For the past several years, rosacea has been linked with the onset of gastrointestinal (GI) diseases like celiac disease, irritable bowel syndrome, and small intestinal bacterial overgrowth (SIBO). However, oral doxycycline is also commonly associated with GI problems. The latest research on this subject suggests that doxycycline, which is often used to treat moderate to severe rosacea, could be the root cause of GI symptoms and not the skin disease itself.
What the Latest Research Says
Recent research published in the Journal of the American Academy of Dermatology examined individuals between 30 and 64 years of age with moderate to severe rosacea during an eight-year period. Some participants were on low-dose doxycycline, some were on high-dose, and others were not taking the antibiotic at all.
Researchers found that participants treated with low-dose doxycycline and those treated with no doxycycline at all experienced a significantly lower incidence of GI symptoms than those who were treated with high-dose doxycycline. Moreover, there was not a difference in GI symptoms among the low-dose and no-dose group, indicating that adverse GI-related symptoms may be dose-dependant and that rosacea might not be the underlying cause of GI disease after all.
Although this is a preliminary study, there will certainly be more research to come, so be on the lookout for additional information in the coming months.
What Is the Best Approach to Treating Rosacea?
Because of this potential link between doxycycline and the onset of GI issues, it is advisable to avoid treating rosacea with oral antibiotics whenever possible. Early detection of rosacea is key to effectively treating its symptoms. Using a tool such as the Skin Type Solutions validated questionnaire can be a great way to assess your patients’ skin types and detect conditions like rosacea early. Then, get them started on cosmeceutical anti-inflammatories right away to help with symptoms. Some of the best anti-inflammatory skin care ingredients to recommend include argan oil, feverfew, chamomile, and aloe. You can also suggest eating a diet rich in anti-inflammatory foods such as salmon, walnuts, and berries.
If redness is not controlled by cosmeceuticals alone, then progress to topical medications like Rhofade™ and Soolantra®. Many rosacea sufferers have seen great success using topical Rhofade, the latest treatment option for this skin disease.
The data recently presented in JAMA shows promising evidence that by avoiding oral doxycycline, rosacea patients may also be able to avoid developing troublesome GI symptoms. While additional research will undoubtedly be coming in the near future, doctors and dermatologists can do their best now to limit using oral antibiotics in the treatment of rosacea.
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