Rosacea Meds

I am a mid 50s male, medium skin tone, with dx rosacea and taking 1800mg Niaspan (limited flushing problems) and 20 mg Zocor for elevated Lp(a) and lipid control.  After a recent and significant rosacea flare primarily affecting my nose (redness/papules), my dermatoligist switched me from daily metrogel to: a Finacea 15% gel, Elidel cream and Keflex tabs 500 twice daily.  Next visit in 6 weeks.  

Would you explain the role of each medication for symtomatic Rosacea control.  Also would you comment on the possible benefits of Keflex in this context rather than tetracycline?  

[Alan Rockoff, MD]

Finacea (azelaic acid) has been shown effective in rosacea.  Antibiotics, both oral and topical, seem to work as anti-inflammatory agents in this condition, rather than as germ-killers.  Elidel may be intended to reduce inflammation without the need for steroids, which can aggravate rosacea.  I am not familiar with Keflex as a rosacea drug; tetracycline derivatives are the standard ones, and I don't know exactly why your doctor chose Keflex.

Best.

Dr. Rockoff