Anti-inflammatory dose doxycycline for the treatment of rosacea

Rosacea is a chronic inflammatory facial condition that has traditionally been treated with topical therapies, oral antibiotics or both. The use of oral antibiotics at conventional doses can lead to antimicrobial resistance, alterations in the balance of normal microflora and potentially serious side effects. Anti-inflammatory dose doxycycline is a novel approach to the treatment of rosacea that separates the anti-inflammatory effects of doxycycline from its antimicrobial properties by limiting plasma concentrations to a range below the minimal inhibitory concentrations of susceptible bacteria. This review describes the evidence supporting the use of anti-inflammatory dose doxycycline in the treatment of rosacea, explores its mechanism of action and considers its place in therapy.