapy

Demodex mites play an as but to be absolutely elucidated position within the flushing, redness, and pimple misadventures of rosacea. Discouraging mite abundance helps rosacea. However the mites come again. Yep, they’re again inside a month which means mite inhabitants management therapy is ongoing – and costly.

Permethrin Cream, the Off-Label Different

I’ve used permethrin cream (a scabies therapy cream) to manage facial Demodex mites in my observe for many years. This cream is economical and I discover that it really works properly. My little trick is ‘off label’ which means that it’s not FDA authorised and I share it solely for academic functions as a subject of debate between you and your physician.

Brimonidine Gel for Rosacea

• fast however non permanent outcomes
• causes capillaries to constrict to scale back facial flushing
• relieves redness [10] in as little as half-hour
• the outcomes can last as long as 6 hours

It solely works when used and doesn’t enhance rosacea over the long term. I take into account it helpful when the flushing must be managed for an occasion.

Usually, research past 1 yr of use usually are not printed. Nevertheless, one case report of an individual who used it for two years was printed and refractory facial redness [11] was an unlucky aspect impact. It is sensible to me as a result of this class of medicines, referred to as alpha blockers, is thought to try this.

Oxymetazoline Hydrochloride: This associated drugs works the identical approach. You recognize it as Afrin nasal decongestant spray. Principally, it is a variation on brimonidine and I anticipate the identical problems with refractory vascular congestion and redness. For my part, I solely use alpha blockers for the actually vital days the place facial flushing should be managed.

Benzoyl Peroxide Cream

Benzoyl peroxide cream may be helpful for papulopustular rosacea [9] on complexions that aren’t delicate. Most individuals’s pores and skin with rosacea is much too delicate to tolerate benzoyl peroxide. That mentioned, I’ve had sufferers use it who I by no means thought would tolerate it and but had glorious responses. Why it really works in rosacea is a thriller. Benzoyl peroxide has a broad mechanism of motion in opposition to microbes. I additionally suppose it might have some efficacy in opposition to Demodex mites, however that has but to be studied.

Clotrimazole and Ketoconazole Cream

I typically use clotrimazole cream or ketoconazole cream for my rosacea sufferers which have each rosacea and facial dandruff. It is a frequent pores and skin drawback mixture; facial redness, flaking, sensitivity and pimples which can be troublesome to deal with.

Clotrimazole is an antifungal and anti-yeast treatment. The concept is that the Pityrosporum yeast (aka Malassezia) overgrows its regular degree on the pores and skin and performs a job in inflicting facial seborrheic dermatitis, which in flip will increase facial redness and sensitivity. Clotrimazole helps to deal with the yeast.

• I’ve my sufferers apply clotrimazole cream after the Inexperienced Tea Antioxidant Pores and skin Remedy, included in my Rosacea Therapy Kit.
• I take advantage of it twice a day for a month then as wanted to manage flaking and sensitivity.
• The clotrimazole cream is available in a moisturizing base that will make the necessity for added moisturizer pointless.
• Lengthy-term administration: Calming Zinc soap, a part of my Rosacea Remedy Equipment, is my go-to for addressing Pityrosporum yeast on a long-term foundation, as a result of yeast and fungi can develop resistance to clotrimazole a lot the way in which micro organism change into immune to antibiotics.

Azelaic Acid

Azelaic acid lotions, foams, and gels [5] (usually within the 15 to twenty% vary) are used to deal with rosacea, particularly pustular rosacea.

Over time, I’ve not been vastly impressed by azelaic acid and most of my rosacea sufferers discover it causes their pores and skin to sting or itch [7] whereas doing little to enhance their rosacea. That mentioned, everybody’s pores and skin is completely different and you will see that individuals who discover it useful for his or her rosacea.

Apparently, azelaic acid is a molecule made by the frequent pores and skin germ Malassezia furfur [6] that may

• trigger ‘fungal’ acne (a misnomer as a result of Malassezia is a yeast)
• modify pigment manufacturing and azelaic acid may be helpful for pigment pores and skin issues comparable to melasma. You will note it in pores and skin brightening merchandise.

Cortisone Cream

Can You Use Prescription Cortisone Cream on Rosacea?

Solely below your physician’s strict supervision could this be acceptable! And, it is vital to make use of solely non-halogenated topical cortisone steroid lotions (comparable to over-the-counter hydrocortisone cream) on the face. I take advantage of them as a final resort for brief time period management of facial irritation. For my part, any physician prescribing cortisone cream for somebody’s face must know what ‘non-halogenated cortisone’ means and why it is vital on the face!

Warning: Cortisone cream, particularly halogenated corticosteroids, will:

• worsen rosacea
• result in perioral dermatitis, a situation that’s no enjoyable
• steroid lotions can skinny your pores and skin
• and harm your eyes

Your dermatologist will know what this implies and needs to be the one to prescribe and supervise any cortisone use in your face.

Anticipated Outcomes

How Lengthy Does it Take Medicated Prescription Lotions to Work for Rosacea?

It varies. It’s possible you’ll start seeing enchancment in your rosacea in as little as 1 week. That mentioned, I give any therapy technique 2 months to actually declare itself efficient or ineffective. I prefer to see a medicated cream enhance pores and skin and assist preserve enchancment over all of the ups and downs that rosacea flare ups can create.

Oral Antibiotics Therapy for Rosacea

When dealing with a rosacea flare-up with its embarrassing facial rash that may be laborious to manage, you may marvel: What oral prescription medicines do dermatologists use? On condition that rosacea is a poorly understood, irritating pores and skin situation [21], the place precisely do antibiotics match into its therapy? Dermatologists write extra antibiotic prescriptions [18] than another specialty, typically for situations not confirmed to be bacterial. This part will allow you to perceive the way you and your dermatologist can stability all these issues when your rosacea flares up.

 

Most popular Oral Antibiotics for Rosacea

Tetracycline and Doxycycline

Over my profession, my favourite oral antibiotics to deal with rosacea have been tetracycline and doxycycline.

Low-Dose Doxycycline (Sub-Antimicrobial)

Oral antibiotics may be prescribed at low, non-antibacterial doses and nonetheless work. Low dose doxycycline is the perfect different in my view for long term use. Right here’s why:

• thought-about ‘sub antimicrobial’ [13]
• anti-inflammatory by way of doxycycline’s mechanisms
• thus, it is an antibiotic that is not working as an antibiotic
• decreased danger of antibiotic resistance (“superbugs”)
• decrease affect on microbiome
• fewer negative effects in comparison with full-dose antibiotics

How Low-Dose Works for Rosacea

We dermatologists have used antibiotics for his or her anti-inflammatory efficacy [21] for years to deal with numerous pores and skin issues that aren’t identified to be associated to germs comparable to bullous pemphigoid, pityriasis rosacea, Candy’s syndrome, and a bunch of different situations you’ve by no means heard of. It is at all times been laborious to clarify to sufferers why an antibiotic works for these situations, as a result of we don’t know. We predict it’s the anti-inflammatory motion of the antibiotics that work. What all these situations have in frequent is that we don’t know what causes them.

Subantimicrobial doses of doxycycline assist:

• clear and management rosacea and scale back the event of superbugs
• decrease danger of altering the helpful micro organism microbiome neighborhood that lives on you
• scale back the environmental load of antibiotics
• fewer drug associated negative effects comparable to abdomen ache

Antibiotics to Keep away from

There are different antibiotics that you will notice promoted for rosacea.

Minocycline & Erythromycin: I don’t use minocycline due to its distinctive and severe negative effects like liver irritation, autoimmune syndrome/arthritis, and grey pores and skin discoloration. I additionally not often use erythromycin as a result of its drug interactions.

In sufferers with very extreme rosacea, I’ll take into account a short lived course of Accutane as a final resort if we have tried the whole lot and their rosacea is excessive and nonetheless making them depressing.

The Execs and Cons of Taking Antibiotics to Deal with Rosacea

Rosacea is an inflammatory pores and skin situation [20]. It’s not a pores and skin an infection and the precise position micro organism play in inflicting rosacea is unsure. We do not actually know why however antibiotics assist management rosacea and so we use them. That call is getting a brand new degree of scrutiny.

Over the course of my lengthy profession in drugs and dermatology, I’ve witnessed an entire reversal of how docs and sufferers view antibiotics. Within the early 80s, physicians and sufferers have been enamored with them and sufferers felt comforted by getting a prescription for these trusted medication. That’s modified due to superbugs and the human microbiome.

Do Antibiotics Create Superbugs & MRSA?

Taking antibiotics can result in the event of ‘superbugs’ that are antibiotic resistant micro organism that trigger severe life-threatening infections like MRSA.

MRSA (Methicillin Resistant Staph Aureus)

MRSA, probably the most infamous “superbug,” emerged in 1959, with antibiotic-resistant infections skyrocketing within the Nineties and early 2000s. Right now, the time period “MRSA” is extensively understood and I haven’t wanted to clarify it to sufferers for numerous years. As a dermatologist, I acknowledge that antibiotic prescriptions for situations like rosacea and zits, issued on my own and colleagues, have sadly contributed to this improve.

Does Taking Antibiotics for Rosacea Injury Your Microbiome?

Sure, antibiotics are a priority for the well being of your microbiome. Medical doctors are more and more centered on microbiome stewardship, recognizing that the pleasant micro organism dwelling on and in your physique play an important position in general well being, impacting the whole lot from metabolism to temper, together with serving to you fight obesity, diabetes, asthma, and depression. Antibiotics can disrupt this delicate stability, resulting in refined but probably far-reaching penalties we’re nonetheless working to grasp. Because of this frequent prescriptions like tetracycline for rosacea are actually present process nearer scrutiny.

Environmental Accumulation of Antibiotics

Past particular person well being, the widespread use of antibiotics in drugs and agriculture is resulting in their accumulation within the atmosphere [22] and aquatic ecosystems. This rising concern is one other essential issue when contemplating antibiotic use for inflammatory pores and skin situations like rosacea, which can not even be attributable to micro organism. Society’s relationship with antibiotics is clearly evolving.

For my part, antibiotics nonetheless have a job in rosacea administration as a final resort; when the complexion is so infected and uncontrolled, antibiotics can reign within the irritation. – Dermatologist Dr. Cynthia Bailey

Discover Additional:

Beauty Procedures for Rosacea

These are the perfect beauty procedures I discovered whereas treating rosacea in my observe.

Intense Pulsed Gentle (IPL)

Intense pulsed mild therapies are the largest advance we’ve had for rosacea therapy over the complete course of my medical profession. In my expertise it each improves the beauty look of the pores and skin’s ‘damaged’ capillaries and quiets down an individual’s propensity for flare ups of their rosacea.

How IPL Works for Rosacea

Robust mild of many wavelengths within the seen spectrum are flashed into the pores and skin and goal hemoglobin within the capillaries and melanin within the pores and skin and create warmth. We are able to tune this mild know-how to focus extra particularly on the hemoglobin to considerably selectively goal the capillaries. When heated, the capillaries usually collapse and go away.

Limitations: However melanin remains to be at all times heated and so folks with darker pores and skin tones or tans usually are not good candidates for IPL.

Therapy Course: In my workplace the therapies are achieved as an preliminary collection of 5 after which upkeep therapies are obligatory yearly. IPL therapies have made an enormous enchancment in my very own rosacea and I’m an enormous fan.

Electrocautery for Telangiectasias of Rosacea

Selective ‘damaged’ capillaries may be cauterized with electrocautery to enhance the beauty look of the pores and skin.

Process: Low voltage electrical energy is utilized to the pores and skin instantly over seen capillaries with a needle-small probe that thermally damages the vessel. The capillary must be traced at about 2mm increments till sufficient of it has been heated such that it disappears. It is a easy, however uncomfortable process that is economical and works instantly.

Laser Therapy of Rosacea

Plenty of lasers have been used to deal with the big, plentiful, and flush-prone facial capillaries of rosacea. We dermatologists have our favorites. Lasers [14] comparable to Neodymium-doped, yttrium–aluminium–garnet (Nd-YAG) laser, 532 nm Potassium-Titanil-Phosphate (KTP), 595 nm PDL, IPL and twin wavelength long-pulsed 775 nm alexandrite/1,064 nm neodymium:yttrium-aluminum (LPAN) goal hemoglobin to take away capillaries. What’s most vital is that your dermatologist will get good outcomes with the laser they’ve.

Closing Issues: A Holistic Method to Medical Therapy for Rosacea Management

Relying solely on prescriptions typically results in frustration. You will have a whole lot of choices for this continual and irritating pores and skin drawback. Each prescription and process has execs and cons that have to be weighed thoughtfully due to negative effects. Utilizing low dose sub antimicrobial doses is the only option for intermittent antibiotic use to deal with rosacea.

The Most Efficient Method to Treating Rosacea

I solely add topical or oral medial therapies for rosacea once we actually need them. I like to make use of a holistic strategy to manage rosacea:

Rosacea is a continual inflammatory pores and skin situation that’s greatest handled from as many angles as doable to assist management this irritating and embarrassing rash.

 

Take management of your rosacea – learn these guides:

Concerning the Creator

Dr. Cynthia Bailey is a Board Licensed Dermatologist working towards basic, surgical and beauty dermatology in California since 1987. She has achieved properly over 200,000 pores and skin exams throughout her profession. Dr. Bailey is the Founding father of DrBaileySkinCare.com, the longest working dermatologist written pores and skin well being useful resource on the earth. Dr Bailey is at the start a clinician with a realistic holistic strategy to medical care and a heavy emphasis on pores and skin well being training. Her sensible skincare info and recommendation may be discovered at DrBaileySkinCare.com, throughout the net and in quite a few worldwide publications.

Cited Scholarly Articles

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2. Sulphur for rosacea: Are we reinventing the wheel? JAAD, 66 (4),Complement 1, AB33, April 2012<
3. Del Rosso JQ, Baum EW. Complete medical administration of rosacea: an interim research report and literature assessment. J Clin Aesthet Dermatol. 2008;1(1):20-25.
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5. Liu RH, Smith MK, Basta SA, Farmer ER. Azelaic Acid within the Therapy of Papulopustular Rosacea: A Systematic Evaluate of Randomized Managed Trials. Arch Dermatol. 2006;142(8):1047–1052. doi:10.1001/archderm.142.8.1047
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9. van Zuuren, E.J., Arents, B.W.M., van der Linden, M.M.D. et al. Rosacea: New Ideas in Classification and Therapy. Am J Clin Dermatol 22, 457–465 (2021). https://doi.org/10.1007/s40257-021-00595-7
10. Anderson MS, Nadkarni A, Cardwell LA, Alinia H, Feldman SR. Highlight on brimonidine topical gel 0.33% for facial erythema of rosacea: security, efficacy, and affected person acceptability. Affected person Want Adherence. 2017 Jul 6;11:1143-1150. doi:10.2147/PPA.S115708
11. Lowe Erin MSIV, Lim Scott DO, Paradoxical Erythema Response of Lengthy-term Topical Brimonidine, JDD 15(6):763-765 (2016)
12. Jackson JM, Knuckles M, Minni JP, Johnson SM, Belasco KT. The position of brimonidine tartrate gel within the therapy of rosacea. Clin Cosmet Investig Dermatol. 2015;8:529-538. Revealed 2015 Oct 23. doi:10.2147/CCID.S58920
13. ElAhmed Husein Huesein, Steinhoff Martin, Analysis of the efficacy of subantimicrobial dose doxycycline in rosacea: a scientific assessment of scientific trials and meta-analysis, JDDG, 19(1): 7-17 Jan 21
14. Engin B, Özkoca D, Kutlubay Z, Serdaroğlu S. Typical and Novel Therapy Modalities in Rosacea. Clin Cosmet Investig Dermatol. 2020;13:179-186. Revealed 2020 Feb 20. doi:10.2147/CCID.S194074
15. Rivero AL, Whitfeld M. An replace on the therapy of rosacea. Aust Prescr. 2018;41(1):20-24. doi:10.18773/austprescr.2018.004
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17. The mixture of metronidazole gel and sodium sulfacetamide cleanser is efficacious and well-tolerated by rosacea sufferers, Journal of the American Academy of Dermatology, Volume 58, Issue 2, AB14
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