Table of ContentsView AllTable of ContentsHow It WorksHow Much to UseEffectivenessHow Quick Is It?Side EffectsPrecautionsOther Treatments
Table of ContentsView All
View All
Table of Contents
How It Works
How Much to Use
Effectiveness
How Quick Is It?
Side Effects
Precautions
Other Treatments
Rosaceais a chronic inflammatory skin condition that causes redness or flushing in areas of the face, such as the cheeks, forehead, and nose.
Other common symptoms of rosacea include:
When people with darker skin tones develop rosacea, early signs (e.g., flushing) may be missed or mistaken for another condition. People with darker skin tones and rosacea may present with brown or violet tones and yellowish-brown, hard bumps.
Some people have found success usingdoxycyclinefor rosacea. Doxycycline is atetracyclineantibiotic commonly prescribed for moderate to severe rosacea.Brand names include Vibramycin, Oracea, and Doryx.
Yuliya Shauerman / Getty Images
How Doxycycline Works for Rosacea
Doxycyclineis available as a prescription in capsule and tablet forms with a range of dosages.
The Food and Drug Administration (FDA) has approved one brand of doxycycline product, calledOracea, forrosacea. It is the only systemic (body-wide) treatment the FDA approved for this use.
Factors to consider if you decide to take Oracea or other forms of doxycycline for rosacea include:
A Word on Antibiotic ResistanceHigher doses of doxycycline, such as of 100 milligrams (mg) a day or more,have an antibiotic effect and may contribute toantibiotic resistance.Antibiotic resistance can develop when bacteria learn to evade the antibiotics designed to kill them, making the medicines less effective. Low-dose doxycycline does not cause antibiotic resistance.
A Word on Antibiotic Resistance
Higher doses of doxycycline, such as of 100 milligrams (mg) a day or more,have an antibiotic effect and may contribute toantibiotic resistance.Antibiotic resistance can develop when bacteria learn to evade the antibiotics designed to kill them, making the medicines less effective. Low-dose doxycycline does not cause antibiotic resistance.
How Much Doxycycline Will I Need?
The dose of doxycycline you will take for rosacea depends on whether you’re taking traditional or modified-release forms.
Immediate-release doxycycline (brand names include Vibramycin and Monodox), 100 to 200 mg per day, can be effective for rosacea.
Doxycycline may also be prescribed at a lower dose of 20 mg twice a day with the brand-name drug Periostat.
Modified-release doxycycline (Oracea) is administered at 40 mg once a day.Forty milligrams (40 mg) is considered an anti-inflammatory dose rather than an antibiotic dose, so it’s a lower dose than you would take if you were using it as an antibiotic for an infection.
How Effective is Doxycycline for Rosacea?
Four subtypes of rosacea exist and are based on symptoms.Doxycycline is effective for the type known aspapulopustular. This form of rosacea is often mistaken for acne and involves bumps that can be papules or pustules.
However, a larger review of data concluded that low doses of doxycycline are unlikely to improve flushing.
Oracea is effective for up to a year in reducing skin lesions on the face, both papules and pustules. It also works to lengthen the time between flares (relapses).
Clinical trials have shown that Oracea is about twice as effective as a placebo (an ineffective substance given to people in control groups in clinical trials) in reducing lesions.For instance, in one trial, people who took a placebo had about six fewer bumps at the end of 16 weeks than before treatment, while those who took Oracea had 12 fewer bumps.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet New Zealand and © Dr. Mashihul Hossainwww.dermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet New Zealand and © Dr. Mashihul Hossainwww.dermnetnz.org2023.
How Quickly Does Doxycycline Work for Rosacea?
It can take weeks or months for doxycycline to work for rosacea. In one study, over half the people surveyed reported that Oracea started to work in two weeks.
Another trial showed that people who took Oracea plus a topical medicine had reduced skin lesions starting at four weeks.
What Are the Major Side Effects of Doxycycline?
Doxycycline is associated with side effects that affect the digestive tract and the skin. These are considered dose-dependent, meaning they are more likely to occur at higher doses.Side effects of doxycycline include the following:
Oracea is less likely to cause gastrointestinal effectsor skin reactions.Rarely, it may cause side effects that include:
What Should You Avoid When Taking Doxycycline?
It would be best if you avoided the following when taking doxycycline for rosacea or another condition:
What Other Treatments Work for Rosacea?
It’s important to know that rosacea is a chronic condition with no cure. Treatments aim to keep symptoms at bay and prevent flare-ups.
If doxycycline does not work for you or you can’t take it for any reason, remember there are many other options for managing rosacea.
Other Medications
Besides doxycycline, prescription medications include the following:
Note that, unlike doxycycline, these medicines are all topical, meaning they’re applied to the skin.
Lasers
Another alternative treatment for rosacea islasers. These therapies use light to treat symptoms like redness, small blood vessels on the face,or thickening skin.
You may need up to three treatments to see an effect. Keep in mind that you may also need follow-up laser treatments down the road as new blood vessels are produced.Your dermatologist may suggest one of the following laser treatments:
Diet
One intervention that may help is modifying yourdiet. Consider limiting foods that trigger rosacea and adding anti-inflammatory foods to your meals. Foods and beverages that may trigger rosacea or make symptoms worse include the following:
Foods that are part of theMediterranean dietmay improve rosacea symptoms and include the following:
This improvement may be due, in part, to their anti-inflammatory effects.
Supplements
Some people usesupplementsfor rosacea. Among these are:
Your healthcare provider can help you navigate your options and find the most appropriate therapy for you.
Remember that there is only minimal evidence to support using these or other supplements for rosacea. If you decide to go this route, discuss it with a registered dietitian or pharmacist for best results.Furthermore, in the United States, the Food and Drug Administration (FDA) does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.
Remember that there is only minimal evidence to support using these or other supplements for rosacea. If you decide to go this route, discuss it with a registered dietitian or pharmacist for best results.
Furthermore, in the United States, the Food and Drug Administration (FDA) does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.
Summary
Doxycycline is an antibiotic used to treat moderate to severe rosacea. It is most effective for lesions on the face. Doxycycline can improve these skin lesions in a few weeks to months.
At high doses, doxycycline is associated with gastrointestinal side effects and skin reactions, including sensitivity to sunlight. Lower doses of doxycycline, including the brand-name product Oracea, reduce the likelihood of these side effects.
If you take doxycycline for rosacea, you’ll need to avoid excess sunlight, along with certain medications and supplements. Do not use doxycycline if pregnant or breastfeeding. Be sure to discuss your concerns with your healthcare provider or pharmacist.
If doxycycline is not a good option for you, ask your healthcare provider about other topical (applied to the skin) prescriptions, supplements, or laser therapy.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sharma A, Kroumpouzos G, Kassir M, et al.Rosacea management: A comprehensive review.J Cosmet Dermatol. 2022;21(5):1895-1904. doi:10.1111/jocd.14816National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rosacea.National Rosacea Society.Rosacea looks different in skin of color.American Academy of Dermatology Association.People with darker skin tones can get rosacea.U.S. Food and Drug Administration.ORACEA® (doxycycline) prescribing information.Nguyen C, Kuceki G, Birdsall M, et al.Rosacea: Practical guidance and challenges for clinical management.Clin Cosmet Investig Dermatol. 2024;17:175-190. Published 2024 Jan 23. doi:10.2147/CCID.S391705Valentín S, Morales A, Sánchez JL, et al.Safety and efficacy of doxycycline in the treatment of rosacea.Clin Cosmet Investig Dermatol. 2009;2:129-140. Published 2009 Aug 12. doi:10.2147/ccid.s4296Del Rosso JQ, Brantman S, Baldwin H.Long-term inflammatory rosacea management with subantibiotic dose oral doxycycline 40 mg modified-release capsules once daily.Dermatol Ther. 2022;35(1):e15180. doi:10.1111/dth.15180U.S. Food and Drug Administration.Doxycycline capsules prescribing information.Del Rosso JQ.Anti-inflamatory dose doxycycline in the treatment of rosacea.J Drugs Dermatol. 2009;8(7):664-668.Di Caprio R, Lembo S, Di Costanzo L, et al.Anti-inflammatory properties of low and high doxycycline doses: an in vitro study.Mediators Inflamm. 2015;2015:329418. doi:10.1155/2015/329418Xiao W, Chen M, Wang B, et al.Efficacy and safety of antibiotic agents in the treatment of rosacea: a systemic network meta-analysis.Front Pharmacol. 2023;14:1169916. Published 2023 May 11. doi:10.3389/fphar.2023.1169916Johnson SM, LeVine P.Self-reported treatment impressions and satisfaction of papulopustular rosacea patients treated with doxycycline, USP, 40 mg capsules.J Drugs Dermatol. 2011;10(12):1376-1381.Nguyen TA, Krakowski AC.The “heart sign”: An early indicator of dose-dependent doxycycline-induced phototoxicity.Pediatr Dermatol. 2016;33(2):e69-e71. doi:10.1111/pde.12775American Academy of Dermatology Association.Lasers and lights: How well do they treat rosacea?Guertler A, Volsky A, Eijkenboom Q, et al.Dietary patterns in acne and rosacea patients-A controlled study and comprehensive analysis.Nutrients. 2023;15(20):4405. Published 2023 Oct 17. doi:10.3390/nu15204405Barbalho SM, de Sousa Gonzaga HF, de Souza GA, et al.Dermatological effects of Curcuma species: a systematic review.Clin Exp Dermatol. 2021;46(5):825-833. doi:10.1111/ced.14584Nowicka D, Chilicka K, Dzieńdziora-Urbińska I, et al.Skincare in rosacea from the cosmetologist’s perspective: A narrative review.J Clin Med. 2022;12(1):115. Published 2022 Dec 23. doi:10.3390/jcm12010115Ebneyamin E, Mansouri P, Rajabi M, et al.The efficacy and safety of permethrin 2.5% with tea tree oil gel on rosacea treatment: A double-blind, controlled clinical trial.J Cosmet Dermatol. 2020;19(6):1426-1431. doi:10.1111/jocd.13177National Institutes of Health.Vitamin C.Algarin YA, Pulumati A, Jaalouk D, et al.The role of vitamins and nutrients in rosacea.Arch Dermatol Res. 2024;316(5):142. Published 2024 May 2. doi:10.1007/s00403-024-02895-4
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sharma A, Kroumpouzos G, Kassir M, et al.Rosacea management: A comprehensive review.J Cosmet Dermatol. 2022;21(5):1895-1904. doi:10.1111/jocd.14816National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rosacea.National Rosacea Society.Rosacea looks different in skin of color.American Academy of Dermatology Association.People with darker skin tones can get rosacea.U.S. Food and Drug Administration.ORACEA® (doxycycline) prescribing information.Nguyen C, Kuceki G, Birdsall M, et al.Rosacea: Practical guidance and challenges for clinical management.Clin Cosmet Investig Dermatol. 2024;17:175-190. Published 2024 Jan 23. doi:10.2147/CCID.S391705Valentín S, Morales A, Sánchez JL, et al.Safety and efficacy of doxycycline in the treatment of rosacea.Clin Cosmet Investig Dermatol. 2009;2:129-140. Published 2009 Aug 12. doi:10.2147/ccid.s4296Del Rosso JQ, Brantman S, Baldwin H.Long-term inflammatory rosacea management with subantibiotic dose oral doxycycline 40 mg modified-release capsules once daily.Dermatol Ther. 2022;35(1):e15180. doi:10.1111/dth.15180U.S. Food and Drug Administration.Doxycycline capsules prescribing information.Del Rosso JQ.Anti-inflamatory dose doxycycline in the treatment of rosacea.J Drugs Dermatol. 2009;8(7):664-668.Di Caprio R, Lembo S, Di Costanzo L, et al.Anti-inflammatory properties of low and high doxycycline doses: an in vitro study.Mediators Inflamm. 2015;2015:329418. doi:10.1155/2015/329418Xiao W, Chen M, Wang B, et al.Efficacy and safety of antibiotic agents in the treatment of rosacea: a systemic network meta-analysis.Front Pharmacol. 2023;14:1169916. Published 2023 May 11. doi:10.3389/fphar.2023.1169916Johnson SM, LeVine P.Self-reported treatment impressions and satisfaction of papulopustular rosacea patients treated with doxycycline, USP, 40 mg capsules.J Drugs Dermatol. 2011;10(12):1376-1381.Nguyen TA, Krakowski AC.The “heart sign”: An early indicator of dose-dependent doxycycline-induced phototoxicity.Pediatr Dermatol. 2016;33(2):e69-e71. doi:10.1111/pde.12775American Academy of Dermatology Association.Lasers and lights: How well do they treat rosacea?Guertler A, Volsky A, Eijkenboom Q, et al.Dietary patterns in acne and rosacea patients-A controlled study and comprehensive analysis.Nutrients. 2023;15(20):4405. Published 2023 Oct 17. doi:10.3390/nu15204405Barbalho SM, de Sousa Gonzaga HF, de Souza GA, et al.Dermatological effects of Curcuma species: a systematic review.Clin Exp Dermatol. 2021;46(5):825-833. doi:10.1111/ced.14584Nowicka D, Chilicka K, Dzieńdziora-Urbińska I, et al.Skincare in rosacea from the cosmetologist’s perspective: A narrative review.J Clin Med. 2022;12(1):115. Published 2022 Dec 23. doi:10.3390/jcm12010115Ebneyamin E, Mansouri P, Rajabi M, et al.The efficacy and safety of permethrin 2.5% with tea tree oil gel on rosacea treatment: A double-blind, controlled clinical trial.J Cosmet Dermatol. 2020;19(6):1426-1431. doi:10.1111/jocd.13177National Institutes of Health.Vitamin C.Algarin YA, Pulumati A, Jaalouk D, et al.The role of vitamins and nutrients in rosacea.Arch Dermatol Res. 2024;316(5):142. Published 2024 May 2. doi:10.1007/s00403-024-02895-4
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sharma A, Kroumpouzos G, Kassir M, et al.Rosacea management: A comprehensive review.J Cosmet Dermatol. 2022;21(5):1895-1904. doi:10.1111/jocd.14816National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rosacea.National Rosacea Society.Rosacea looks different in skin of color.American Academy of Dermatology Association.People with darker skin tones can get rosacea.U.S. Food and Drug Administration.ORACEA® (doxycycline) prescribing information.Nguyen C, Kuceki G, Birdsall M, et al.Rosacea: Practical guidance and challenges for clinical management.Clin Cosmet Investig Dermatol. 2024;17:175-190. Published 2024 Jan 23. doi:10.2147/CCID.S391705Valentín S, Morales A, Sánchez JL, et al.Safety and efficacy of doxycycline in the treatment of rosacea.Clin Cosmet Investig Dermatol. 2009;2:129-140. Published 2009 Aug 12. doi:10.2147/ccid.s4296Del Rosso JQ, Brantman S, Baldwin H.Long-term inflammatory rosacea management with subantibiotic dose oral doxycycline 40 mg modified-release capsules once daily.Dermatol Ther. 2022;35(1):e15180. doi:10.1111/dth.15180U.S. Food and Drug Administration.Doxycycline capsules prescribing information.Del Rosso JQ.Anti-inflamatory dose doxycycline in the treatment of rosacea.J Drugs Dermatol. 2009;8(7):664-668.Di Caprio R, Lembo S, Di Costanzo L, et al.Anti-inflammatory properties of low and high doxycycline doses: an in vitro study.Mediators Inflamm. 2015;2015:329418. doi:10.1155/2015/329418Xiao W, Chen M, Wang B, et al.Efficacy and safety of antibiotic agents in the treatment of rosacea: a systemic network meta-analysis.Front Pharmacol. 2023;14:1169916. Published 2023 May 11. doi:10.3389/fphar.2023.1169916Johnson SM, LeVine P.Self-reported treatment impressions and satisfaction of papulopustular rosacea patients treated with doxycycline, USP, 40 mg capsules.J Drugs Dermatol. 2011;10(12):1376-1381.Nguyen TA, Krakowski AC.The “heart sign”: An early indicator of dose-dependent doxycycline-induced phototoxicity.Pediatr Dermatol. 2016;33(2):e69-e71. doi:10.1111/pde.12775American Academy of Dermatology Association.Lasers and lights: How well do they treat rosacea?Guertler A, Volsky A, Eijkenboom Q, et al.Dietary patterns in acne and rosacea patients-A controlled study and comprehensive analysis.Nutrients. 2023;15(20):4405. Published 2023 Oct 17. doi:10.3390/nu15204405Barbalho SM, de Sousa Gonzaga HF, de Souza GA, et al.Dermatological effects of Curcuma species: a systematic review.Clin Exp Dermatol. 2021;46(5):825-833. doi:10.1111/ced.14584Nowicka D, Chilicka K, Dzieńdziora-Urbińska I, et al.Skincare in rosacea from the cosmetologist’s perspective: A narrative review.J Clin Med. 2022;12(1):115. Published 2022 Dec 23. doi:10.3390/jcm12010115Ebneyamin E, Mansouri P, Rajabi M, et al.The efficacy and safety of permethrin 2.5% with tea tree oil gel on rosacea treatment: A double-blind, controlled clinical trial.J Cosmet Dermatol. 2020;19(6):1426-1431. doi:10.1111/jocd.13177National Institutes of Health.Vitamin C.Algarin YA, Pulumati A, Jaalouk D, et al.The role of vitamins and nutrients in rosacea.Arch Dermatol Res. 2024;316(5):142. Published 2024 May 2. doi:10.1007/s00403-024-02895-4
Sharma A, Kroumpouzos G, Kassir M, et al.Rosacea management: A comprehensive review.J Cosmet Dermatol. 2022;21(5):1895-1904. doi:10.1111/jocd.14816
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rosacea.
National Rosacea Society.Rosacea looks different in skin of color.
American Academy of Dermatology Association.People with darker skin tones can get rosacea.
U.S. Food and Drug Administration.ORACEA® (doxycycline) prescribing information.
Nguyen C, Kuceki G, Birdsall M, et al.Rosacea: Practical guidance and challenges for clinical management.Clin Cosmet Investig Dermatol. 2024;17:175-190. Published 2024 Jan 23. doi:10.2147/CCID.S391705
Valentín S, Morales A, Sánchez JL, et al.Safety and efficacy of doxycycline in the treatment of rosacea.Clin Cosmet Investig Dermatol. 2009;2:129-140. Published 2009 Aug 12. doi:10.2147/ccid.s4296
Del Rosso JQ, Brantman S, Baldwin H.Long-term inflammatory rosacea management with subantibiotic dose oral doxycycline 40 mg modified-release capsules once daily.Dermatol Ther. 2022;35(1):e15180. doi:10.1111/dth.15180
U.S. Food and Drug Administration.Doxycycline capsules prescribing information.
Del Rosso JQ.Anti-inflamatory dose doxycycline in the treatment of rosacea.J Drugs Dermatol. 2009;8(7):664-668.
Di Caprio R, Lembo S, Di Costanzo L, et al.Anti-inflammatory properties of low and high doxycycline doses: an in vitro study.Mediators Inflamm. 2015;2015:329418. doi:10.1155/2015/329418
Xiao W, Chen M, Wang B, et al.Efficacy and safety of antibiotic agents in the treatment of rosacea: a systemic network meta-analysis.Front Pharmacol. 2023;14:1169916. Published 2023 May 11. doi:10.3389/fphar.2023.1169916
Johnson SM, LeVine P.Self-reported treatment impressions and satisfaction of papulopustular rosacea patients treated with doxycycline, USP, 40 mg capsules.J Drugs Dermatol. 2011;10(12):1376-1381.
Nguyen TA, Krakowski AC.The “heart sign”: An early indicator of dose-dependent doxycycline-induced phototoxicity.Pediatr Dermatol. 2016;33(2):e69-e71. doi:10.1111/pde.12775
American Academy of Dermatology Association.Lasers and lights: How well do they treat rosacea?
Guertler A, Volsky A, Eijkenboom Q, et al.Dietary patterns in acne and rosacea patients-A controlled study and comprehensive analysis.Nutrients. 2023;15(20):4405. Published 2023 Oct 17. doi:10.3390/nu15204405
Barbalho SM, de Sousa Gonzaga HF, de Souza GA, et al.Dermatological effects of Curcuma species: a systematic review.Clin Exp Dermatol. 2021;46(5):825-833. doi:10.1111/ced.14584
Nowicka D, Chilicka K, Dzieńdziora-Urbińska I, et al.Skincare in rosacea from the cosmetologist’s perspective: A narrative review.J Clin Med. 2022;12(1):115. Published 2022 Dec 23. doi:10.3390/jcm12010115
Ebneyamin E, Mansouri P, Rajabi M, et al.The efficacy and safety of permethrin 2.5% with tea tree oil gel on rosacea treatment: A double-blind, controlled clinical trial.J Cosmet Dermatol. 2020;19(6):1426-1431. doi:10.1111/jocd.13177
National Institutes of Health.Vitamin C.
Algarin YA, Pulumati A, Jaalouk D, et al.The role of vitamins and nutrients in rosacea.Arch Dermatol Res. 2024;316(5):142. Published 2024 May 2. doi:10.1007/s00403-024-02895-4
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