Topical medications (applied to the skin) include:
- Metronidazole (MetroGel®). Topical metronidazole reduces the papules and pustules, as well as redness (erythema) of rosacea. Metronidazole may also be prescribed to prevent relapses of rosacea.
- Azelaic acid (Azelex®, Finacea®). Azelaic acid treats redness, bumps and pimples of mild to moderate rosacea. Patients in clinical studies who used Finacea® saw their symptoms improve in as early as 4 weeks.
- Other topical rosacea medications include clindamycin, erythromycin, and sulfacetamide and sulfur lotions (Clenia®, Plexion®)
Oral medications (taken by mouth) include:
- Anti-inflammatory dose doxycycline (Oracea®) Doxycycline is used most commonly as an antibiotic for the treatment of bacterial infections, including acne. However, doctors rely on its anti-inflammatory properties when prescribing it for rosacea. When prescribed for rosacea, doxycycline is usually prescribed in low doses of 40mg per day. This is referred to as an “anti-inflammatory” dose. This amount is below the standard antimicrobial dose of doxycycline that kills bacteria. The low dose reduces the risk of developing side effects associated with antibiotics and of developing bacterial resistance. Oracea® is the brand name of doxycycline that has been formulated to provide anti-inflammatory effects when taken once a day. It’s low dose formulation makes it safe for long-term use.
Combination Therapy
A combination of medications may be recommended for maximal benefit. For instance, an oral medication, such as Oracea®, may be combined with an antibiotic applied to the skin, such as metronidazole or azelaic acid.
