Systemic Treatments

Select Treatments:
  • What is it and how does it work?
  • Who is it for?
  • Who is it not for?
  • How well does it work?
  • What are the possible side effects?
  • Will it inconvenience me?
  • How much does it cost?

Systemic Treatments

What is it and how does it work?

Doxycycline

Doxycycline works in rosacea by reducing inflammation.

Isotretinoin

Isotretinoin works by reducing the size of oil-producing glands and reducing oil production.

Who is it for?

Doxycycline

Moderate to severe pimples, inflamed skin thickening, mild and moderate eye or eyelid problems.

Isotretinoin

Moderate to severe rosacea that didn't respond to previous treatment, inflamed skin thickening that didn't respond to previous treatment.

Who is it not for?

Doxycycline

Patients sensitive to doxycycline or other ingredients. Children under 8 years old should avoid this drug because of the risk of dental staining. Specific brands may have additional contraindications listed on the label.

Isotretinoin

Patients sensitive to isotretinoin, vitamin A, or other ingredients. Patients who are pregnant, breastfeeding, or have liver/kidney disease, high vitamin A, high blood fats, and who are also taking tetracyclines should not use this drug.

How well does it work?

Doxycycline

Doxycycline may slow the progression of skin thickening (case reports; very low certainty).

Isotretinoin

Isotretinoin may reduce early skin thickening (case reports; very low certainty).

What are the possible side effects?

Doxycycline

Serious: skin darkening, enamel reduction, dental staining

Other: increased blood sugar, belly enlargement/pain, diarrhea, dry mouth, female genital infections.

Pregnancy: Doxycycline taken by a pregnant women can reach the baby and cause harm. Doxycycline should be avoided during pregnancy. Category D.

Isotretinoin

Serious: Risk of birth defects if a child is conceived while taking medication.

Other: Back pain, joint stiffness, muscle/bone disease, decreased bone density

Pregnancy: Category X; Not to be used in women who are or may become pregnant.

Will it inconvenience me?

Doxycycline

Involve taking pill(s) on a regular basis. Reminders for taking the pill(s) are required.

Isotretinoin

Involve taking pill(s) on a regular basis. Reminders for taking the pill(s) are required.

How much does it cost?

Doxycycline

$+. Cost is based on price without insurance and may vary.

Isotretinoin

$$$. Cost is based on price without insurance and may vary.