What is the first-line treatment for rosacea?

For the treatment of rosacea, metronidazole topical therapy is recognized as a first-line option. This medication possesses anti-inflammatory properties and effectively reduces the papules and pustules associated with rosacea. Metronidazole's mechanism involves inhibiting the inflammatory process that contributes to the condition's symptoms.

When considering other treatments, azelaic acid is indeed beneficial for rosacea and has its place as an alternative first-line treatment, particularly for patients who might not tolerate metronidazole or need additional options. Clindamycin topical gel also serves a role in managing bacterial factors, although it is typically not the primary choice in the treatment of rosacea. Oral tetracyclines are used in more severe cases, particularly for inflammatory rosacea with significant pustular lesions, but they are not the first-line treatment for milder forms of the condition. Therefore, the choice of metronidazole topical therapy aligns best with established treatment protocols for managing rosacea effectively.