Follow-up on Elidel for rosacea

Dr. Rockoff- Your answers are always very helpful.  A follow-up to my last question: Is metonidzole (like MetroGel) effective in reducing the inflammation that causes discomfort in rosacea patients, or is it only effective in treating the bumps associated with rosacea?  Also, is there any evidence to suggest that Elidel--in at least some patients--can aggravate rather than help with rosacea?  I know its safer than steroids for rosacea, but wasn't sure if it could have steroid-induced rosacea-like effects (at least, in a minority of patients).  Thanks.  

[Alan Rockoff, MD]

Metronidazole should help the irritation as well as the bumps.  Elidel is safer to use on rosacea patients than steroids are, but I believe it can aggravate rosacea sometimes.  It would be best to try to get rid of the irritation with anti-rosacea medication.

Best.

Dr. Rockoff