What are the topical medications for rosacea?
Jul 22, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, rosacea is a chronic inflammatory skin condition that commonly occurs on the central face. It can be treated with topical medications such as metronidazole gel, azelaic acid cream, benzoyl peroxide gel, tacrolimus ointment, and fusidic acid cream, as directed by a physician. If significant irritation or worsening of skin lesions occurs, medical attention should be sought promptly to adjust the treatment plan.
Generally, rosacea is a chronic inflammatory skin disease that commonly occurs on the central face. It can be treated with topical medications such as metronidazole gel, azelaic acid cream, benzoyl peroxide gel, tacrolimus ointment, and fusidic acid cream, as directed by a physician. A detailed analysis is as follows:
1. Metronidazole Gel
By killing Demodex folliculorum mites, inhibiting anaerobic bacteria, and exerting anti-inflammatory effects, it reduces inflammatory lesions such as papules and pustules. It is suitable for the inflammatory stage of mild to moderate rosacea, applied topically twice daily. Some patients may experience mild local irritation.
2. Azelaic Acid Cream
With antibacterial, anti-inflammatory, and keratolytic properties, it improves erythema and papules while reducing follicular obstruction. It is suitable for patients with abnormal keratinization or mild hyperplasia. Treatment should start at a low concentration, gradually building tolerance.
3. Benzoyl Peroxide Gel
By releasing oxygen free radicals, it effectively kills Propionibacterium acnes and exerts strong anti-inflammatory effects. It works well for rosacea with numerous pustules but may cause local dryness and peeling. It is recommended to use it in combination with a moisturizer.
4. Tacrolimus Ointment
As a non-hormonal immunomodulator, it suppresses T-cell activation and the release of inflammatory cytokines, alleviating erythema and itching. It is suitable for patients with corticosteroid dependency or intolerance to other topical medications. Skin barrier repair should be emphasized during long-term use.
5. Fusidic Acid Cream
Fusidic acid cream is a topical antibiotic primarily used to treat skin infections caused by various bacteria. It is generally applicable for treating impetigo, folliculitis, acne, and similar conditions.
Topical treatment must follow the principle of individualization. The acute phase focuses on anti-inflammatory and infection control measures, while the erythematous phase may include vasoconstrictive agents. Concurrently, gentle moisturization is necessary to restore the skin barrier. If significant irritation or worsening lesions occur, prompt medical consultation is advised to adjust the treatment plan.
