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Rosacea: Possibilities of Combined Use of Metronidazole Gel and Phototherapy

https://doi.org/10.33667/2078-5631-2025-8-14-20

Abstract

Rosacea is a chronic inflammatory skin disease of the face, characterized by extreme prevalence, long-term recurrent course and slow rehabilitation of patients. Multifactorial genesis of this disease determines the validity of the use of combined methods of therapy using local therapy agents with proven effectiveness in combination with physiotherapeutic techniques that affect the restoration of microcirculation and the elimination of residual erythema. The article presents data from a comparative observational study aimed at determining the effectiveness and tolerability of combined therapy for papulopustular rosacea using 1% metronidazole gel (Metrogyl Gel), as well as photo- and laser therapy. As a result of examination and treatment of 87 patients, it was shown that rosacea is characterized by pronounced disturbances of facial skin microcirculation. The use of an external drug with anti-inflammatory activity and modern hardware technologies helps to reduce the time to achieve a clinical effect, good tolerability of therapy and normalization of regional blood flow.

About the Authors

L.  S. Kruglova
Central State Medical Academy of the Administrative Department of the President of Russia
Russian Federation

Kruglova Larisa S., DM Sci (habil.), professor, head of Dept of Dermatovenereology and Cosmetology, rector

Moscow



K. B. Olkhovskaya
Central State Medical Academy of the Administrative Department of the President of Russia
Russian Federation

Olkhovskaya Kira B., PhD Med, associate professor at Dept of Dermatovenereology and Cosmetology

Moscow



K.  A. Novikov
LLC “Center for Laser Dermatocosmetology and Health Doklaser”
Russian Federation

Novikov Kirill A., PhD Med, dermatovenereologist, cosmetologist, physiotherapist

Moscow



L.  V. Terentyeva
N.I. Pirogov Russian National Research Medical University
Russian Federation

Terentyeva Lada V., PhD Med, associate professor at Dept of Dermatovenereology named after academician Yu.K. Skripkin

Moscow



References

1. Agafonova E.V., Kruglova L.S., Avagumyan M.A. Genetic markers of rosacea. Bulletin of new medical technologies. 2018; 25 ( 4): 137–145. (In Russ.).

2. Agafonova E.V., Kruglova L.S., Sofinskaya G.V. Rosacea: current issues of therapy using physical factors. Physiotherapist. 2018; 4: 23–33 (In Russ.).

3. Weinkle AP, Doktor V, Emer J. Update on the management of rosacea. Plast Surg Nurs 2015; 35: 184–202.

4. Acne and rosacea. Edited by L.S. Kruglova. GEOTAR-Media. 2021. 207 s. (In Russ.).

5. Steinford M. New insights into rosacea pathophysiology. J Am Acad Dermatol 2013; 69: 15–26.

6. Schwab V.D., Sulk, M., Seeliger S., Nowak P., Aubert, J., Mess C., Steinhoff M. Neurovascular and Neuroimmune Aspects in the Pathophysiology of Rosacea. The Journal of Investigative Dermatology. Symposium Proceedings / the Society for Investigative Dermatology, Inc. [and] European Society for Dermatological Research 2011; 15 (1): 34–54.

7. Reinholz N., Tietie K. rosacea S1 Guideline. JDDG J. Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition Int J Mol Sci. 2016 Sep; 17 (9): 1562.

8. Woo Y.R., Lim J.H., Cho D.H., Park H.J. Rosacea: molecular mechanisms and management of a chronic cutaneous inflammatory condition. Int J Mol Sci. 2016; 17 (9): 1562. https://doi.org/10.3390/ijms17091562

9. Egorova O.A., Agafonova E.V., Kruglova L. S. Comorbidity in rosacea. Hospital medicine: science and practice. 2018; 1 (1): 23–29. (In Russ.).

10. Perlamutrov Yu.N., Olkhovskaya K.B., Aivazova T.V. Modern view on the etiopathogenesis of rosacea, the role of diet and intestinal microbiome in the course of the disease «Dermatovenereology. Cosmetology». 2022; 8 (2): 99–110. (In Russ.). https://doi.org/10.34883/PI.2022.8.2.001

11. Dahl M.V., Katz H.I., Krueger G.G., et al. Topical metronidazole maintains remissions of rosacea. Arch Dermatol. 1998; 134 (6): 679-83. https://doi.org/10.1001/archderm.134.6.679

12. Koçak M., Yağli S., Vahapoğlu G., Ekşioğlu M. Permethrin 5% cream versus metronidazole 0.75% gel for the treatment of papulopustular rosacea. A randomized double-blind placebo-controlled study. Dermatology. 2002; 205 (3): 265–270. https://doi.org/10.1159/000065849

13. Elewski B., Draelos Z., Dreno B., Jansen T., Layton A., Picardo M. Rosacea–global diversity and optimized outcome: proposed international consensus from the Rosacea International Expert Group. J. Eur. Acad. Dermatol. Venereol. 2011; 25: 188–200.

14. Orlova E.N., Kruglova L.S., Kotenko K.V. Laser therapy and ultrasound therapy in the treatment of patients with rosacea. (Electronic journal Bulletin of New Medical Technologies). (In Russ.). ISSN2075 4094 2014. 2–83

15. Kruglova L.S., Sharshunova A.A., Sofinskaya G.V .Use of ND: YAG laser (1064 nm) in patients with erythematotelangiectatic subtype of rosacea. Physiotherapist. 2017; 2: 60–67. (In Russ.).

16. Carruth B.P., Meyer D.R., Wladis E.J. et al. Extreme eyelid lymphedema associated with rosacea (Morbihan Disease): case series, literature review, and therapeutic considerations. Ophthal Plast Reconstr Surg 2017; 33 (3 Suppl 1): 34–S38.

17. Aljoudi S.B., Tallab M., Al Hawsawi K. (February 13, 2023) Haber’s Syndrome: A Case Report. Cureus 15 (2): e34906. DOI 10.7759/cureus.34906

18. Del Rosso JQ. Advances in understanding and managing rosacea: part 1: connecting the dots between pathophysiological mechanisms and common clinical features of rosacea with emphasis on vascular changes and facial erythema. J Clin Aesthet Dermatol 2012; 5: 16–25.

19. Steinhoff M., Schmelz M., Schauber J. Facial erythema of rosacea – aetiology, different pathophysiologies and treatment options. Acta Derm Venereol 2016; 96: 579–586.

20. Taieb A., Ortonne J.P., Ruzicka T. et al. Superiority of ivermectin 1% cream over metronidazole 0.75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial. Br J Dermatol 2015; 172: 1103–1110.

21. Anzengruber F., Czernielewski J., Conrad C., Feldmeyer L., Yawalkar N., Häusermann P., Cozzio A., Mainetti C., Goldblum D., Läuchli S., Imhof L., Brand C., Laffitte E., NavariniA.A. Swiss S1 guideline for the treatment of rosacea. J Eur Acad Dermatol Venereol. 2017 Nov; 31 (11): 1775–1791. doi: 10.1111/jdv.14349. Epub 2017 Aug 21. PMID: 28833645.

22. Kassir R., Kolluru A., Kassir M. Intense pulsed light for the treatment ofrosacea and telangiectasias. J Cosmetic Laser Therapy 2011; 13: 216–222

23. Kruglova L.S., Kotenko K.V., Korchazhkina N.B., Turbovskaya S.N. Physiotherapy in dermatology. Moscow. GEOTAR. 2016. 304 p. (In Russ.).

24. Potekaev N.N., Kruglova L.S. Laser in dermatology and cosmetology. Moscow. MDV. 2018. 280 p. (In Russ.).


Review

For citations:


Kruglova L.S., Olkhovskaya K.B., Novikov K.A., Terentyeva L.V. Rosacea: Possibilities of Combined Use of Metronidazole Gel and Phototherapy. Medical alphabet. 2025;(8):14-20. (In Russ.) https://doi.org/10.33667/2078-5631-2025-8-14-20

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ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)