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Rosacea conglobata is a severe rosacea that can mimic acne conglobata, with hemorrhagic nodular abscesses and indurated plaques. [26] Phymatous rosacea is a cutaneous condition characterized by overgrowth of sebaceous glands. [11] Phyma is Greek for swelling, mass, or bulb, and these can occur on the face and ears. [26]: 693
Consistency and viscosity affect the adhesion and retention property of the gel, and are important in ensuring the gel is retained at the site of application and effective delivery of the drug. [ 3 ] The ingredients in topical gel formulation can be broadly categorized into four types: gelator, solvent, drug, and excipients.
Metronidazole, sold under the brand name Flagyl among others, is an antibiotic and antiprotozoal medication. [10] It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis. [10]
Oxymetazoline, sold under the brand name Afrin among others, is a topical decongestant and vasoconstrictor medication. It is available over-the-counter as a nasal spray to treat nasal congestion and nosebleeds, as eye drops to treat eye redness due to minor irritation, and (in the United States) as a prescription topical cream to treat persistent facial redness due to rosacea in adults.
Metronidazole is less effective, but is available in a gel and can be applied twice daily. For pediatric patients, metronidazole can be used as an alternative to tetracycline. Metronidazole comes in various concentrations ranging from 0.75% to 2%. Higher concentrated metronidazole did not equate to shorter time to cure times. [27]
Brimonidine is an α 2 agonist medication used to treat open-angle glaucoma, ocular hypertension, and rosacea. [4] [5] In rosacea it improves the redness. [5] It is used as eye drops or applied to the skin. [4] [5] It is also available in the fixed-dose combination medication brimonidine/timolol along with timolol maleate. [6]
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