Fabrication and efficacy assessment of combination of brimonidine and ivermectin for treatment of papulopustular rosacea

• Published in: Journal of cosmetic dermatology 2024-09, Vol.23 (9), p.2973-2981
• Main Authors: Pakdaman, Samin Fallah, Samadi, Aniseh, Fattahi, Mahsa, Naeimifar, Atefeh, Ardehali, Fatemeh Amiri, Ketabi, Yasaman, Nasrollahi, Saman Ahmad, Firooz, Alireza
• Format: Article
• Language: English
• Subjects: dermatopharmacology; rosacea; skin analysis; skin disease; topical treatment
• ISSN: 1473-2130; 1473-2165; 1473-2165
• DOI: 10.1111/jocd.16372

Background & Aim Rosacea is a chronic inflammatory, multifactorial disease for which combination therapy could be an effective treatment. In this study, we evaluate the effect of the combination therapy of brimonidine 0.33% and ivermectin 1% as a single cream for the treatment of papulopustular rosacea. Method A stable and appropriate formulation was prepared by adding the aqueous phase to the lipid phase while being stirred. The stability and physicochemical properties of the formulation were evaluated under accelerated conditions. Twelve patients (36–60 years) with mild to moderate papulopustular rosacea and a Demodex count of five or more were treated with the combination of brimonidine 0.33% and ivermectin 1% cream. Clinician's Erythema Assessment (CEA), Patients Self‐Assessment (PSA), skin erythema (ΔE) and lightness (ΔL), and skin biophysical parameters including transepidermal water loss (TEWL), skin hydration, pH, and sebum content, as well as erythema and melanin index and ultrasound parameters, were measured before treatment and 4 and 8 weeks after. Adverse drug reactions were also recorded. Results CEA and PSA decreased significantly from 3 to 2 after 8 weeks, respectively (p‐value = 0.014 for CEA and 0.010 for PSA). ΔE and ΔL, as well as skin erythema index and TEWL improved after 8 weeks of treatment (p