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Antibiotics for Rosacea

Examples

Oral antibiotics

Generic Name Brand Name
doxycycline Doryx, Oracea, Vibramycin
Generic Name Brand Name
erythromycin Akne-mycin
minocycline Minocin
Generic Name Brand Name
tetracycline Sumycin
Generic Name Brand Name
trimethoprim-sulfamethoxazole Bactrim, Septra

Topical antibiotics

Generic Name Brand Name
metronidazole MetroCream, MetroGel, Noritate

How It Works

The ability of antibiotics to kill bacteria does not seem to be important when treating rosacea.1 Instead, the antibiotics may reduce overall inflammation of your skin. They also may reduce the number of pimples and the amount of redness around pimples.

You can apply antibiotics directly to the skin (topically), or you can take them by mouth (orally). Oral and topical antibiotics may be used together or alone to treat rosacea.

Oral antibiotics also help treat eye problems caused by rosacea.

Why It Is Used

You can use antibiotics to reduce the symptoms of rosacea, including redness, pimples, and eye symptoms.

People with mild rosacea may only need antibiotic creams. Moderate or severe symptoms usually require oral antibiotics.

How Well It Works

With antibiotic treatment, symptoms usually improve in 3 to 4 weeks, with greater improvement seen in 2 months.

A low-dose form of doxycycline (Oracea) works well to clear up inflamed skin within the first few weeks. It doesn't usually cause any side effects and is available in a pill that is taken once a day.2

Oral antibiotics, such as tetracycline, are often used with good results to treat eye problems from rosacea.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Metronidazole

Call your doctor right away if you have:

  • Hives.
  • Numbness, tingling, pain, or weakness in your hands or feet.

Common side effects of these antibiotics include:

  • Diarrhea.
  • Dizziness.
  • Headache.
  • Tiredness.
  • Trouble sleeping.
  • Mild stomach pain or cramps, nausea, loss of appetite.
  • Metallic or unpleasant taste in the mouth.

Diarrhea and vaginal yeast infections may occur when oral antibiotics destroy some of the normal and necessary bacteria that live in the body. Eating yogurt that contains active cultures (lactobacillus) may help prevent some of these side effects.

A large study has shown that people who take erythromycin along with some common medicines, such as certain calcium channel blockers, antidepressants, and antifungal medicines, increase their risk of sudden heart-related death.3

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

An antibiotic that works for one person with rosacea may not work for another.

Over time, antibiotics can stop being effective. When this occurs, a different antibiotic may be used.

Some antibiotics are not safe for pregnant women.

Complete the new medication information form (PDF)new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Del Rosso JQ (2007). Acne vulgaris and rosacea. In DC Dale, DD Federman, eds., ACP Medicine, section 2, chap. 12. New York: WebMD.
  2. Del Rosso JQ, et al. (2007). Two randomized phase III clinical trials evaluating anti-inflammatory dose doxycycline (40-mg doxycycline, USP capsules) administered once daily for treatment of rosacea. Journal of the American Academy of Dermatology, 56(5): 791–802.
  3. Ray WA, et al. (2004). Oral erythromycin and the risk of sudden death from cardiac causes. New England Journal of Medicine, 351(11): 1089–1096.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Alexander H. Murray, MD, FRCPC - Dermatology
Last Revised February 6, 2013

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