Rosacea Medications

  • Best Results8-16 weeks
  • Treatment RecoveryNA
  • Procedure TimeNA
  • Skin SpecialistDermatologist
  • Duration of ResultsVariable
  • AnaestheticNA
  • Back to WorkNA
  • Cost$

Rosacea Medications

Prescription tablets are considered in severe cases of rosacea or if topical creams & lifestyle modifications are not effective. Tablets do not cure rosacea; however they can be an effective way of temporarily suppressing skin inflammation. These groups of tablets are more effective for acne-rosacea or papular pustular disease. A treatment course ranges from 2 to 20 weeks.

FactsFacts on Tablets for Rosacea

  • Primary aim of tablets is to reduce skin inflammation secondary to rosacea
  • The most prescribed tablets include doxycycline, minocycline & erythromycin
  • Dermatologists also prescribe low dose oral vitamin A
  • Lifestyle changes, skin care & lasers can reduce the requirement for tablets
  • Tablets are useful as part of rotational therapy during rosacea flare ups
  • A course of tablets ranges from 2 weeks to several months
  • Tablets can be synergistic with laser in reducing inflammation

What do tablets do?

The main role of tablets is to treat skin inflammation associated with rosacea. Many of these tablets are also classified as antibiotics, however in the context of rosacea, they decrease inflammatory papules & pustules. Some tablets work by modifying the response of blood vessels that cause redness & flushing.

Why do dermatologists prescribe antibiotics for rosacea?

This group of medications are designed to treat skin inflammation & not a skin infection. (demodex infection responds to sulphur & ivermectin).

In many cases of rosacea, your skin is super inflamed & will not tolerate topicals, hence why they choose a systemic approach. Consider skin care & lifestyle changes prior to prescription tablets if you are naturally inclined to treat medical conditions.

What types of antibiotics & anti-inflammatories are prescribed?

The most frequent group are tetracyclines. They include doxycycline, minocycline & in Europe azithromycin. This group of tablets are not indicated in pregnancy or if you have allergies to tetracycline. Erythromycin or other macrolides is another group of anti-inflammatories.

How long will you need to take anti-inflammatory tablets?

It depends on how aggressive your rosacea is. It also depends on how insightful you are in the context of flare factors, acknowledging there are factors beyond your control. Examples include ambient UV, temperature changes, seasons & exercise.

Most patients take anti-inflammatory tablets in a pulsed manner, meaning a limited cycle during the year. For example if your pattern flares up in winter, you may want to limit use say from May to July.

Davin’s viewpoint on tablets for rosacea

In the treatment ladder of rosacea, tablets are about midway. View prescription tablets as an option when the usual lifestyle changes, dietary changes, topicals, & skin care don’t control your rosacea. Anti-inflammatory tablets are useful as adjunctive treatments, usually in a cyclic manner.  

I view rosacea as an adjustment disorder, namely it takes time for you to adjust to a chronic condition (much like lower back pain). Most people will take 3-5 years to understand their pattern. Everyone has a unique blueprint of exacerbating factors that includes stress, foods, heat, emotion, topical skin care, UV, climate changes, alcohol, & a whole lot more. The more analytical you are, the faster you can adjust. Keeping a simple rosacea diary can speed up the process.

Typically rosacea patients will have timely flares, most often in winter (cold, westerly winds) & seasonal change (UV, wind). This is when tablets, including oral antiinflammatories & isotretinoin can be useful. The aim of therapy, in my opinion, is to limit any oral medication to the minimum amount required to control rosacea- this includes dose & duration. Be guided by your dermatologist.

Disclaimer: My work is procedural, namely I specialise in laser management of rosacea. I do not practice medical dermatology (namely prescription medications), however I often initiate oral medications concurrently with laser treatments. This is due to the fact that my job is to get your rosacea under control in the fastest/safest way possible. The choice of tablets is yours.

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