We were recently emailed a question about rosacea treatment…

I saw your Youtube page and I am now interested in getting some advice from you.  I have some flushes in my face and they turn a patchy red by my cheeks, towards my nose. My doctor prescribed me Metronidazole, Ovace,
and Doryx. I am fine taking the Metro lotion and ovace but I am a little “iffy” about taking the oral antibiotic, Doryx. My flush isn’t too bad but it is a bit noticeable. Combined with these other medications, would it be best to try to topical lotion first?

Also, with the metro lotion, will alcohol still effect me if the metro is topical? I know that we shouldn’t mix alcohol with anything, but  I’m wondering if it makes a difference if it is topical or oral.

To my understanding, antibiotics can kill the ‘good’ bacteria. I don’t like using antibiotics ever even if I have a sinus infection. I believe it is best for my body to build up that defense on its own.

Please let me know your thoughts on this. And thanks for sharing your advice.

Here is my answer:

I am glad you contacted us!  Your symptoms and medications point toward you having rosacea.  There are a couple of options at this point.

1)  Start with topical medications only -which can take over 6 weeks for symptoms to improve.  Oral antibiotics can always be added later if needed.

2) Start with topical and oral for about 4-6 weeks then slowly (over 4 weeks) taper off the oral antibiotics.

The benefit of starting with topical and oral is that the symptoms will improve more quickly.  However, it is not a bad choice to just use topicals alone.   Just an FYI here about saving money with Doryx.  Doryx is extended release doxycyline.  To save money, you can take generic doxycyline twice a day instead of Doryx once a day.  It depends -money versus convenience.

The topical treatment of metronidazole should be safe with alcohol because it is minimally absorbed into the body.

You are right -antibiotics do not discriminate -they kill good and bad bacteria.  We have “good” bacteria in our gut that the antibiotics can kill and cause issues such as fungal infections, belly ache and diarrhea.  If you choose to take the oral antibiotics, consider also taking probiotics.  The probiotics replace the good bacteria.  To get these probiotics, you can either eat yogurt daily or if that is not your thing, you can find capsules of acidophilus or lactobacillus OTC at most pharmacies.

Okay, almost done here!  Just a note about rosacea and lifestyle changes.  There are some triggers that can worsen rosacea -everyone is different so your triggers can be unique to you.  However, general triggers include: spicy food, hot foods, alcohol -red wine, hot temperatures and sunlight.

End of email!

Would you like to discuss rosacea some more?  Please email me at nova@getpharmacyadvice.com or just leave us a comment!