Antibiotics for rosacea

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Antibiotics for rosacea


Oral antibiotics

Generic NameBrand Name
doxycyclineDoxycin, Vibramycin

Topical antibiotics

Generic NameBrand Name
metronidazoleMetroCream, MetroGel, Noritate

How It Works

The ability of antibiotics to kill bacteria does not seem to be important when treating rosacea.2 Instead, the antibiotics may reduce overall inflammation of your skin. They also may reduce the number of pimples and the amount of redness around pimples.

You can apply antibiotics directly to the skin (topically), or you can take them by mouth (orally). Oral and topical antibiotics may be used together or alone to treat rosacea.

Oral antibiotics also help treat eye problems caused by rosacea.

Why It Is Used

You can use antibiotics to reduce the symptoms of rosacea, including redness, pimples, and eye symptoms.

People with mild rosacea may only need antibiotic creams. Moderate or severe symptoms usually require oral antibiotics.

How Well It Works

Treatment usually begins with an oral antibiotic, such as tetracycline, minocycline, or doxycycline, which is then gradually stopped when symptoms improve. Sometimes, a combination of oral and topical antibiotics is used. Long-term use of oral antibiotics may cause side effects.

Following treatment with oral antibiotics, the person continues treatment with a topical antibiotic, such as metronidazole. Studies have found that if red, raised bumps have developed, topical metronidazole is safe and effective. Metronidazole gel is effective in preventing or minimizing recurrences of rosacea.3

With antibiotic treatment, symptoms usually improve in 3 to 4 weeks, with greater improvement seen in 2 months.

Oral antibiotics, such as tetracycline, are often used with good results to treat eye problems from rosacea.

Side Effects

Common side effects of oral antibiotics include:

  • Nausea or vomiting.
  • Diarrhea.
  • Photosensitivity.
  • Allergic reaction.
  • Vaginal yeast infections.

Diarrhea and vaginal yeast infections may occur when oral antibiotics destroy some of the normal and necessary bacteria that live in the body. Eating yogourt that contains active cultures (lactobacillus) may help prevent some of these side effects.

A large study has shown that people who take erythromycin along with some common medicines, such as certain calcium channel blockers, antidepressants, and antifungal medicines, increase their risk of sudden heart-related death.1

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

An antibiotic that works for one person with rosacea may not work for another.

Over time, antibiotics can stop being effective. When this occurs, a different antibiotic may be used.

Some antibiotics are not safe for pregnant women. Some of these antibiotics also lower the effectiveness of birth control pills.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.



  1. Ray WA, et al. (2004). Oral erythromycin and the risk of sudden death from cardiac causes. New England Journal of Medicine, 351(11): 1080–1096.
  2. Del Rosso JQ (2007). Acne vulgaris and rosacea. In DC Dale, DD Federman, eds., ACP Medicine, section 2, chap. 12. New York: WebMD.
  3. Wolff K, Johnson RA (2009). Rosacea. In Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 6th ed., pp. 9–13. New York: McGraw-Hill.


By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Alexander H. Murray, MD, FRCPC - Dermatology
Last Revised December 8, 2009

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.