What are the risks of treating rosacea with antibiotics?

My dermatologist has prescribed me antibiotics to treat my rosacea. I have read about a bunch of risks of constantly treating rosacea with antibiotics vs. creams or lasers. Any advice?


F, 55, Tennessee

Tags:woman age 45-54 rosacea laser risks cream

I was also concerned about the risks of using antibiotics to treat my rosacea. In the past, my doctors have over-prescribed antibiotics to treat my coughs and other ailments. At the time I didn’t think anything of it. I felt that antibiotics were safe, and I was unaware of any adverse side effects. But when I saw my new dermatologist for treatment of my severe rosacea, he informed me that he only prescribes antibiotics as a last option and only in extreme cases and usually in low doses. He said that taking antibiotics when they aren’t really necessary can compromise your gut health by destroying all your good gut bacteria. And if you take too many antibiotics, eventually long term your immune system will weaken, and your body’s bacteria could become resistant to antibiotics. My doctor also said he prefers to use topical antibiotics for severe rosacea instead of pill form to avoid gut damage.

I was diagnosed with acne rosacea a few years ago and have also struggled with finding the best treatment that has the fewest side effects. Antibiotics are not something I take regularly. There have been a few occasions, though, usually when my life gets chaotic and stressful, that my symptoms become unmanageable, and in these cases, I do take antibiotics for a month or so and then taper back off. For symptom management, I have tried metronidazole cream which helps with redness after a few weeks of regular usage. As far as laser treatments go, my doctor has told me that this is an option if my redness and burning is persistent, but my symptoms are usually well managed by avoiding triggers. If I were you, I wouldn't be afraid to take antibiotics for bad flare ups as long as you're not on them for more than about a month.

There aren't too many risks because most doctors will only prescribe antibiotics for a short time. My rosacea gets pretty nasty at times, and tetracycline calms it down immediately. My doctor usually gives me a week or two on it, no more than that. If your doctor has prescribed you antibiotics, it's because he/she feels that the pros far outweigh the cons and because your swelling needs to go down immediately! Rosacea left untreated can cause more harm than antibiotics can.

I have been dealing with rosacea for several years. Initially, dermatologist recommended that I try a few lifestyle changes. She suggested changing my skincare regimen and my diet. I tried doing that, but my rosacea was hard to treat and a pretty severe case. My dermatologist put me on doxycycline, an oral antibiotics to manage my flare-ups, but I was not supposed to use the antibiotics forever. When my symptoms subsided, I could reduce my usage of antibiotics. My doctors didn't want me to overuse the antibiotics because overusing antibiotics can result in bacterial resistance.