Treatment - Non-approved therapies

The following treatments have been described in literature as successful in rosacea patients, but they have not been approved for this disease, and large controlled surveys are lacking. These suggestions should not in any way encourage or promote the off-label use of these products.


Topical

Tacrolimus, an immunomodulator which, as a topical agent, is approved for the treatment of atopic eczema, has been shown to be effective in patients with steroid-induced rosacea. Tacrolimus ointment has been applied in a concentration of 0,075% and 0,1% for rosacea.

Ascomycin, another immunomodulator, has been reported to be effective in rosacea in a concentration of 1%.

Infestation with demodex folliculorum mites has been discussed as an etiologic factor in some cases of rosacea or rosacea-like skin lesions. Thus, antiinfectives such as permethrin 5% cream, lindane and benzoyl benzoat have been recommended for stage II-rosacea.

Systemic

Dapsone, an antibiotic and antiparasitic agent, has been reported effective in a dosage of 100 mg daily in rosacea fulminans.

Clonidine, a centrally active antihypertensive agent, has been shown to reduce facial flushing. However small doses, which do not cause a decrease in blood pressure, are said to have little or no effect.
Propranolol, a non-cardioselective beta-blocker has also been reported to be helpful in reducing flushing. A dosage of 40 mg twice daily has been recommended for this indication.

Orally administered metronidazole has been reported effective in a dosage of 500 mg daily for stages II and III.
A treatment duration of up to 20 – 60 days was required. This drug is not approved for a treatment duration longer than 6 days, and it displays considerable side effects.