What are the first-line topical treatments for managing acne rosacea in adults?

The first-line topical treatments for managing acne rosacea in adults include topical ivermectin, applied once daily for 8–12 weeks, especially for mild-to-moderate papules and/or pustules ¹.

Alternative topical treatments are metronidazole 0.75%, applied twice daily, or azelaic acid 15%, applied twice daily, if ivermectin is not suitable or available ¹.

For persistent erythema, topical brimonidine 0.5% gel may be prescribed for temporary relief, applied once daily as needed ¹.