Oral Medication for Rosacea

NYU dermatologists may recommend a combination of topical medications and oral medications to treat patients with rosacea. Oral medications are taken by mouth and are particularly helpful in treating people who have symptoms—such as blemishes or whiteheads—that are resistant to topical medications.

In order to see optimal results, it’s important to take oral medications exactly as recommended by your dermatologist.

Oral Antibiotics

The class of antibiotics known as tetracyclines can have powerful anti-inflammatory effects. Your doctor may recommend these oral antibiotics to help clear your skin of the blemishes caused by rosacea, as well as to reduce redness and swelling.

A low dose of a tetracycline keeps it below the antibiotic threshold, meaning the medication does not stop the growth of bacteria but can work as an anti-inflammatory treatment. These nonantibiotic doses of a tetracycline, such as doxycycline, can be used as long-term rosacea treatment without heightening your risk of developing a resistance to antibiotics. Side effects may include an upset stomach, rash, sun sensitivity, or allergic reactions.

Oral Isotretinoin

Isotretinoin is a medication taken by mouth that can help to reduce the number of skin blemishes caused by rosacea. These blemishes include pustules, or whiteheads, and papules, which are small red bumps. Isotretinoin targets the oil-producing glands in your skin, shrinking them so that less oil is produced, therefore reducing the chances that pores may become clogged.

Oral isotretinoin was previously marketed under the brand name Accutane® but is now only available as a generic medication.

This medication is usually prescribed for several weeks to months, with many people seeing a reduction in the number of blemishes after four weeks. Each month your dermatologist examines your skin to assess how well the medication is working before making a recommendation about further treatment. Blood tests are often done to monitor for side effects, including liver toxicity.

Research suggests that isotretinoin can cause birth defects if women take the medication while pregnant. As a precaution, the U.S. Food and Drug Administration has created the iPLEDGE™ distribution program, which requires that people taking medications with isotretinoin register with this program to fill the prescription. Women must also agree to use birth control throughout treatment.

NYU Langone doctors are registered with this program as prescribers and can help you with the registration process.

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