Understanding Rosacea · Chapter 10
Systemic Treatments: Tablets, Capsules and Injections
When creams are not enough, tablets can bring moderate to severe or frequently relapsing rosacea under control.
What is the best tablet for rosacea?
Doxycycline 40 mg modified-release (Efracea) is the best-evidenced and licensed tablet for the spots of rosacea. At this dose it calms inflammation rather than acting as an antibiotic, so it does not drive antibiotic resistance.
How long should I take antibiotics for rosacea?
Conventional-dose antibiotics are now usually given for up to about 12 weeks to gain control, with a cream continued afterwards to maintain it.
Does low-dose isotretinoin work for rosacea?
Yes. Low-dose isotretinoin is the most effective treatment for stubborn papulopustular and phymatous rosacea, reducing spots by around 85% in studies. It is used off-label, and pregnancy must be strictly avoided during and for one month after treatment.
Are there tablets for rosacea flushing?
Flushing and persistent redness respond less well to tablets. Beta-blockers, clonidine and some other medicines help some people, and erenumab, an injection that blocks the nerve chemical CGRP, is a promising treatment still at the research stage.
Key takeaways
- Doxycycline 40 mg is the licensed, best-evidenced tablet.
- Conventional antibiotics are for short courses.
- Low-dose isotretinoin is the most effective option for stubborn disease.
- Combining a tablet with a cream works faster.
This page summarises Chapter 10 of Understanding Rosacea: Your Complete Guide. The full chapter, with references, is in the free PDF.
Download the free 108-page Rosacea Guide (PDF) →
Written and medically reviewed by Professor Vishal Madan, MBBS (Hons), MD, FRCP, MBA, Consultant Dermatologist, Laser and Dermatological Surgeon (GMC 6036936).
Last reviewed:
This page provides general information about rosacea and is not a substitute for personal medical advice. Please discuss your symptoms and treatment with a qualified healthcare professional.