Medications for Rosacea

Topical Antibiotics

Common name: metronidazole]]> (MetroGel, MetroCream)

Topical metronidazole and other antibiotics are applied to your skin to help reduce the redness and pimples of rosacea.

You may have to use this medicine for at least nine weeks before seeing improvement. The long-term use of metronidazole helps maintain remission in most people with rosacea. Use cosmetics sparingly and make sure they are oil-free (noncomedogenic) to reduce irritation.

Possible side effects include:

• Dry skin
• Redness, stinging, and burning of the skin
• Watering of the eyes

Oral Antibiotics

Common names include:

• Tetracycline]]> (Achromycin V)
• ]]>Minocycline]]> (Dynacin, Minocin)
• ]]>Erythromycin]]> (Ery-Tab, Erythro, Erythrocin, Ilotycin, Ilosone, Wintrocin)
• ]]>Doxycycline]]> (Doryx, Monodox, Vibramycin, Vibra-Tabs, Oracea)

If you have a more severe case of rosacea, your doctor may prescribe an oral antibiotic. Doxycycline, minocycline, and less commonly tetracycline, and erythromycin are often used to treat rosacea. Some people respond quickly, while others require long-term therapy.

Possible side effects include:

• Increased skin sensitivity to sunlight
• Stomach cramps or burning sensation
• Diarrhea
• Light-headedness

Topical Anti-acne Agents

Common name: tretinoin]]> (Retin A)

Tretinoin helps to treat acne by keeping skin pores clear.

Tretinoin should not be used during pregnancy. It should also not be used with some other types of medication and skin products. Ask your doctor for a list of products that should not be used with tretinoin.

Possible side effects include:

• Burning feeling or stinging skin
• Lightening of the treated skin
• Peeling of skin
• Redness of skin
• Unusual dryness of skin

Systemic Anti-acne Agents

Common name: isotretinoin]]> (Accutane)

Isotretinoin is used to treat severe or therapy-resistant rosacea if other medicines have failed to help. However, isotretinoin is linked to a number of adverse effects, some of which can be severe. The most serious potential adverse effect is that it can cause birth defects in pregnant women who take it. Therefore, you should not be pregnant or get pregnant while taking isotretinoin. If you are a woman of childbearing age, you must use an appropriate birth control method one month before the initiation of therapy, during the entire course of therapy, and until two months after stopping taking the drug. Your doctor will order a pregnancy test before therapy is started and every month during therapy. Also, you should not donate blood while taking this medicine or for 30 days after you stop taking it, in the event that it could be donated to a pregnant woman.

Possible side effects include:

• Dryness of the mouth, nose, eyes, and skin
• Headache
• Sensitivity to sunlight
• Upset stomach
• Fatigue
• Thinning of hair
• Depression

Cortisone Cream

Cortisone creams can decrease inflammation in the skin. However, they can also cause the skin to become too thin, so they should be used for only brief periods of time (1-2 weeks). Furthermore, although cortisone will produce fast improvement in rosacea, the disease will flare very soon after discontinuation. Therefore, cortisone should not be used for long-term treatment of rosacea.

Possible side effects include:

• Thinning of the skin
• Increased skin fragility
• Acne-like breakout
• Worsening of rosacea upon discontinuation

Azelaic acid (Finacea)

This is an acid compound that works to kill bacteria on the skin and helps the skin turnover to newer, healthier skin.

Possible side effects include:

• Burning
• Tingling
• Stinging
• Redness
• Peeling
• Skin irritation