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Thread: Does Metrogel & Oracea cause Rosacea symptoms to worsen initially?

  1. #1
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    Default Does Metrogel & Oracea cause Rosacea symptoms to worsen initially?

    Hi Folks,

    I was recently diagnosed with Seb Derm and Rosacea. I've had a red nose for years and then in early 2009 I noticed my face was getting really dry and flaky. No rosacea symptoms were detected at that point, i.e. except for the red nose I didn't have red cheeks or anything. I thought I had dry skin from being out in the sun too much and started using hydrating creams like H2O etc and they seemed to occasionally help the dry skin but I was never able to get rid of the issue all together.

    Recently I decided to visit the doctor as the dry skin was not going away and my cheeks were looking red as well, people always asked me if I was out in the sun on the weekend. He diagnosed me initially with Seb Derm and prescribed Desonide cream for 3 weeks. I noticed my skin got a lot better and softer during this treatment although towards the end of the treatment I started getting small pus filled acne bumps on my nose and cheek, about the size of a pore. When I saw the doc after the 3 week Desonide treatment he told me I may have symptoms of Rosacea and started me off on a treatment of Metrogel once a day and Oracea once a day in the morning.

    It is now day 5 of my metrogel/Oracea treatment and my symptoms seem a lot worse than when I started, the cheeks are bright red and so is the nose. The dry skin also seems to be coming back with little flaking in spots. Is this a normal initial response to the treatment or am I allergic to one or both of these medicines? I was under the impression that if allergic to Oracea I would see a rash all over my body.

    I'm going to call the doctor tomorrow but I wanted to post on here to see if anyone else who took this combination of drugs saw the same worsening of symptoms initially.

    Thanks
    Sal

  2. #2
    Senior Member TheMediumDog's Avatar
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    Metrogel can make you worse before getting better. Its because, in order to get the active ingredient into the skin, the gel needs to contain what is called a "penetration enhancer" - all topical meds have these - and this can be a bit harsh on the skin. It tends to balance in favour of the active ingredient over time though (around a week, I find).

    On the other hand - it was stupid of your doctor to give you Desonide cream. Steroids are not a friend to facial skin; over time, use can be dangerous and really, they should be reserved for specific skin conditions. Anyway, after you withdraw steroid use, you can get a 'rebound' reaction, and it is possible that this is what you are experiencing. I would have thought a couple of weeks since stopping the steroid would be enough for this to die down.

    So overall, I'd say wait a little longer.

    The Oracea I don't think should be causing initial redness (but see below). More generally, for skin that has become flaky, if it is an "all over" thing rather than just in specific patches, then I don't think I would agree with your diagnosis (rosacea and seb derm). The skin becoming 'overall flaky' doesn't seem to have a medical name; but my focus for locating the cause might be somewhere in the gut/digestive region - unless there are other notable aspects of your lifestyle that might be responsible.

    The trouble is this: doctors and dermatologists will tend to diagnose 'rosacea' whenever they see the outward signs - i.e. redness in the right kind of places. But this redness could be due to all sorts of different reasons, so without further investigation, just saying 'rosacea' isn't that informative.

    If your skin has become flaky, that means that the skin barrier has lost some of its integrity, it isn't keeping out the things it should be. Well, in that circumstance, irritants can penetrate where they shouldn't. Your blood vessels lie just beneath the surface of your skin, so one thing that irritants can do is gradually over-sensitize these; and this can lead to redness.

    Flakiness doesn't just happen. But, as I say, there doesn't seem to be a dermatological category for this affliction, even though a fair number of people on the board have reported it. The integrity of the skin is controlled by numerous processes...its all very complicated. But digestive issues are a good place to start looking. Also hormonal - since a couple of hormones are big regulators of skin integrity.

    I personally have experienced big-time flakiness in response to long-term antibiotics. It seems to be due to killing off good bugs/allowing bad bugs to flourish. Anyway, long story short, both metrogel and oracea are antibiotics (metrogel is an antifungal as well). So it is possible that, you know, if your flakiness is due to some kind of disturbance of your internal flora, then these two meds would be making it worse. I experienced an increase in flakiness over a few days when trying different antibiotics, so it is possible for them to have quite an immediate effect in this respect. ...On the other hand, I was on antibiotics for 4 years; I doubt you have been on them anywhere near long enough to cause significant damage to your bacterial populations.....but then what do I know.
    Last edited by TheMediumDog; 22nd February 2010 at 03:58 AM.

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    Thanks for your reply.

    The switch from desonide to oracea/metrogel was within a day, i.e. I used desonide for 3 weeks went to see the doc and the very next day he had me discontinue it and start metrogel/oracea.

    The flakiness is basically only on my face, small patches on the cheek area and the forehead. The skin feels dry and tight at times. The rest of the body is fine.

    The last time I took any antibiotics was over 10 years ago. Other than the occasional tylenol or aleve for flu/fever relief I don't take any medicines. Not sure what could have changed my hormones or gut bug makeup. Are there any tests that can be run to diagnose this? The dermatologist did have me take a blood test for AutoImmune nuclear bodies just to make sure it wasn't lupus or something similar. That came back negative.

    I'm going to give this one more day before I call him up, hopefully it's just a rebound from stopping desonide that is causing this.

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    Again another victim of the dumbness of doctors...
    Steroid cream on the face for redness...

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    Looks like the symptoms are slowly getting better. I don't have any pus filled breakouts today as mentioned in my earlier post and although my face is red and blotchy it's not as bright red as it was two days ago.

    The skin is fairly dry though and flaky in spots on the cheek and forehead area. I've started applying Cetaphil moisturizer to the face in the morning now.

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    Hi,

    I have a similar question for people on Oracea/50 mg doxy. I have been taking generic doxy 50 mg for 3 days now and my papules have increased. Are there other people who experienced a worsening of p&p at the beginning of treatment with doxy/oracea?

    Angela

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    Hi everyone,

    I began Oracea on Tuesday and I have developed a huge bump on my forehead. Can Oracea make my face worse before it gets better? Also, is it okay to use topical acne medication (like proactive) while on Oracea?
    Thanks for any info. I appreciate it.

  8. #8
    Moderator Melissa W's Avatar
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    Hi Angela
    If I remember correctly it did get a bit worse before it cleared so I would definitely give it more time. Oracea took months for me to see real clearance so I had to be very patient and I definitely think it is possible for you to have an increase in papules before you see good results. Good luck!!!

    Hi tiredofacne,
    Proactive is too harsh for most of us who have rosacea so I would not suggest you use it if that is your diagnosis as well. If you want to use a topical you could ask your doctor for samples of Finacea or one of the metros (gel, cream, lotion).
    Good luck and welcome to the RF.

    Best wishes,
    Melissa

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    Hi Melissa,

    Thanks for your response. I had very clear skin using proactiv, and then I switched over to Murad, and that's when my skin started to misbehave. I just felt like my face was on fire from it and my acne has gotten really bad. Now it seems that I can't use anything with benzoyl peroxide or even salicyclic acid. The toner for proactive is what really burns my face, so I don't use. I used the cleaner last night and then left a thin layer of the sulfur mask on my face overnight and this morning when I woke up, my face is not as red and the bumps have decreased in size, so I think I'll do this combo every other night.

    I also have a question about cleansers. My dr. recommended that I use Cetaphil or CeraVe. I am using CeraVe cleanser and moisturizer and the oil production in my T-Zone went crazy (which is why I used proactiv last night). Are these products supposed to increase the amount of oil on my face?

  10. #10
    Moderator Melissa W's Avatar
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    Hi there,
    I'm not sure about the products increasing the oil production but I use CeraVe because my face is dry and Cerave allows it to better retain moisture. So perhaps CeraVe is not suited to your face. It is best for skin that is on the dry side. I am not sure about Cetaphil.

    Whenever you try a new product (topical) just try it on a small area of your face for a few days before applying to the whole face to make sure you don't have an adverse reaction.

    Melissa

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