March 1, 2007 Antibiotics have been the traditional treatment for the skin disorder rosacea, but patients often develop antibiotic resistance to the drugs. A drug recently approved by the FDA, Oracea, contains a low dose of the antibiotic doxycycline, which reduces the risk of antibiotic resistance, and as a result, stops the release of chemicals that cause inflammation, bumps and pimples in the skin.
Kathy Olivierio has been covering up and hiding a skin condition called rosacea for almost 20 years. "Rosacea is like this monster that's in you and has to get out," she says.
Fourteen million Americans suffer from the skin condition. When rosacea flares up, skin becomes inflamed. It's painful, causing redness and bumps to the face and embarrassment to the person it affects.
"Rosacea is in your face and on your face, reminding you every day of what's going on in your skin," dermatologist Richard Fried, M.D., of Yardley Dermatology and Yardley Skin Enhancement and Wellness Center in Pa., tells DBIS.
After years of trying to find something that works the first FDA-approved pill to treat rosacea, called Oracea, may help heal rosacea in just a matter of weeks.
Fried says, "It tells us that the big, bad thing that we've been chasing is not a bug, not a fungus, but inflammation."
Rosacea is traditionally treated with antibiotics, but Fried says long-term use can lead to resistance. However, he says Oracea is an opportunity for physicians to escape from that "resistant bacteria nightmare."
Oracea contains a low dose of the antibiotic doxycycline, which reduces the chance of a patient developing antibiotic resistance. As a result, one capsule a day stops the release of chemicals that cause inflammation bumps and pimples in the skin.
...and with just a pill a day, Olivierio is now blemish-free.
Doctors don't know what causes rosacea. Some believe it's genes. Studies show rosacea is much more common in fair-skinned people.
BACKGROUND: CollaGenex Pharmaceuticals has introduced a new drug for the treatment of rosacea, a skin condition that affects fair-skinned people of European descent. In two controlled clinical trials, those patients who received Oracea showed a 61 percent and 46 percent reduction, respectively, in inflammatory lesions, compared to 29 percent and 20 percent reduction in patients who received a placebo.
HOW IT WORKS: Research has shown that certain antibiotics can be chemically modified to remove their antibiotic effects while retaining those properties that make them effective in treating inflammatory diseases. CollaGenex scientists modified the antibiotic doxycycline, typically prescribed to control inflammation from rosacea. They separated the antibiotic and anti-inflammatory active ingredients to produce a version of doxycycline that can be used for longer periods, with no stomach problems or side effects, because it is no longer an antibiotic. Patients can benefit from the anti-inflammatory properties without taking antibiotics they don't really need.
ABOUT ROSACEA: Rosacea is a chronic inflammatory skin condition that affects approximately 14 million adults in the United States. It primarily affects the face. If it progresses untreated, it can cause itching, pain and thickening of the skin. Rosacea can affect anyone, but individuals with fair skin who tend to flush or blush easily are believed to be at greatest risk. There is no cure for rosacea and no known cause, but medication can control or reverse the symptoms. You should see a dermatologist for diagnosis and treatment if you experience chronic redness on the cheeks, nose, chin, or forehead; small visible blood vessels on the face; bumps and pimples on the face; or water or irritated eyes. Left untreated, there may be burning or stinging sensations; rough, dry central facial skin; raised red patches known as plaques; and facial swelling (edema).
WHAT TO DO: Treatment varies from patient to patient depending on the severity of the condition, including oral and topical medications to treat the bumps, pimples and redness. Good skin care can help control symptoms: use mild cleaners and blot your face dry, and be sure to use non-irritating skin-care products. In extreme cases, laser treatment or surgery may be necessary to remove visible blood vessels or reduce wetness. Some people find certain things aggravate their rosacea: hot baths, strenuous exercise, menopause, hot or spicy foods, alcohol, and motional stress. Identifying potential triggers and avoiding those things can also reduce outbreaks.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.