Rosacea Medications that Work

For years, rosacea treatment consisted of the antibiotic medications tetracycline and doxycycline, and doctors often prescribed other antibiotics that were not expressly indicated for rosacea. Then, in 2006, the U.S. Food and Drug Administration (FDA) approved a low-dose version of doxycycline named Oracea specifically for rosacea treatment.

Oracea differs from antibiotics previously used to treat rosacea primarily because it is delivered in what’s called a sub-antimicrobial dose, meaning a dose not strong enough to kill bacteria, but that will reduce inflammation. This removes the risk of the higher dose doxycycline causing the growth of resistant bacteria from long-term use and resulting in its inability to combat infection. Oracea’s ability to reduce the inflammation of rosacea as well as treat ocular rosacea was demonstrated in at least two large, controlled trials.

Oracea Side Effects and Cautions

When following recommended dosage and directions, most people who take Oracea tolerate it well. Serious adverse side effects of this rosacea treatment are rare, but there are more common side effects that you should be aware of:

• Increased sensitivity to sunlight, which can lead to severe sunburns
• Permanent discoloration of the teeth if given to children
• Decreased rate of bone growth
• Decreased effectiveness of oral birth control medications

The most serious gastrointestinal side effects associated with Oracea are esophagitis (an inflammation of the esophagus) and esophageal erosions, both of which are most commonly seen when the medication is taken at bedtime and with too little water. It’s worth noting that Oracea has not been formally evaluated for more than nine months of continuous use.

There are also a number of people should not take doxycycline, including those who:

• Are pregnant or nursing
• Have allergies to tetracycline, doxycycline, or minocycline
• Have esophageal erosions
• Are under the age of eight

Other Oral Medications for Rosacea Treatment

Although there is considerable evidence that the antibiotics azithromycin, doxycycline (in the higher antibiotic dosage), and tetracycline are effective rosacea treatments, they also have side effects that call into question the overall benefits of using them to treat rosacea. The antibiotic minocycline can be prescribed for rosacea treatment if other treatments have failed, however, like azithromycin, minocycline is not FDA-approved for rosacea treatment.

Because of unpleasant and potentially serious side effects associated with oral antibiotics — most commonly upset stomach and diarrhea — many rosacea patients have been treated with short-term oral antibiotics to control flare- ups, followed by topical medications or laser or light therapy and suggested lifestyle changes to avoid rosacea triggers.

In addition to antibiotics’ adverse side effects for individual patients, long- term use is widely believed to contribute to their ineffectiveness in combating infections, encouraging medical researchers to seek alternatives to antibiotic treatment of non-infectious illnesses.

Some doctors have found oral contraceptives can help control flushing associated with rosacea; however, birth control pills also are not approved for rosacea treatment.

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