From the Guidelines

Yes, doxycycline is used for rosacea.

Doxycycline, specifically a 40-mg dose with modified-release formulation, is approved by the FDA for the treatment of rosacea 1.
This formulation utilizes the anti-inflammatory properties of doxycycline at a dose that is below the typical antibiotic threshold, reducing the risk of promoting antibiotic resistance 1.

Clinical trials, including two phase 3 randomized, double-blind, placebo-controlled trials, have demonstrated the efficacy and safety of once-daily doxycycline 40 mg in reducing inflammatory lesions in patients with moderate to severe rosacea 1.
The long-term efficacy and safety of modified-release doxycycline as monotherapy have also been established, showing that it can prevent relapse and maintain long-term control of rosacea symptoms 1.

The Global Rosacea Consensus (ROSCO) panel recommends oral doxycycline as a treatment option for all severities of inflammatory papules/pustules, clinically inflamed phyma, and ocular features of rosacea 1.
The panel suggests that the 40-mg modified-release dose of doxycycline is a viable option, especially in regions where it is available, due to its anti-inflammatory effects without antibiotic activity, which may help alleviate concerns over antibiotic resistance 1.

The treatment approach for rosacea should be phenotype-led, considering the individual patient's expression of concern and desire for treatment, and may involve combination therapy based on disease activity, severity, and presenting features 1.
General skincare and eye care are underlying components of rosacea management, with emphasis on sun protection, moisturizers, gentle cleansers, and trigger avoidance 1.

From the Research

Doxycycline is used in the treatment of rosacea, with studies showing its efficacy in improving symptoms of the disease 2, 3, 4, 5, 6.
The medication is often administered at a dose of 40-100 mg daily for 3-6 months 6.
Doxycycline has anti-inflammatory properties, which may be beneficial in the treatment of mild cases of rosacea 2.
Combination therapy of doxycycline with laser or intense pulsed light treatments has been shown to be safe and effective in improving signs and symptoms of rosacea 3.

Doxycycline has been compared to other treatments such as azithromycin, with studies showing similar efficacy between the two medications 5.
Other systemic therapies for rosacea include metronidazole, retinoids such as isotretinoin, and dapsone 6.
Beta blockers may be used to reduce erythema, while oral ivermectin may be used to treat demodicosis 6.

Doxycycline is generally well-tolerated, but may have contraindications such as pregnancy, children below 8 years, and known hypersensitivity to tetracyclines 4.
The risk of permanent teeth discoloration and decreased bone growth rate make doxycycline contraindicated in infants and children 4.
No photosensitivity reactions were observed when doxycycline was used in conjunction with laser or nonlaser light therapy 3.