Azithromycin (Zithromax) is anti-oxidant, helps Rosacea

Written by on January 31, 2007 in macrolides, What Causes Rosacea? with 6 Comments

This study shows that one of the effects of Azithromycin is to suppress reactive oxygen species, one of the chemicals involved in the inflammatory pathway. Other systemic antibiotics, macrolides and non-antibiotic doses of doxycycline have also been shown to be helpful in treating the inflammation of rosacea.

The inflammatory pathway that leads to rosacea is an interesting area that is attracting more and more interest and research. Note here that in this study they were also able to measure that rosacea sufferers have higher levels of reactive oxygen species (ROS) than non rosacea sufferers.

The effect of azithromycin on reactive oxygen species in rosacea. Clin Exp Dermatol. 2007 Jan 18; Bakar O, Demirçay Z, Yuksel M, Haklar G, Sanisoglu Y

Background. Recent evidence suggests that inflammation in rosacea is associated with generation of reactive oxygen species (ROS) that are released by inflammatory cells. The efficacy of current therapeutic agents for rosacea such as tetracyclines and metronidazole has also been attributed to their antioxidant properties. Recently, a macrolide antibiotic, azithromycin, has been found to be an effective alternative in the treatment of rosacea.

Aim: We planned a study to evaluate the antioxidant effects of azithromycin on ROS in rosacea. We compared basal ROS concentrations measured in the facial skin of patients with rosacea with the post-treatment levels and with those of healthy controls.

Methods. Facial skin biopsies of 17 papulopustular patients with rosacea and 25 healthy controls were taken. Rosacea patients were assigned to receive oral azithromycin 500 mg on three consecutive days each week for 4 weeks. The total number of inflammatory lesions (the sum of papules and pustules) on the face of each patient with rosacea was counted at each visit. The luminol- and lucigenin-enhanced chemiluminescence (CL) levels of patients with rosacea were measured before and after 4 weeks of treatment and compared with those of healthy controls.

Results. Rosacea patients had higher ROS levels than healthy controls (P < 0.001). A statistically significant decrease of both luminol- and lucigenin-enhanced CL levels were observed in patients with rosacea after treatment with azithromycin (t = 4.602, P < 0.001; vs. t = 4.634, P < 0.001, respectively).

Conclusion. Rosacea patients have higher ROS levels than healthy controls. The results of our study support the antioxidant properties of azithromycin in rosacea.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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6 Reader Comments

  1. Colleen Hearn says:

    A few years ago I had a terrible sinus infection as well as an outbreak of rosacea on my nose. The doctor I saw for my sinus condition prescribed Zithromax, due to my allergy to penicillin. The Zithromax took care of my sinus infection as well as dealing with the outbreak of the rosacea. I was pleasantly surprised. The effects also lasted longer than the results I achieve with a course of tetracycline, and I only took the Zithromax for one week, my usual prescribed course of treatment for tetracycline is three months.
    When next I required medication to calm my next major outbreak I discussed with my own doctor the benifits I had recieved from Zithromax, I was told by him that this medication had no effect on skin conditions. I was very pleased to see this article and be able to send you my own success with this medicine. If control of my rosacea can be achieved with a one week course of Zithromax, why would I want to take tetracycline for three months ( a real compliance issue), when the results were the same and acturally I had a longer outbreak free period after the Zithromax. Colleen Hearn

  2. J Couts says:

    I was first diagnosed with Rosacea in the early 1990’s. Was given Metrogel which had absolutely no effect. Subsequently, I was treated for an upper respiratory infection with Zithromax and the Rosacea completely went away for 6 months…even though my physician said that Rosacea shouldn’t respond to Zithromax! While I worked in a very large office, I seemed to get sick enough for antibiotics once or twice a year, so I always asked for Zithromax “it works so well for me”, is what I always told my Dr., when what I really wanted was for my Rosacea to please just go away. For years, my Rosacea wasn’t a problem, as long as I could get Zithromax. Now that I’m retired…I don’t get sick…so my face is a mess. I’m miserable. I need to find a medicare physician who will believe me and prescribe the Zithromax. So frustrating. Joyce Couts

  3. Hi Colleen and Joyce,

    Thanks for leaving your comments. Great to hear that zithromax was able to help your rosacea, and that this paper might even help prove it !

    Any antibiotic is likely to interrupt the inflammatory pathway that causes rosacea symptoms. It isn’t so much that the antibiotics kill the bacteria that cause skin problems as previously thought.


  4. Shelley Jordan says:

    I had my dermatologist prescribe Amoxicillin for my rosacea and after being on it for 2 months, it made EVERYTHING worse!! I was just on azithromycin for a nasty sinus infection and my face cleared up within a couple of days!! MIRACLE! I am hoping my dermatologist will believe me and figure out an ongoing treatment with this medication. I hate living with rosacea and if this works, why not keep it going if you can??

  5. Amanda says:

    I have severe Rosacea and azithromycin is the ONLY thing that clears up my face completely! Please continue doing research on this!

  6. Tia says:

    I had severe cystic acne/rosacea that broke out on my face when I was 28 years old. I dealt with this for over a year before I went to the dermatologist, and they prescribed prascion face wash, and told me to use it 3 times a day, mind you, I had severe cysts, and my face was swollen because of that, I was hardly recognizable, and the pain was unbearable. I couldn’t even smile without causing pain. Anyway, my face was really raw when I started using the product (prascion sp?), and it ripped my face up even more, to the point where it was bleeding. 🙁 They told me the next thing they wanted to try was accutane, and there was no way I was going to take that, so I went to my regular physician, and she gave me a face cream to put on, and it cleared it up a little, but it didn’t really improve that much. However, she moved away, and I was forced to find a new doctor. I went in to see her, because I developed social anxiety, as well as severe depression, mostly due to the appearance of my face. She gave me some medications for the anxiety/depression, and she told me that I needed to start taking some medication for my face. She prescribed me with Zithromax, and within 30 days, all of my facial cysts were gone, and the redness had faded fifty percent. I am now happy to say that I am 90 days into my treatment, and my face looks 75% better, however, now I am left with the aftermath of the condition. My face is completely scarred, and has cystic acne ‘pits’ all over. Now I have to wear make up everyday to try to cover the scars, but I am so glad that I do not have to endure that awful pain any longer. So please, to all physicians, and dermatologists, prescribe this medication for rosacea, and even acne, yes it does work, I am living proof. For those of you who are living with the condition, I would advise you keep looking for the physician or dermatologist that will take their patients best interest to heart, and prescribe Zithromax.

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