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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.
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.
With antibiotic treatment,
symptoms usually improve in 3 to 4 weeks, with greater improvement seen in 2
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.
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:
Call 911 or other emergency services right away if you have:
Call your doctor right away if you have:
Common side effects of these antibiotics include:
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.)
An antibiotic that works for one
person with rosacea may not work for another.
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)(What is a PDF document?) to help you understand this medication.
Del Rosso JQ (2007). Acne vulgaris and rosacea. In DC
Dale, DD Federman, eds., ACP Medicine, section 2, chap.
12. New York: WebMD.
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):
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.
February 6, 2013
E. Gregory Thompson, MD - Internal Medicine & Alexander H. Murray, MD, FRCPC - Dermatology
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