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Antibiotics For Rosacea


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Antibiotics have been used to treat rosacea for over fifty years.

"TCN became available in the United States (US) as an oral formulation in the early 1950s, doxycycline in 1967, minocycline in 1971, and sarecycline in 2018." [3]

The most popular antibiotics used in the treatment for rosacea are:

Azithromycin (Zithromax)
Clindamycin (Clindagel, Cleocin and Cleocin T)
Doxycycline (Doryx, Oracea)
Doxycycline Hyclate (Periostat)
Doxycycline Monohydrate (Monodox)
Sarecycline [3]
Tetracycline (TCN)

Macrolide Antibiotics seem to be more popular with rosaceans than tetracycline. Macrolides include: erythromycin, azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), roxithromycin (Rulid, Surlid). There are, of course, other antibiotics used to treat rosacea, which you can discuss with your physician. For example, Minocycline as Good as Doxycycline for Rosacea.

Low Dose Doxycycline
An article issued in August 2012 reports, "it now seems clear that the role of antibiotics in patients with rosacea depends upon their anti-inflammatory rather than their antimicrobial properties." [1] Thus the emergence of Oracea or low dose doxycycline.

Short Term or Long Term?
Short term antibiotics for rosacea is an acceptable treatment, however, there may be issues with long term antibiotic treatment:

Antibiotic Resistance, Bacterial Overgrowth.

Another report says, Antibiotics targeting brain’s inflammatory response may exacerbate cognitive deficits in children.

Dermatologists Prescriptions for Antibiotics Decreased
"Between 2008 and 2016 among 985 866 courses of oral antibiotics prescribed by 11,986 unique dermatologists, overall antibiotic prescribing among dermatologists decreased 36.6% (1.23 courses per 100 visits) from 3.36 (95% CI, 3.34-3.38) to 2.13 (95% CI, 2.12-2.14) courses per 100 visits with a dermatologist (prevalence rate ratio for annual change, 0.931; 95% CI, 0.930-0.932), with much of this decrease occurring among extended courses for acne and rosacea." [2]

For more information on antibiotics for rosacea

Your Thoughts
Why not add your experience by posting in this thread what antibiotic treatment your physician prescribed and your thoughts?

End Notes

[1] J Drugs Dermatol.
2012 Jun;11(6):725-30.
Diagnosis and treatment of rosacea: state of the art.
Baldwin HE.

[2] JAMA Dermatol. 2019 Mar 1;155(3):290-297. doi: 10.1001/jamadermatol.2018.4944.
Trends in Oral Antibiotic Prescription in Dermatology, 2008 to 2016.

Barbieri JS, Bhate K, Hartnett KP, Fleming-Dutra KE, Margolis DJ.

[3] J Clin Aesthet Dermatol. 2020 Oct; 13(10): 45–48.
SARECYCLINE AND THE NARROW-SPECTRUM TETRACYCLINE CONCEPT: Currently Available Data and Potential Clinical Relevance in Dermatology
James Q. Del Rosso, DO, FAAD, FAOCD




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