The Zileuton Debate

A member from the RS group was saddened to read a recent release on the effect of Zileuton on moderate to severe acne in a small study. It is quite tricky to evaluate results and to extrapolate those findings to rosacea. He sadly crossed off this oral medication for rosacea too.
Some points to make that show this will be used off label for rosacea: 1. Countless rosacea sufferers using Singulair for other disorders have noticed significant clearance of inflammatory rosacea and flushing. Ths is what opened up the eyes for an even more specific medication, Zyflo (zileuton).
 2. Acne has many variables in its causation that are distinctly different from rosacea papules and pustules, so its impossible to compare.
 3. It is known and published that inflammatory leukotrienes (the ones Zyflo blocks) are involved in rosacea inflammation of the dermis, swelling, papule formation and active flushing. These are abnormally high and thus blocking the enzyme that makes them will bring relief to many. Its frustrating some times to read an article and not know how to evaluate it or come to the wrong conclusion. No problems or setbacks that I see with this med for rosacea. Even the CEO stated the promising signs of this study. "We believe this small trial supports that 5-LO inhibition may be a useful therapy in patients with moderate to severe inflammatory acne," said Critical Therapeutics President and Chief Executive Officer, Paul Rubin, M.D. "The relative severity of disease and size of the patient population in this study have given us valuable information to consider for the design of any clinical trials in acne patients that we may decide to pursue in the future."

G. Nase's View