Rosacea

INFORMATION FOR WOMEN WHO HAVE ROSACEA DURING PREGNANCY OR BREASTFEEDING

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is rosacea during pregnancy?

Rosacea is a chronic skin disorder that shows up, particularly on the face, as erythematous (reddened) inflammation that looks somewhat like acne, but is related to blood vessels near the surface of the skin, in contrast with acne, where the inflammation involves hair follicles and sebaceous glands (glands that produce oil). The condition also can involve the eye, usually in people who already suffer the cutaneous aspect of the disease, although eye inflammation, redness, and itching can start ahead of the skin manifestations. Based on characteristics of the skin lesions and affected blood vessels and based on the presence or absence of ocular (eye) symptoms, rosacea is classified into four types: papulopustular, erythematotelangiectatic, phymatous, and ocular. It affects young women, and so it can occur during pregnancy.

How common is rosacea during pregnancy?

Rosacea has been reported at rates ranging from 2 to 22 percent in western countries. The risk for the condition is highest among Caucasians with fair skin that are sensitive to sunlight. Classically, rosacea has been nicknamed The curse of the Celts, because it was believed to be more common among Celtic people than among any others. Still, it appears to affect various European people whose ancestors spoke various Indo-European languages. Except for the phymatous rosacea subtype, rosacea develops on the skin more often in females than in males.

How is rosacea during pregnancy diagnosed?

Rosacea is a clinical diagnosis, meaning that there is no particular test that is specific for the condition. Your family doctor, or dermatologist, will make the diagnosis based on your history and physical examination, although various tests (including blood tests and biopsies) may be ordered to rule out conditions that can be confused with rosacea, such as eczema, psoriasis, and discoid lupus erythematosus.

Does rosacea cause problems during pregnancy?

In addition to your skin feeling hot, irritated, and affecting your appearance, the condition can give you irritated, swollen eyes. People afflicted with rosacea, especially women of childbearing age, are at risk for a severe exacerbation of rosacea, called rosacea fulminans (also called facial pyoderma). Along with severe skin lesions, cases of eye involvement have been reported to the point of an eye being perforated. The nose also may be enlarged and completely red.

Does rosacea during pregnancy cause problems for the baby?

Rosacea is mostly a problem for the mother who is afflicted with it.

What to consider about taking medications when you are pregnant or breastfeeding:

  • The risks to yourself and your baby if you do not treat the rosacea
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat rosacea during pregnancy?

Treatment includes medications that constrict skin blood vessels, such as brimonidine (Mirvaso) and oxymetazoline (Rhofade), and various other agents, such as metronidazole, azelaic acid, and ivermectin (Soolantra), which are applied topically in gels, so they are unlikely to harm the fetus. The antibiotic doxycycline also may be prescribed to treat pimples that are part of the condition. Doxycycline is not thought to be especially dangerous to the fetus, although more data are needed for a full evaluation of the safety of this drug during pregnancy. One drug that is given in severe cases of rosacea in non-pregnant people is isotretinoin, but this drug is absolutely contraindicated in pregnancy.

Who should NOT stop taking medication for rosacea during pregnancy?

Rosacea is not life-threatening, but treatment is given because it is very unpleasant and can cause eye damage. You should make any decisions regarding stopping therapy with your physician.

What should I know about choosing a medication for my rosacea during pregnancy?

It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.

You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.

What should I know about taking a medication for my rosacea when I am breastfeeding?

Doxycycline gets into breastmilk, and its effects on nursing infants over the long term are not known. Still, it is generally not thought to be dangerous as the exposure is expected to be low and of short duration for the typical nursing infant.

What alternative therapies besides medications can I use to treat my rosacea during pregnancy?

Laser treatments are available and fairly effective in improving the condition.

What can I do for myself and my baby when I have rosacea during pregnancy?

It is very important to follow the instructions of your physician.

Resources for rosacea in pregnancy:

For more information about rosacea during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations:

 

Read the whole report
General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.


Medications for Rosacea


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