Rosacea came back after antibiotics - what next?
Rosacea is a chronic condition, and tablets such as lymecycline are used to gain control rather than to cure it. They are usually taken for about 3 months, sometimes up to 6, and are not continued long term. If nothing is in place to maintain control afterwards, rosacea often returns.
Maintaining control after the tablets
The usual approach is to continue a cream once the tablets have done their job. Ivermectin (Soolantra), metronidazole or azelaic acid can keep the spots under control, often applied only a few nights a week once the skin is stable. Gentle skincare and daily sunscreen also help.
If it comes back despite a cream
- A further course: a repeat course of tablets can regain control, followed by a cream. Some patients will need a course of treatment once or twice a year.
- A different tablet: erythromycin is a second-line option where tetracyclines have not worked or are not tolerated.
- Isotretinoin: reserved for rosacea that keeps returning despite these treatments, or for early thickening of the skin.
If it is redness rather than spots that has come back
Antibiotics treat inflammation. They do not remove the blood vessels that cause persistent redness, which is treated with vascular laser.
Rosacea keeps coming back?
I can plan a long-term approach to keep your rosacea under control, rather than repeated courses of tablets. Consultations can be in person or remote.
Related Articles
- Tetracyclines for rosacea
- Erythromycin when doxycycline fails
- Long-term rosacea management
- Can rosacea ever really go away?
