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Rosacea - Antibiotic Prescribing

Non anti-microbial recommendations

  • Avoidance of triggers
  • Sun protection factor (SPF) 30 or more year round.
  • Cosmetics containing a UV filter.
  • Non-perfumed non-abrasive gentle cosmetics.
  • Be aware of triggers such as alcohol and spicy foods.
  • Avoid topical steroids.
  • Medications contributing to blushing e.g. Calcium channel blockers.

Topical preparations

  • Azelaic acid
  • Brimonidine gel (warn patient of rebound symptoms)
  • Topical ivermectin (Soolantra)
  • Metronidazole gel

Oral antimicrobials

  • (Effraceo) Doxycycline 50 mgs od 3-6 months
  • (Effraceo) Doxycycline 40mgs od 3-6 months
  • Tetralysal 408(300) mgs od 3-6 months

Be aware of ocular Rosacea and refer to ophthalmology.

Recalcitrant disease or Rhinophyma and phymatous changes refer to dermatology for consideration of Isotretinoin or surgical/non-surgical intervention.


Reviewed June 2017