There are currently three main types of topical preparations approved by the U.S. Food and Drug Administration (FDA) for the treatment of rosacea (rosacea): 0.75% metronidazole and l% metronidazole, 10% sodium acetyl sulfonate and 5% sulfur complex, and 15% azelaic acid gel. Mainly used for the treatment of papules, pustules and erythematous lesions. 1, metronidazole: for the treatment of papulopustular rosacea. The mechanism for the treatment of rosacea may lie in its anti-inflammatory and immunosuppressive effects. Randomized, placebo-controlled trials have validated the effectiveness of topical metronidazole in the treatment of rosacea and its tolerability by patients. Another study showed that metronidazole gel helped maintain lesions without recurrence compared to placebo. 2. Azelaic acid: A natural saturated dicarboxylic acid used in the treatment of acne and various hyperpigmented disorders. 15% azelaic acid gel was approved by the FDA in December 2002 for the treatment of mild to moderate rosacea. Its efficacy is attributed to its antibacterial activity, promotion of keratin normalization and anti-inflammatory activity. Clinical trials have shown that topical 15% azelaic acid gel is a safe and effective first-line agent for the treatment of mild to moderate papulopustular rosacea. 3. Sodium acetyl sulfonamide/sulfur formulation: The combination of sodium acetyl sulfonamide and sulfur can treat rosacea, acne vulgaris, perioral dermatitis, and seborrheic dermatitis. Several studies have validated the effectiveness and tolerability of sodium acetyl sulfonamide/sulfur preparations for papulopustular rosacea in both the active and maintenance phases of the disease. It is contraindicated in patients with sulfonamide allergy and renal disease. 4, antibiotics: patients can use topical erythromycin, clindamycin and other drugs. Some studies have shown that topical clindamycin is comparable in efficacy to oral tetracycline, and even better than tetracycline in the regression of pustular lesions. 5. Benzoyl peroxide: It can lead to increased erythema and stinging pain in some sensitive patients. However, studies have shown that for some non-sensitive patients, erythema, papules and pustules can be eliminated quickly. Another study has shown that a peroxymethylphenidate/clindamycin combination can be used to treat moderate rosacea. In addition, dermatomal rosacea responds well to peroxyphenylmethanide treatment. 6. Tacrolimus and pimecrolimus: Tacrolimus is a calcium phosphatase inhibitor with strong immunomodulatory and anti-inflammatory activity. The drug inhibits the release of inflammatory cytokines through the inhibition of calcium-regulated phosphatase. The efficacy of topical 0.03% tacrolimus ointment on different lesions of facial rosacea varied, with better efficacy on erythema (83.86%) and poorer efficacy on inflammatory papules and pustules (38.70%), as reported by Sherry Li et al. Pimecrolimus is also a macrolide with anti-inflammatory activity that inhibits T-cell factor production and the release of inflammatory mediators from tissue mast cells. It is more lipophilic than tacrolimus, so it has a high degree of binding to the skin. Both can treat rosacea, especially glucocorticoid-induced rosacea. However, topical topical tacrolimus and pimecrolimus for the treatment of facial dermatitis may occur with rosacea-like trichomycosis. Because both tacrolimus and pimecrolimus inhibit T-cell activation, the downregulation of local immune and inflammatory responses may induce proliferation of creeping mites. Regarding the efficacy of tacrolimus and pimecrolimus in the treatment of rosacea, the findings are inconsistent and require further evaluation.