The antiinflammatory properties of ivermectin and brimonidine in the treatment of papulopustular rosacea

Introduction: The pathophysiology of papulopustular rosacea (PPR) is not fully understood; however, there is increasing evidence that immune and inflammatory responses play an important role in the persistent and perilesional erythema of PPR. Multiple trials have demonstrated the efficacy of ivermectin 1% cream (IVM) and brimonidine 0.33% gel (BR) for treatment of the inflammatory lesions and erythema of PPR, respectively. Two recent studies suggest a promising synergy between IVM and BR in PPR.