Apologies that this is longish. I will start by saying this is in no way a complaint about her my NHS GP who is really very good, but rather an attempt to understand what prevents them from prescribing a medicine I wish to try. I have other health issues (CFS/ Fibro). I suffer from rosacea and its ocular component pre-dating the aforementioned conditions. I have v v sensitive eyes and skin, and chemical sensitivities. I do not have facial bumps but I do have painful sensitivity wrt to my face and eyes. I have blepharitis (posterior-type/ Meibomian Gland Dysfunction) with dry eye.
Anyhow, I heard about a medicine called Efracea, a low-dose (40mg) modified release doxycycline which targets the inflammation of rosacea without the negative effects of antibiotics, short-term and long-term. I was surprised when my GP said they weren't allowed to prescribe and offered to contact a derm for advice, which they kindly did.
The derm said no to Efracea (unless I try regular doxycycline or lymecycline first and react badly) when they might then reconsider.
My GP said they would recommend I try the lymecycline because it's gentler than regular doxy.
I really want to try the Efracea because I want to target the inflammation of my rosacea symptoms without anti-bacterial properties of regular doxycycline or lymecycline.
I don't understand why, with the big push to limit antibiotics, the derm refuses a low-dose MR antibiotic which targets inflammation only. I feel like my GP's hands are tied. But I don't want to further burden my already struggling body. I have anxiety too and the idea of trying the alternatives to Efracea (low-dose, one a day) is making me feel worse. I don't want to help one issue while making others worse.
Is there a reason why I can't get the Efracea from my GP? Cost, for example?
I see I can try to obtain online or with a private prescription (not sure if that would have to be from the derm or my GP?) with Lloyds but am not sure how to go about it.
I had tried various antibiotics in the past for my rosacea (pre-CFS/ Fibro) but I am pretty convinced that my CFS/ Fibro (which originally started with a very severe sinus infection) was not helped from getting worse in its early stages by three increasingly potent courses of antibiotics over six weeks. I got worse and worse and never recovered. Of course, I will never know if the antibiotics really did make everything worse and prevent improvement/ recovery, but I'd rather avoid them, especially if I can get the advantage of the anti-inflammatory aspect of them without all the negatives that usually come with antibiotics. Btw, it was a different GP then.
I think, to compound matters, I have a couple of items (took a long time to find!) that I can use to help my facial rosacea (esp my v. red nose) so, at a glance, my rosacea can look not so bad. I'd be stuck if they were discontinued. But, while I have dry skin, and no acne/ pustules, it feels much sorer than it looks..it's hot, sore, tight burning, throbbing pain when it's flaring and can be unbearable. My eyes can be hell and I get a lot of severe headaches from them and both cause increased pain in my upper body muscle groups (tension?). The eyes flaring worsen the skin and vice versa. On top of my other conditions, it can be unbearable.
I could possibly try to raise funds for a private derm appt but if they've told my GP no in a letter, is it worth it anyway, and I hate the idea of trying to explain the more bizarre aspects of my conditions with someone new? Are these online places where you can have a consultation and buy privately safe? I worry about whether the meds are fake...
Thanks for bearing with me and any advice you can offer wrt to a further talk with my GP would be really appreciated.