Doxycycline for Acne

Doxycycline for Acne
Dr. Leah Millheiser, MD Headshot
Medically reviewed by Leah Millheiser, MD Written by Our Editorial Team Last updated 6/18/2020

When you struggle with acne, there’s little you wouldn’t do to have clearer skin. As you look back on all of the cleansers, ointments, medications and treatments you’ve tried, you realize you may have spent a fortune. Yet, here you are. Still looking. 

Antibiotics like doxycycline treat acne from the inside out, attacking the bacteria that causes breakouts. Sounds good, right? However, as with any prescription medication, doxycycline may not be right for everyone. Take the time to research this treatment option before diving in head-first. 

TL;DR: What You Need to Know About Doxycycline for Acne 

  • Doxycycline is a tetracycline antibiotic drug that’s been on the market for decades. 
  • It is one of the most popular antibiotic medications used in the treatment of acne. 
  • Doxycycline may reduce the number and severity of acne lesions when used as directed. 
  • Side effects of doxycycline include increased photosensitivity, digestive problems and more. 
  • Certain drugs and supplements may impact the effectiveness of doxycycline or increase the risk of adverse events. 

What Is Doxycycline? 

Doxycycline is an antibiotic drug introduced in 1967 — over half a century ago. It is a member of a class of drugs known as tetracyclines. 

Doxycycline is used to treat many different types of bacterial infections, including those of the skin, gastrointestinal, genital and urinary systems; pneumonia and other infections of the airways; food poisoning; infections spread by animals and insects; as well as acne and bumps caused by rosacea. It can also be used to treat anthrax exposure, the plague, tularemia and is even used to prevent malaria.

Doxycycline is the generic name for the drug that is also sold under the names Adoxa®, Doryx®, Monodox®, Oracea®, Periostat®, Vibramycin® and Acticlate®. 

There are two types of doxycycline — doxycycline hyclate and doxycycline monohydrate. The Centers for Disease Control and Prevention says these medications are equally effective, though doxycycline hyclate is generally less expensive.

Your doctor can prescribe doxycycline as a powder, capsule, tablet or syrup.

Acne 101: The Basics 

You know this part, right? Acne is pimples. It’s caused when hair follicles become stopped up with dead skin cells, oil and bacteria .

The result? Whiteheads, blackheads, painful cysts, papules, pustules and nodules. Who knew there were so many types of zits?

There are four primary things that combine to create acne: clogged hair follicles, excess oil or sebum, excess hormonal activity and bacteria. 

The bacteria P. acnes, which normally lives on the skin’s surface, can get trapped along with the sebum in your clogged pore. 

There, where it’s warm and damp, the bacteria grows, causes inflammation and likely discomfort, and you’re left with a big pimple — or several.

The Evidence: Acne and Doxycycline 

Doxycycline is a commonly prescribed antibiotic in the treatment of acne and is one of the two most commonly prescribed tetracycline drugs by dermatologists, overall, according to research in the Journal of Clinical and Aesthetic Dermatology

For instance, in 2011, nearly 76 percent of antibiotic prescriptions written in the U.S. were for tetracyclines, and of those, 43 percent were for doxycycline hyclate. 

Doxycycline’s popularity in the treatment of acne is largely due to it’s long track record of safety and effectiveness, but also because, according to research, it requires less frequent dosing and is more effective against all strains of P. acnes when compared to other medications.

Because doxycycline has been around for decades, there are numerous studies about its effectiveness. This is not a new or novel treatment for acne, and its popularity among dermatologists as a go-to treatment for acne is evidence of its reliability and safety. 

In general, the research has shown doxycycline reduces total number of lesions and acne severity. 

In one study originally published in 2010, a group of 100 patients with modest acne vulgaris were analyzed to test the efficacy of doxycycline and azithromycin, another antibiotic sometimes prescribed to treat acne. 

At the end of the 15-month study, researchers found that in patients 18 and older, doxycycline was significantly more effective, and patients across the board experienced only minor complications.

Another 2005 study out of Penn State University analyzed the efficacy of a mix of doxycycline and adapalene — a naphthoic acid derivative with retinoid properties — versus doxycycline alone, and found that both treatments offered significant improvement in acne over baseline at the end of the 12-week study.

The point is, the research is there and doxycycline is effective.

Doxycycline Risks and Side Effects

Doxycycline, like all prescription drugs, comes with potential risks and side effects, and it’s important to be aware of them.

The most common risks associated with doxycycline include: diarrhea, esophageal irritation and increased sensitivity to sunlight that can result in sunburns and skin irritation after minimal exposure.

Taking certain medications and supplements may reduce the effectiveness of doxycycline, so talk to your doctor about everything you take. 

Avoid antacids with magnesium, aluminum and calcium, calcium and iron supplements, or take doxycycline at least two hours before or six hours after these medications. 

Also be sure to tell your doctor if you’re taking drugs like penicillin, barbiturates, carbamazepine, phenytoin or anticoagulant therapy

Some side effects may be signs of a serious reaction, so contact your healthcare provider if you experience: nausea, vomiting, appetite loss, itching of the rectum, tongue swelling, anxiety, back pain, throat irritation, fever, chest pain, blurred vision, headache, hives, bleeding or bruising, joint pain or other side effects that are disruptive.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.