Treatment of rosacea: a new protocol

Iranian dermatologists in the Journal of Cosmetic Dermatology published a protocol for the treatment of facial rosacea using permethrin gel 2.5% with tea tree oil, which aims to rid patients of the Demodex folliculorum mite.

A double-blind, randomized clinical trial included 47 patients with papulopustular rosacea. 35 patients completed a 12-week treatment using permethrin 2.5% with tea tree oil on one side of the face and placebo on the other twice daily.

The use of permethrin 2.5% with TTO gel has demonstrated good efficacy and safety for rosacea. The topical gel suppressed the inflammatory effects of rosacea and reduced the effects of demodex mites. Clinical features and global assessments showed that papules, pustules, and intransitive erythema had improvement in the drug group at 12 weeks (P values <0.05). The improvement in burning, stinging, and dryness was greater than that of placebo gel (P value <0.05). Pruritus in the placebo group was significantly greater than in the other group (P value = 0.002).

Permethrin is an insecticide and acaricide. The action is due to a violation of the ion permeability of sodium channels and inhibition of the processes of polarization of the membrane of nerve cells of ectoparasites such as arthropods, which leads to their paralyzing effect.