What Are the Pros and Cons of Treating Rosacea With Antibiotics?

Rosacea is not diagnosed with a single, standardized lab test. Your medical care provider will instead rely on a combination of your symptom history and a physical examination of your skin to make a diagnosis. Several tests may be performed to rule out the possibility of other diseases. Research shows that rosacea is often misunderstood as an allergic response or seborrheic dermatitis in persons of color.

Your primary care physician may suggest seeing an ophthalmologist for further examination if your symptoms have anything to do with your eyes.


  • A reddening or flushing of the face. Persistent flushing or blushing in the center of the face may be a symptom of rosacea. This disease symptom could not be readily apparent on dark and Black skin.

  • Veins that can be easily seen. When the blood vessels in your nose and cheeks burst, they become apparent (spider veins).

  • Large, puffy lumps. Acne-like facial blemishes are a common symptom of rosacea. Pus may sometimes be seen in these lumps.

  • It feels like your skin is on fire. The afflicted region may feel hot to the touch and sensitive.

  • Challenges in seeing clearly. Rosacea patients often complain of red, itchy, and puffy eyes and eyelids. The condition is called ocular rosacea. Several individuals have eye problems before they notice any changes to their skin.

  • Nose enlargement. Rosacea may cause a thickening of the skin of the nose, giving the appearance of a swollen, bulbous nose (rhinophyma).

Medicines and Skin Care for Rosacea

It's important to know the rosacea subtype you have so your doctor can prescribe the appropriate medication. Those with papulopustular rosacea benefit the most from these topical and oral treatments. There, people may have mild acne, flushing, and fine wrinkles on the cheeks as symptoms.

Those with different forms of rosacea may still take these therapies, although they may not be as effective. And even if they do help, you may want to maintain taking them to avoid future flare-ups. There's a chance your doctor may prescribe a combination of lotions and pills.

Antibiotics are often used to treat rosacea, but this isn't because the condition is bacterial. Antibiotics, however, may reduce inflammation and itching, assisting with any skin conditions resembling acne.


Reducing the severity of rosacea's symptoms is the primary goal of treatment. This can often only be resolved by combining effective topical skin treatments with oral medications.

Your symptoms and their intensity will determine how long therapy will last. That often happens again.


In recent years, many novel treatments for rosacea have been discovered. The symptoms you're experiencing will determine the medicine your doctor recommends. Finding a therapy that works for you may need you to try many different approaches or medications.

A few of the prescription medications available for rosacea are −

  • Treatments are used topically to lessen flushing. You may be prescribed a topical cream or gel for mild to moderate rosacea. Blood vessel constrictors such as brimonidine (Mirvaso) and oxymetazoline (Rhofade) can minimize flushing. During 12 hours of usage, you might perhaps see an improvement. The medication's impact on the blood vessels is short-lived. Therefore it must be administered periodically to sustain gains.

  • Mild rosacea acne may be managed with other topical treatments. Ivermectin, azelastine, metronidazole (Metrogel, Noritate, and others), and azelaic acid (Azelex, Finacea) are some examples of such medications (Soolantra). Improvements with azelaic acid and metronidazole often don't become apparent for two to six weeks. Although ivermectin takes longer to restore skin than metronidazole, the remission it causes is far more permanent.

  • Sublingual antibiotics. For moderate to severe rosacea that causes bumps and pimples, your doctor may recommend an oral antibiotic such as doxycycline (Oracea, others).

  • Medication is used orally for acne. Your doctor may recommend isotretinoin if you have severe rosacea that hasn't improved with prior treatments (Amnesteem, Claravis, others). It's an effective oral treatment for acne that also reduces rosacea's acne-like lesions. You should avoid using this medication while pregnant because of the risk of devastating effects on the unborn child.

Therapeutic Laser Surgery

As a result of laser treatment, dilated blood vessels may be less noticeable. Discuss laser treatment's potential side effects and advantages with your healthcare provider. Laser treatment for rosacea might cause swelling and bruising that would linger for a few days. To aid healing, icing, and moderate skin care are recommended. Laser therapy can potentially produce long-term or permanent discoloration of the treated skin in patients with dark or black skin.

The therapy may take a few weeks to show its full impact. You may need to schedule touch-up procedures regularly to keep your skin looking its best.

In most cases, insurance won't pay for laser therapy for rosacea since it's considered a cosmetic operation.

Healthful Habits and Natural Cures

The following self-care measures may reduce rosacea symptoms and the frequency of flare-ups −

  • Learn to spot and avoid what sets you off. Recognize your triggers and do your best to avoid them.

  • Be sure to cover your face. Regular use of a high-SPF sunscreen is recommended before any outdoor activity. Please protect yourself from the sun using broad-spectrum sunscreen with an SPF of 30 or higher. Sunscreen should be used after any topical facial medications but before makeup.

  • Put on a hat and stay out of the noon sun to protect your skin. Use a ski mask or scarf if the weather is chilly and windy.

  • Be gentle with your skin. Don't be too rough with your face by touching it excessively. Clean your face twice a day with a soap-free cleanser and then moisturize. Choose fragrance-free products and stay away from ones that have skin irritants like alcohol, camphor, urea, and menthol.

  • Use cosmetics to conceal any redness. Makeup and application methods may be used to mask redness caused by flushing.

Medicine that isn't the FDA's Standard

Regular, light face massage may help reduce puffiness and redness. Use your fingers circularly, beginning in the middle of the face and ending where the ears would be. Caffeine may help prevent rosacea, according to new research. Yet, hot drinks are a frequent aggravating factor.

Emu oil, laurelwood, and oregano oil are just a few of the alternative medicines proposed as potential approaches to cure rosacea. Yet, no concrete proof exists that any of these chemicals really work.

Discuss the benefits and risks of any alternative therapy you're considering with your doctor.

Assistance and Coping

Rosacea is a frustrating condition. You might become introverted or self-conscious due to being ashamed or nervous about your looks. The responses of others around you may cause you frustration or even anger. It may help to discuss your emotions with a professional counselor.

In-person or virtual, a rosacea support group may connect you with individuals who understand what you're going through.

Making Arrangements for Your Consultation

You probably want to start with your primary care physician. Instead, you may be directed to a dermatologist when you phone to schedule an appointment (dermatologist). A referral to an ophthalmologist may be made if your disease has any noticeable effect on your eyes (ophthalmologist). Plan so that you can make the most of your appointment.


Low-dosage sub-antimicrobial doses are the best option for occasional antibiotic treatment to manage rosacea. Antibiotic treatment for rosacea should always be complemented with a thorough skin care regimen, the appropriate prescription for topical rosacea drugs, and avoiding rosacea triggers. The irritating and unsightly rash caused by rosacea should be addressed from as many directions as possible.

Updated on: 29-Mar-2023


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