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Main Page | Risk Factors | Symptoms | Diagnosis | Treatment | Screening | Reducing Your Risk | Talking to Your Doctor | Living With Rosacea | Resource Guide Medications for Rosacea by Amy Scholten, MPH En Español (Spanish Version) The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor. There are several prescription medications available to treat rosacea. They are used to control the redness and clear up bumps and pustules on your face. You may be given medication to apply to your skin (topical) and medication to take by mouth (oral). It may take a few weeks to see results. Once your symptoms have cleared, you may need to continue taking medication to keep rosacea under control. Prescription Medications + Topical antibiotics Metronidazole (MetroGel, MetroCream, MetroLotion) Clindamycin (Cleocin, Clindagel) Clindamycin and Benzoyl Peroxide (BenzaClin, Duac) Sulfur and Sodium Sulfacetamide (Plexion, Plexion TS, Plexion Sct, Sulfacet-R, Zetacet, Nicosyn, AVAR Cleanser, Rosula, Rosanil, Rosac Cream w/Sunscreens, Clenia, AVAR-e, AVAR-e Green, AVAR Gel, AVAR Green) + Oral antibiotics Tetracycline (Achromycin V) Minocycline (Dynacin, Minocin) Erythromycin (Ery-Tab, Erythro, Erythrocin, Ilotycin, Ilosone, Wintrocin) Doxycycline (Doryx, Monodox, Vibramycin, Vibra-Tabs) Metronidazole + Topical anti-acne agents Tretinoin (Retin A) + Systemic anti-acne agents Isotretinoin (Accutane) Cortisone creams Azelaic acid (Finacea) Prescription Medications Topical Antibiotics Page 1 of 4 Copyright © 2011 EBSCO Publishing. All rights reserved. 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 Page 2 of 4 Copyright © 2011 EBSCO Publishing. All rights reserved. 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 Special Considerations Page 3 of 4 Copyright © 2011 EBSCO Publishing. All rights reserved. Whenever you are taking a prescription medication, take the following precautions: Take your medication as directed. Do not change the amount or the schedule. Do not stop taking them without talking to your doctor. Do not share them. Know what the results and side effects. Report them to your doctor. Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements. Plan ahead for refills so you don’t run out. REFERENCES: National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ . National Rosacea Society website. Available at: http://www.rosacea.org/index.php . USP DI . 21st ed. Micromedex; 2001. Last reviewed September 2011 by Ross Zeltser, MD, FAAD Last Updated: 9/1/2011 Page 4 of 4 Copyright © 2011 EBSCO Publishing. All rights reserved.