Can I switch from Metronidazole to Soolantra cream for rosacea?

Question

Hello doctor,

I live in a tropical country, where the exposure to the sun is too much. My skin used to be fair before moving to this country. Back in my country, I used to never go out in the sun. After I moved here, my skin was burnt. It was red at first, and then the blood vessels were visible. I started using Metronidazole cream for two years, for four to five months with breaks, after I was diagnosed with rosacea. I even tried laser treatment last year, but it did not help much. My condition is slowly getting worse, and I stopped Metronidazole cream last year. When can I start using Metronidazole again? Can I switch to Soolantra? I have read that it is a new cream for type 2 rosacea. Do I have type one or type 2 rosacea? Should I try laser or IPL? I have attached a picture of my skin.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Indeed your images (attachment removed to protect patient identity) are more in favor of acne rosacea. This is a chronic and recurrent condition characterized by erythema with flushing sensation, predominantly affecting the cheeks. The management of rosacea needs to be holistic, ranging from medication to lifestyle modifications.

To begin with, you first have to start using a sunscreen regularly, preferably a one with physical blockers such a titanium dioxide or zinc oxide, in the mornings.
Azelaic acid 20 % or Metronidazole 0.75 to 2 %, do work well for rosacea. They can be applied in the evenings.
IPL (intense pulsed light) and other lasers would be more helpful in treating the vascularity, which tends to persist after using the creams. Lasers would be helpful in later stages.
Apart from this, you should strictly avoid exposure to extremes of both hot and cold weather and food items, restrain from spicy foods, and try not to treat your skin harsh by forcibly rubbing it.

I hope this information will help you.

Thanks.