Demodex brevis

Topical metronidazole is effective in the treatment of rosacea. The mechanism of action is unknown, but it may relate to the inhibitory effects of metronidazole on Demodex brevis alternately, the drug may act as an anti-inflammatory agent by direct effect on neutrophil cellular function. Oral metronidazole has been shown to be a carcinogen in susceptible rodent species, and topical use during pregnancy and by nursing mothers and children is therefore not recommended. 

Rosacea has characteristic clinical findings. These include an acneiform papular-pustular eruption associated with erythema and hypertrophic sebaceous glands. Typically, these changes appear on the cheeks, nose, and forehead, known as the fecial flush areas. The frontal area of the chest may also be involved. Infestation and possible inflammation caused by the hair follicle mites Demodex folUculorum and Demodex brevis have been linked to rosacea. Rosacea has no known relationship to previous juvenile acne. 

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