Oracea User Reviews

ORACEA

Periostat (20 mgs doxycycline hyclate) has been helpful to some rosacea sufferers. Originally developed to combat periodontal disease (gum disease), periostat was approved by the FDA in 1998.

Recently the FDA approved the introduction of generic periostat equivalents. Ivax Pharmaceuticals and CorePharma are now free to sell their generic equivalents of Periostat.

Oracea is a new form of doxycycline, the same active ingredient as CollaGenex’s gum disease treatment Periostat. CollaGenex is shifting its focus to the dermatology market following the approval of generic competition for Periostat.

Colin Stewart, CollaGenex’s president and chief executive officer of CollaGenex, said he believes the product could “significantly expand” the current $500 million market for prescription drugs to treat rosacea.

The lead investigator for the trial, says

“Oracea provides therapeutic efficacy in rosacea through anti-inflammatory and anti-collagenolytic effects and is devoid of antibiotic activity. Therefore, even with long-term use, development of antibiotic resistance is not an issue. Many rosacea patients will benefit from a once-daily formulation of doxycycline that has been optimized to treat rosacea effectively and safely.”

Oracea is a new sustained release, once a day 40 mg tablet. 10mg of this 40mg is coated to delay the release of the doxycycline.

As part of the latest Phase III study for Oracea, when compared to the placebo, erythema showed a trend towards improvement. In a second study, the reduction in erythema achieved statistical significance as erythema scores improved (again against placebo).

CollaGenex is also developing a new once-daily version of Periostat, called Periostat MR, to protect it position in the dental market. Collagenex has restructured their sales team around the fact that Periostat is about to become a generic label.

The company is also seeking to expand the label for the drug’s main ingredient to include its use in treating a variety of skin disorders including acne and rosacea. Additionally Oracea may also be targeted towards treating ocular rosacea as well.

Promoting Oracea

Oracea is promoted as safe and effective for long term use. It was reported that the average duration of Oracea therapy is 4 months, compared to an average of 2.5 months for other rosacea prescriptions.

Collagenex are holding up to 6 patents relating to Oracea. These patents cover Oracea’s method of use, mechanism of action and pharmacokinetic profile (i.e. how it is absorbed and acts over time).

Collagenex reports that Oracea is equally effective as 100mg of doxycycline. That particular press release is a culmination of a trial that we have reported previously – oracea plus metrogel, better than 100mg doxycycline plus metrogel ? and also a 2007 SkinMed paper; maximum effective dose of doxycycline is 40mg a day.

See more about how Collagenex are promoting Oracea.

Oracea Plasma Concentration

The following graph, sourced from Collagenex, shows the blood plasma concentration of doxycycline for Oracea compared to 50mg once a day of generic doxycycline. The horizontal axis stretches out to 24 hours post dosage. The vertical axis is in nano-grams per milli-litre (ng/mL). The anti-microbial threshold is listed here as a concentration of 1000 nano grams/mL (i.e. 1.0µg/mL).

oracea (click for a larger view)

I read this graph to suggest that Oracea is able to maintain a sustained release of the active ingredient doxycycline without venturing into anti-microbial territory. The advantage of a delayed release product is that Oracea can offer the `area under the concentration-by-time curve’ delivery, but at sub-antimicrobial dosage over 24 hours.

Method of Action

As part of Collagenex’ push to promote Oracea and Incyclinide, a new web site developing the idea that rosacea is a chronic inflammatory disease has been created. Be sure to check out the video of the the suggested Doxycycline Method of Action.

A Cheaper Alternative ?

As Oracea is a new prescription product it can be quite expensive, especially if you don’t have comprehensive insurance coverage. One possible alternative you could discuss with your doctor is 50mg a day of generic doxycycline. Whilst this dosage won’t have exactly the same profile in your blood, it is likely to be very close. As with all systemic treatments both, Oracea and a low dose of doxycycline can cause unwanted side effects so the supervision of your doctor is important.

Galderma and Oracea

Galderma is now the owner of Oracea, having purchased Collagenex in 2008.

Is Oracea Too Expensive?

Given that Oracea is really just doxycycline with a low dose and modified release mechanism, is it worth the extra expense compared to generic doxycycline low dose? Many are wondering if indeed Oracea is too expensive.

Your Thoughts

Have you tried Oracea or another low-dose doxycycline ? How long did it take to see some benefit ? Did you experience any side effects ? Please leave a comment below.

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About the Author

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

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239 Reader Comments

  1. Missy says:

    My derm put me on Oracea about a year ago as part of a clinical trial after my skin stopped responding to Prosacea. It has worked very well for me! It really helps keep the bumps/pustules under control and also seems to have greatly improved my discomfort from stinging/burning/itching. I still always have mild redness on my cheeks and still get asked sometimes if I have a sunburn but my skin feels much more comfortable and I can at least cover it up more easily without all the bumps/scabby peeling. If I stop taking the medication for a few days my face explodes with bumps again.

  2. Kim says:

    I am a 47 year old female who was diagnosed with Rosecea last spring. Never had an acne problem in my life. I have sore papules around my mouth, checks and temples. Some redness, but that is insignificant compared to the pain of the bumps. My doctor put me on Oracea and Metrogel, told me to stop using my current moisturizer and face wash and to wash only with Cetaphyl. My face cleared up completely, although I got an itchy, red rash on my arms when in the sun (I assume this was from the Oracea). My only problem now is that the anti-aging regimen I was on before the treatment for my rosecea has been nixed and my skin seems to be aging more quickly. I need an oil-free anti-aging moisturizer for sensitive skin. Any suggestions?

  3. tRACI says:

    Hi Kim,

    Anyone looking for soothing skin care should try good Health food store for Witch Hazel with rose petal (alcohol-free). Also Dr. Hauschka all natural skin care is great. I use the Day Cream, regular or light, with rose petal. And the Milk Cleanser is wonderful. No chemicals to irritate skin. Of course, do not use hot water, and use gentle cloth. The rose petal has properties of reducing inflamation.

  4. sue says:

    I use oracea regularly or as much as possible . I hate taking it every day. i also love the outdoors and enjoy a good glass of wine. I am afraid to drink with the oracea or go out in the sun, i live in Fl so…..Oracea works wonderful but I would like to only take it when i notice a flare up coming and only for a few days. I have suffered for years with rosacea after taking steroids for awhile. It is such a nasty thing.

  5. James says:

    Started having trouble with rosacea about five years ago and tried everything but antibiotics…how silly of me!!! I took Oracea and within a week my face was clear, except for a bit of redness, but no spots riddling my face which were incredibly embarrasing. It’s expensive (a rip-off, in fact, considering how cheap doxycyclene is), but it does work, and perhaps the time release makes it valuable.

    As for combining it with Metrogel, I’ve seen no difference, so I dumped Metrogel and use only the Oracea.

  6. Supramom2000 says:

    Kim,

    Try using either jojoba oil or virgin coconut oil. Also, raw honey masks work very well. Make sure to drink tons of water.

  7. Julia Rives says:

    I have done some research on rosacea and this is what I found. I dont’ know if this will be helpful to anyone, but this is quite surprising. If you are taking CoQ10 supplements – stop. CoQ10 produces high levels of nucleotide Adenosine triphosphate, which is often called the “molecular unit of currency” of intracellular energy transfer. ATP transports chemical energy within cells for metabolism. Researchers have found high levels of ATP in people with rosacea, versus people, who don’t have it. Anyhow, to make the long story short, if you have rosacea – don’t take CoQ10. I’ve been taking CoQ10 for a few months now and could not figure out why my facial redness got so much worse. As soon as I discovered this, which was yesterday I have stopped my CoQ10 supplements. It’s too early to tell if I get better and how soon. I’ll keep you all posted.

  8. Kathleen says:

    I had “stress hives” a couple of times from 2002 until 2005. These are actually rosacea as are rosy cheeks that don’t go away. I am of Irish descent (50%) but I have VERY dark skin . I am 50 y.o. and was diagnosed with rosacea after a biopsy in spring of 2005 after a high stress emotional situation.

    During that time, I thought it would be a good idea to try relaxing facials. Unfortunately, the technician took pity on me and gave me a complimentary chemical peel that stung unbearably. My face was swollen and bright red the next day. Not sure if she single handedly sent me into this downward rosacea spiral since it’s always difficult to find a particular cause.

    Often treatments (both topical and oral) that I have taken may have made the rosacea worse. Metrogel does nothing nor does Finacea except to dry out my skin very badly which can’t be good for keeping a balance. Isotretinoin (aka Accutane) did little good for the 8 mos it was prescribed and although my blood test numbers were always fine, probably was not too good for my liver.

    I have never seen a direct trigger — yes, running, hot showers, and sometimes alcohol cause a heat/redness but that seems logical for anyone and the redness doesn’t stay. If I could find an exact trigger(s), I would be happy to give that up to have clear skin.

    For me the p&p are the culprit. When one doc called it adult acne, I naively thought that I could use Proactive on it — to which I had a very bad reaction. They did give me my money back. 🙂 I also was being very careful once to use sunscreen and used Neutrogena 70 with Helioplex that gave me an outrageous reaction. Luckily, I found a wonderful lotion (Xmaease) in New Zealand that worked on the oozing, scaly reaction I had. I have since used it on rosacea lesions that are healing and become more like facial excema with great success.

    I also have had terrible puffy areas (welts) that one doc treated with Vanos, a steroid. It seemed to work but who knows what damage a steroid does? I see a lot of people on this Blog trying things that could likely be damaging/weakening their skin even more. My motto is now: if it stings, it’s NOT doing any good and is likely doing harm. Remember: rosacea is your immune system over-reacting so when you apply something harmful, your system will over-react and you will cause further damage.

    I also have had exzema on my legs and lower torso which I always thought was a result of long term Oracea use. (I never had much luck with years of Oracea until just recently.) That condition would come and go.

    It wasn’t until I had to go on prednisone in Nov for Sudden Hearing Loss (another mysterious disease!) that the exzema went away. I had stopped the Oracea before that because I was so certain that the build up of it in my system was causing the exzema. The classic rosacea lesions were gone anyway and I only had what looked like facial excema. The Xmaease lotion cleared that right up so for 3+ weeks, I had beautiful skin while on 60 mg prednisone. The ENT did say the rosacea would likely come back. And sure enough, it is absolutely atrocious now. Plus, I had no defense since I stopped the Oracea.

    I can join everyone in the frustration and depression that accompanies this disease. I now look literally monstrous as I not only have bright red welts on the sides of my face and around my eyes, but also bright red scaly lesions on my chin and betw upper lip and nose. BUT the absolute worst thing is the swelling on my eyes that I have often gotten with outbreaks, is at an all time high. And it gets worse with every passing day so that my eyes are nearly swollen shut when I wake up in the morning. I have never heard of anyone having this intense swelling with rosacea. I am hesitant to try too many remedies at once as others here have stated because then you’re not sure which one is responsible.

    Needless to say, I have missed 3 xmas parties and a day of work due to it. I will be trying an accupuncturist for more natural topical remedies and have gone back on Oracea. I have to go to work tomorrow and am considering wearing sunglasses all day so as not to scare my 10 y.o. students!!

    In an earlier entry, someone was wondering if they should double up their Oracea dosage to “blast” an outbreak. Advice was given not to do that. However, that is exactly what I plan to do for a few days. I figure it should be just like doubling or tripling regular doxy with the added benefit of doubling/tripling the extended portion. BTW, at first I took it at night but it made my stomach feel terrible the next day. Morning dose is recommended — first thing upon awakening; eat breakfast an hour later.

    I have resigned myself to being on Oracea for the rest of my life even if I get back to that beautiful skin I had last month. Luckily, my health plan covers Oracea for what I consider a reasonable price.

    That’s my rosacea saga in a nutshell!

  9. Rosie Asia says:

    50mg may be just as effective considering weighing the cost benefit if it is a big diff in $$$ for you. Also remeber weight can play a factor, consider a 115 lb person taking 40 mg vs. a 180 lb. or a 250 lb. man taking 50mg. absortion/metabolic rates etc. play into account , so do yo really think the 10mg sustained release is going to be that accurate among all body types. Just another ploy to make a buck for pharma, and some doctors will take the bite. If you also have bad acne flareup ( or with cystic) consider asking doc to give weight appropriate Mino or Doxy at higher does then once your face significantly clears up switch to a lower dosage 50mg doxy. About the same, sometimes faster and save a lot if your insurance is not rx friendly. Even with the card Oracea $25 for 30 day, BTW ask your doc when going well to consider giving you a 90-day supply. If doctor is at least not willing to work with options in your situationj, consider changing and ask questions like is the derm very open to giving generics and larger supplies, especially after effectiveness and routine is established and working for patient. Good Luck. Remember everyones face and body are different and respond different, you have to be the best judge to insist this is working fine or not. I have also tried most things outside of laser treatments , which if I knew it worked for sure, I would do it as the amount of time and suffering and $$$ spent on derm visits and different topicals and orals and cyst injections, etc. would probably overall be cheaper. The laser worked great for my 21 year old’s acne after 4 sessions and really improved her overall texture and promoted healing of older mild scarlike purpleish marks. But unlike me, she has never had rosacea-knock on wood, so far). ($400 for seven treatments over 9 months, about every 2-3 months at $120 a pop to maintain, she had the laser that also sucks the bacteia /sebum out at same time, no pain just little tingles and got it at an estitician place that has done thousand treatments about half of what some derms charge, go figure, same machine same treatment, less wait time and they give you musc pillows and coffee/or beverage and appetizer stuff if you like that sort of thing, I just want my rosacea kept in check, however I guess better than water, listening to info commercials, a lolipop and old magazines at the derm. But I wouldn’t want some untrained newbie facial aestician messing around either. But just like a phlebotomist or nurse can give shots better than most doics, because of repitition. So check out credentials and training certificates and logged hours, referrals,etc. Just like all docs are not created equal.

  10. Rhonda says:

    Hi all, Just wanted to note a really interesting experience (to me). I had stopped taking Doxy meds after approx. 6 months and still had 90 or so days left that I just put away. I stopped because my face responded to the medicine (50mg/day). It did not completely clear, but compared to what it had been, I thought perhaps it would be the best that could be done without additional doctor visits or meds. Maybe 3 or 4 months later, I got some kind of intestinal bug and thought I would attempt to remedy the situation myself with the doxy. I did change my diet drastically for several days to a liquid diet and then started taking 100mg/twice a day of Doxycyline. Holy mackeral.. it was amazing to me.. MY FACE totally cleared up! I mean TOTALLY! I’ve never had that experience since this started. I didn’t expect it either.

    Do I know anything for sure, now? Not really. But I can tell you that I have been out of Doxy for almost 20 days and my face is back to a condition which is worse than before. My guts are fine, but the Rosacea is back and around the eyelids too, with swelling. It is amazing to watch. They wouldn’t allow a phone refill. I have to go back into the Docs, so I am saving up my money to do just that. Meanwhile, I have my Halloween mask back on. I’m not sure whether to laugh or not. But at least I find this interesting.

    Anyway, I think I remember that quite a few folks had suggested an increased dose for a month or two starting out and then to taper the dosage down gradually? I never did that routine, I started out with the 50mg. I’ll post again when the mask starts to come off. It really feels like one, too. It’s amazing how fast the skin area can change. Looking forward to a reverse course of direction. Hope 2011 is rewarding for you all. Happy New Year 🙂

  11. Miranda Rose says:

    Hello everyone out there. I have had rosacea for over twenty years, mostly confined to one cheek, but in the last two years, it’s got dramatically worse. My whole face is red (when it isn’t a fetching grey and yellow combination), my nose is permanently either purple or red, and the spots have brought “Plus Ones” to the party. Recently, my ears have started to burn for several hours a day, and the dermatologist I eventually got to see has diagnosed the rash on my neck and chest as Granulomatous Rosacea. Lovely.

    I have been on Efracea (UK name for Oracea, from what I can gather) for over 8 weeks, and think I might have to stop, as the intense headaches and extra flushing are making me just a tad depressed, and it’s only calmed the spots down a bit. Has anyone else had these sorts of side effects from Doxys? And let’s not forget the unpleasant gastric burning. Come to think of it, the first time I tried Doxys must have been a 100mg pill, and I had to get out of the car to be sick.

    I was on Oxytetracycline twice before, and that worked much faster, but, like most people, I was worried about the long term effects. My diet’s pretty good, including fish oils, evening primrose and flax oils, lots of veg and water. I don’t use nasty chemicals on my face, I use a physical sunscreen, and all food and drinks are tepid (yum!) I have never done so many things “right” and had such abysmal results. My skin is completely out of control. Of course, my stress levels are fairly high…

    Right now, with my face feeling as if someone is applying a blow torch to it, I am considering a new and innovative approach, which should sort the problem out once and for all – the Guillotine.

    Got to work better than the creams and gels, right?

    Good luck everybody, in turning this ghastly business into some kind of self acceptance,

    MR

  12. DD says:

    Will leave my story. I have “probably” had Rosacea for 20 years or so. Didn’t know what it was. Face always flushed. I always blushed easily. Face turns bright red during work outs, runs, after just one sip of wine, etc. I also always had adult acne. It was there constantly. During a trip to an exotic warm beach destination about three years ago, my face was a complete mess by the thrid day. I was just under 50 years old and had 27 spots on my face. I started to do the computer research. I came home and made an appointment at with my regular doctor. I found a website that mentioned Oracea. My doctor had never heard of it. However, believed my research that it would work and gave me a prescription. Apparently the pharmacy had never heard of it either. Filled the Oracea script with Doxycyline 100 mg…UGH. I took his word that it was the same. Umm, not the same. I felt ill. I went back to the pharmacy, he made some calls and said he was ordering in the Oracea for me. He did, I was floored by the $100 copay with insurance. However found that my 90 day supply will cost anywhere from $798 to my recent $1376 refill. It’s crazy. I’ve been on it for several years. When I stop the Rosacea rages back. So, I don’t stop. I will be on it as long as insurance covers me and when that stops I’ll find some way to pay the high prices. For me it’s a miracle drug.

  13. Donna says:

    Has anyone ever heard of Lupus miliaris disseminatus faciei?? It is a form of granulomateous rosacea and I have been told i have it. Originally i was told i hd gran. rosacea by 1 dr, then sarcoidosis by another dr and now this by my 3rd derm….I guess its best to have this then the sarcoid?? I know these diseases are hard to diagnose but i have had it with doctors…i have had this for over a year now and it is somewhat better…i have been on doryx, minocycline, tetracycline, all kinds of creams and now plaquenil. I guess I will have this for life…its soooo frustrating….

    Thanks for listening..(or reading)

    Donna

  14. Dean says:

    Never heard of that particular kind. What I CAN tell you is what works for my rosacea. I started by taking 100mg of doxycycline every day for about 2 wks until my face completely cleared up. Then it was a matter of trial and error to find the optimum amount of doxy that I take. For ME its 50mg every OTHER day and my face stays clear. Every once in a while I will get a really small flare up so I’ll take 50mg EVERY day or sometimes 100mg a day for a week and it goes away then I go back to the 50mg every OTHER day. What you have to remember is that right now there is no cure. You also have to remember that everyone reacts differently to the disease AND to the medicine. I had zero luck with any of the creams I was given–total waste of time for me. Others tell me it works better than the pills. Some have to use both. I’m also told that stress has something to do with it too so don’t let it stress you out either because it will just make it worse for SOME people–not all though. I also know a few people like my sister who can no longer take really hot showers or baths because it causes hers to flare up. The research I’ve done also says if you are of eastern european stock you are more inclined to get it. Romanina, Czeck etc.
    I would recommend you get your doctor to start you on JUST doxy and keep track of how you do with it. Oracea is doxy but its time released and its expensive because its new. Doxy is cheap. Just make sure you write everything down that you try or you will forget. Make a chart or something. And dont’ expect it to work immediately either. Give whatever it is you try a few weeks. Maybe do a cream and doxy or whatever your doctor recommends then try to wean yourself off like I did. You can’t cure it but in most cases you CAN figure out a way to control it pretty good.

    DISCLAIMER: What I said above works for ME and I give NO guarantee that it will work for you. I am NOT a doctor nor have I ever played on on TV. But I HAVE stayed in a Holiday Inn.

  15. Dean says:

    Also don’t worry about becoming immune to doxy. The studies show that at that low dose it doesn’t work like a antibiotic. It works like an anti inflammatory and that is what rosacea is–an inflammation.

  16. Donna says:

    i have taken doryx for months and then was told to get off of it…i didnt see much change…i am now on plaquenil and finacea cream…i hve tried so many creams and anitbotics and now this plaquenil…i go back to the derm next week so i hope there is something else up his sleeve…by the way…he surgically removed some of the cystic ones on my face a few weeks ago and that helped more then any medicine…wish me luck!

  17. susie says:

    Oracea works for me, but just recently lost my insurance coverage, the drug is over $400 for 30 pills!!!!!! This is robbery! Ridiculous!!! It’s overpriced because the company spends millions of dollars on websites and advertising (and probably flying dermatologists to Hawaii for vacations) and does not offer assistance to those afflicted that don’t have insurance to cover the inflated cost of a drug. I don’t need it to come in a fancy package! I don’t need to see a website!!! I don’t need the $25 dollar copay card when I have insurance!!! What I need is to not be expected to pay $400+ for 30 pills!!!!! Thank God Rosacea is just an embarrassing, painful affliction and not life threatening… Or the makers of Oracea would have us die if we can’t fill their greedy coffers!! It’s criminal.

  18. Rhonda says:

    Suzie, please consider trying Doxycycline either 50 mg or 100mg every other day. Either way, you can go to Walmart or Target or Costco and buy a 90 day supply for roughly $10-15 dollars total. Target charges me $4.00 for 30 pills and $10.00 for 90. Yes, it is that cheap and that is for cash, no insurance and just 1 prescription to cover 90 days and I get that prescription with 3 refills from the clinic in the next town for $59.00 total to see a doctor. Read the posts above to see comments from others regarding their success (or not) with generic 50mg. ok.. I just had to respond because there are alternatives that you may want to consider.

  19. David Pascoe says:

    Hi Susie, there are definitely many who believe that Oracea is too expensive. As Rhonda says, generic doxycycline 50mg a day is a cheaper alternative you could explore with your doctor.

    Just to be fair though, Galderma do offer Metrogel and Oracea for free for those on a low income and have no medical insurance, so they do have at least some compassion….

    all the best,
    davidp.

  20. CJ says:

    Oracea is causing me to have gastrointestinal distress and headaches just like generic doxy. I have been on Doryx 150 mg in the recent past will no side effects thanks to taking it with food and the time release coating which moves the medication beyond the stomach. I am now splitting the Doryx 150 mg tablets into four (4) pieces of approx. 37.5 mg each and taking one (1) piece daily to see if I can achieve the same results as Oracea without any side effects. Doryx is expensive like Oracea, however, getting rid of the side effects is paramount along with maintaining the lowest dose possible. Has anybody else tried this with Doryx?

  21. Lorraine says:

    I am 37 years old and went to my derm initially for dry, itchy red skin at the corners of my mouth. I was diagnosed with seborrheic dermatitis initially, then when I started complaining of redness to my cheeks the derm diagnosed me with mild rosacea. He put me on oracea. I have been on it for more than a year now and have tried to wean off several times with no success. When I try to wean off I get the dreaded P&P’s, which I did not have before taking oracea. My skin is wonderful while taking oracea but I don’t know what harm it is doing to my body in the long term. Any idea on how long you can safely take oracea? I don’t want to be on it for the next 30 years!

  22. Nikki says:

    I was given Oracea trial packs and after 2 weeks I was amazed at how wonderful my skin was…then came a raging yeast infection. Sigh…. I was so hopeful. Does anyone have any experience taking Oracea and preventing yeast infections? Could I take one every other day and still have a benefit and hopefully avoid a YI?

    Thanks! I loved seeing better skin after 15 years of red, bumpy itchyness. ~Nikki

  23. Stella says:

    I tried Oracea before but decided my skin condition did not warrant other side effects that could result from long term use. Yeast infections everytime I take antibiotics are so horrible, I’m not willing to set myself up for it and I don’t think I need to either. Unlike most people on this post, my rosacea is mild and other than redness and the occasional small papule which goes away during the day, I don’t have any other symptoms. I was diagnosed several years ago and it did started with a burning feel on one of my cheeks. I no longer have burning and my skin is soft and normal thickining. Metrogel did not help either but dried my skin instead. I eventually found products that did not worsen the problem, mostly mild cleansers and moisturizers so my Rosacea is under control, with make-up covering the redness for the most part. Yes, exercise, heat, cold, wind, spicy foods, alcohol and caffeine are all triggers that I try but can’t always avoid. The redness subsides after a while so I can deal with that. What I’m most worried about is that due to redness on my eyes and extreme eye pressure/tireness which I started experienced during the last month or so, I came to the conclusion and was just confirmed today that I have ocular rosacea. The doctor prescribed Oracea and Metrocream but I’m not sure if any of them is meant to relieve the ocular rosacea.
    Has anyone used them for that reason and was there improvement?
    I do have an appointment with an ophtalmologist who I hope is knowledgeable of this condition. My dermatologist had never heard of IPL being effective or used for Rosacea so that makes me think he doesn’t know all there is to know about it either.

  24. Dean says:

    Stella I’ve had rosacea for about 10yrs or longer though at first I didn’t know what I had. I thought it was some kind of allergy or something. After doing some research and reading this blog I checked with my doctor and he confirmed I had rosacea. I also read that low dose doxycycline works with a lot of people including me. I’ve been taking 50mg every other day now for about 5yrs. Metrogel never helped me at all. I got to the 50mg dose by trial and error. Started with 100mg a day then reduced it to 50mg a day then every other day then every 3rd day. Every other day seems to work for ME. That doesn’t mean it will work for YOU. I’ve found over the years what works for some may not work for others. MOST people who have it are from eastern european descent though not all. My grandparents were from Czechoslovakia so I am. My sister has it too though not as bad as me and she doesn’t take anything though SHE uses metrogel exclusively and that works for her. Oracea is just a brand name like Tylenol but its slow release so it releases throughout the day. AND its far more expensive than plain doxycycline. What I do works perfectly for ME but it might not for you. At low doses its not supposed to work like an antibiotic. Instead it works as an anti inflamatory which is what rosacea is–an inflamation. Every now and then I get a breakout in one particular place on my face–upper cheek area sort of halfway between my right eye and ear. But NOT on the other side. Weird. But its a weird disease for which their is no cure. You might try getting your doctor to put you on low dose doxy and see what happens. At low doses you SHOULDN”T have yeast infections but then everyone is different and I’m NOT A DOCTOR!! I had to take it for about 2 weeks before I saw any improvement so don’t get discouraged if it doesn’t happen overnight. And I’m TOLD that it will not make you resistant to antibiotics because it IS such a low dose. Hope this helps.

  25. Rhonda says:

    http://rosacea-support.org/treating-ocular-rosacea-from-aao.html

    also read this one too… that David posted in February.

    http://rosacea-support.org/cyclosporin-better-than-artificial-tears-for-ocular-rosacea.html

    Hope these links also help you. Good luck Stella. Rhonda

  26. David Pascoe says:

    Comment via email from Rick.

    “Just a quick thing. My face gets really red after any sun exposure, even if well protected by sunscreen. Now afterwards, I use a sunless tanning lotion to help make the red appear at least a little tan instead. Seems to help as I then don’t look quite as red.”

  27. val says:

    I am 58 and going thru puberty again, trying this and trying that. Dr gave me Doxy 100 which was wonderful and also Metrogel. I do not thing Metrogel helped much at all. He has switched to Oracea 40mg plus Finacea. Seems to help so far but would love any ideas for anything other than pills?? My greatest wish is for clear skin so any other ideas?

  28. danimary says:

    Hi all, I’ve been on doxy 20 mg twice a day for 2 weeks now. Not noticing any difference to my pustules. The papules are pretty much under control though but that may be the hydrocort I use when they appear (once to twice a week). Any idea how long it should take to notice an improvement?

  29. Dean says:

    Everything i have read says 50mg is the optimal dose and that seems
    To work for me. Took about 2wks to see a change then very quickly
    the redness etc was gone. Metrogel does nothing for me. Evwryone
    is different.

  30. danimary says:

    I agree about the metrogel/noristat, did nothing for me either. I’m trying azelaic acid and I don’t know that it’s helping with the pustules but the redness (which luckily for me wasn’t bad to start with) seems better. The oracea site says 3 – 4 weeks, we can’t get oracea here in Canada so I’m trying Periostat. I’ll give it some more time.

  31. David Pascoe says:

    comment via email from Dean.

    “Oracea is nothing more than expensive time release doxycycline. Regular doxy works just as well at 50mg. Try it”

  32. john says:

    ive been diagnosed with rosacea for a few months now but for the last 11 years i’ve had this pimply rash on my forehead that would come and go . the first derm i saw said it was a fungal infection caused by the propecia i was taking for hair loss) so he gave me antifungal cream, lotion , shampoo with sulfa face scrub pads and sulfa lotion to put on and zithromax to take. then i moved too far away to see him so i went to a different derm as the rash came back a few months after i stopped the antifungals and this guy said i was fine -everyone has pimples now and then. The third one said I had acne and gave me a prescription face wash that worked pretty good for a few months. Then I went to a 4th guy who said I had rosacea. He gave me more of the sulfa lotion and oracea which I didn’t take. The sulfa has worked great on my forehead, its totally clear but turns red now in the afternoon. Then I started noticing the veins forming on my nose, lots of veins and one side is red and seems to be enlarging so I started the oracea, I’m not sure its helping. Now Ive started to get the face burn but only when I’m at work and my ears have started to feel like they are going to melt when I lay down to sleep. Then two weeks ago I went on a fishing trip on a sunny day and my face got very slightly burnt which went away except for a patch across my nose and both cheeks. It stays red now . my wife says its so slight she cant really see it but it bugs me to death. Now it looks like the red its forming on my chin. My symptoms seem to get worse at work and always in the afternoon, does anyone else have this ? I’m going to stay on the oracea if I can and I just started taking finacea to see if it helps , I hope so.

  33. Dean says:

    First I’m NOT a doctor I’m just telling you what I do know from personal experience. You say you are using Oracea. THAT is nothing but “fancy” doxycycline that is time released. You COULD do like I do and just get regular doxycyline at 50mg per day. Its worked for me now for 3yrs. ONE reason you might have that problem you had after being in the sun is because of the doxy. It will make you sun sensitive so you REALLY have to cover up if you are going to be in the sun at all. Regular doxy is really inexpensive compared to the Oracea. Sometimes I can get away with only taking it every other day. From all my research and others it appears that 50mg a day is the optimal dose. At that dose it does NOT work like an antibiotic but instead works like an anti inflammatory. Thats what rosacea is–an inflammation. I’ve found that everyone is a bit different. Some swear by the creams and gels. For me they have ZERO effect. Only doxy has had any effect on me. I tried the oracea for a while but after researching it I found its nothing more than a proprietary time released version of doxy. It took about a week for it to show any effects on me but now I’m pretty much “rosacea free”. There is NO CURE for it only control. You may find that different things work for you such as a combination of cream/gel and doxy or Oracea but you will have to experiment a bit. I know one person that controls it by simply not eating anything that is acidic such as tomatoes. Don’t give up hope. Be patient and you will find what works for YOU.

  34. john says:

    thanks Dean, your post gives me hope, my face is slowly getting worse so I’ve been stressing pretty bad. i went out and bought a bunch of creams and lotions off of amazon and I bought some ph strips to test my urine. for the last 3 years I’ve have a fruit smoothie every night, after reading some on what not to eat i stopped the tomatoes, palm juice, yogurt and pro biotic. I guess I need to put some more time into the diet thing. I’ve read you shouldn’t eat beef but is that all read meat or is buffalo and wild game ok?

  35. Dean says:

    Again John I’m not a doctor (nor have I ever played one on tv) so I only go by personal experience and what I’ve read. The veins on your nose are LIKELY sun damage and I’m not sure there is much you can do about them so maybe ask a dermatologist. Don’t know about the beef thing. Thats the first I’ve heard of that idea. I don’t eat much meat anyway so thats something you might research on line. Be persistent with whatever you try though. Don’t use it for a couple of days and quit because it LOOKS like its not working. I used the doxy for at least a week or maybe even 2 before I saw any results. After that I’ve pretty much been clear. I’ve been taking it now for over 3yrs I think. I did try an experiment one time. I slowly decreased the dose so that I was taking 50mg every 3 days–the rosacea came back. Went to 50mg every 2 days and that seemed to work so I did that for a long time. The only time I had a flare up was if I was in the sun too much or I ate tomato soup then I would get a flare up on my face sort of between my right eye and side burn. Thats how I learned about acidic foods. I didn’t stop eating tomato soup but I know if I eat it I will get a small flare up for a day or so. But thats ME and it may not be the same for you. Try keeping a food log for a while and comparing that to your flare ups to see if there is any correlation between the two. I usually take 50mg every other day but sometimes I will up it to EVERY day especially if I want tomato soup!!! If I take it EVERY day when I eat the soup then it doesn’t flare up as much and it takes less time for it to go away. You will eventually figure out what is best for YOU. But I have told many people about the doxy therapy and almost all of them find that it works and its cheaper than Oracea. Good luck.

  36. john says:

    thanks dean, i’ve only been on the the oracea 5 days so hopefully it will kick in soon. i go see the derm thursday, i’ll ask him about the generic doxy and have him look at the nose, i hope its not in my nose, i’ve read there isnt much you can do about it except watch it get bigger and redder.

  37. Dean says:

    Good luck John. Don’t give up. You WILL find a way to control your problem. I did and pretty much everyone else does too.

  38. john says:

    , i saw the derm yesterday, he said since, its just a light pink sunburn on my nose and upper cheeks, to get off the oracea, sulfa and finacea. now i’m on metrogel, or at least i will be when my pharmacy gets it in. i guess i’ll give it a try. i’m keeping a detailed food/symptoms log so hopefully that will shed some light soon. its weird that it went from pimples on my upper forehead to just a rash on my nose and cheeks.

  39. Rhonda says:

    John, It’s hard to believe the derm didn’t say the oracea had started working, or something in the mix you are taking. Anyway, since it was already improving I’m wondering why the derm wouldn’t want you to at least try the full prescription to see the results and especially without the skin cream type meds.

    Anyway, good luck and I was also wondering if you asked about 50 mg Doxycycline as a very inexpensive substitute for the expensive Oracea? They are different, but as Dean has outlined it might be just the ticket. First tho, I would wonder why finishing the prescription out wasn’t a possibility? It takes a couple of weeks to really kick in. Ok.. wishing you the best and if you have any thoughts.. pump ’em up to the board 🙂 Rhonda

  40. john says:

    Rhonda, im a little scared to stop the oracea, like you said, it seemed to be working. he said the metrogel would be the most likely to help with the rash and i don’t have the bumps anymore, at least for now. the burning face thing is gone also, it was pretty severe there for awhile and i think the oreacea helped with that. i was going to ask about the doxy but then he said get off oral meds. we’ll see how this works. if it starts to come back i’ll start and finish the oracea then get an rx for the generic. my brother in law said he has rosacea around his eyes but not in them and he scrubs his eye lids and nose twice a day with baby shampoo and it stays away, anyone else try this?

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