The treatment efficacy of 7.5% dapsone gel in papulopustular rosacea: a prospective study.

Introduction: Topical dapsone has a level A recommendation for the treatment of papulopustular rosacea; however, its treatment efficacy has not been studied previously. The aim of this study is to evaluate the safety and efficacy of topical 7.5% dapsone gel applied once daily at night in the treatment of papulopustular rosacea.

Patients and methods: This is a prospective study including female papulopustular rosacea patients with a minimum IGA score of 2. The patients were recruited at two different outpatient clinics by two independent dermatologists. The patients were prescribed 7.5% dapsone gel (same brand) for once-daily use at night. No other topical or systemic treatment modalities were allowed to be used during the study except for a sun protection factor 50 sunscreen and an emollient face cream. The patients were evaluated with the total lesion counts and IGA scores at weeks 0, 4 and 8 by two independent dermatologists. The side effects of burning, stinging, pain, erythema, and exfoliation were questioned during the follow-up visits.

Results: All 32 recruited patients (18-70) completed the study. The mean lesion counts of the patients were 22.10 ± 8.95 on the initial visit, 11.90 ± 6.49 on the 4th week follow-up and 3.87 ± 3.76 on the 8th week follow up. The mean IGA scores of the patients were 3.06 ± 0.81 on the initial visit, 2.10 ± 0.87 on week 4 and 0.74 ± 0.73 on week 8. The decrease in the mean lesion count and IGA score of the patients in weeks 4 and 8 were statistically significant (p = 0.000 for all). This decrease was independent of the patient's age (p > 0.005). No side effects were reported.

Conclusions: The 7.5% topical formulation of dapsone is effective for papulopustular rosacea both on the first and second months of the treatment regardless of the age of the patient. Its safe side effect profile suits for a comfortable use in rosacea patients with a decreased skin tolerance.