Doxycycline for Acne: Everything to Know

Doxycycline is an antibiotic that belongs to a group of antibiotics called tetracyclines. It is used for treating acne and rosacea. It is also used to treat cellulitis and skin infections.

Doxycycline is the most commonly prescribed antibiotic in pill or capsule form, and is sold under brand names including Doryx, Vibramycin, Oracea, and Adoxa. It’s also sold as generic doxycycline.

This article looks at what doxycycline can (and cannot) do, how it should be used, and what side effects you might expect while taking it.

Doxycycline Uses

Doxycycline is used to treat moderate to severe inflammatory acne, or mild inflammatory acne that isn’t getting better with other treatments. This type of acne happens when bacteria grow in blocked skin pores and cause a red, inflamed bump.

As an oral medication, doxycycline is a good choice if you have back or body breakouts. Some places are hard to reach to apply topical products, which go directly on the skin.

Acne isn’t an infection and it’s not contagious. The doxycycline works by reducing the amount of acne-causing bacteria on the skin. In this case, the bacteria is called Cutibacterium acnes.

Doxycycline also calms inflammation, so it helps to improve the red or pus-filled bumps known as pustules and cysts. It is less effective in treating non-inflamed acne sores like blackheads or milia, though. You'll need a different type of acne treatment to get those blemishes under control.

Doxycycline Dosage and How to Use

You'll need a healthcare provider's prescription to take doxycycline. Doses vary from as low as 40 milligrams (mg) once a day to 100 mg twice daily.

Most likely, you’ll use doxycycline along with a topical acne medication or two, like benzoyl peroxide or topical retinoids. You'll see better and faster results this way.

That's because doxycycline does a good job on inflammation and bacteria, but these aren't the only reasons for an acne breakout. Acne is also caused by excess oil forming a plug, called a comedo, in the skin pore. This plug is the beginning of every acne blemish.

Doxycycline doesn't stop these plugs from forming, but the other drugs do. Plus, using doxycycline along with a non-antibiotic topical drug helps reduce the chance of developing antibiotic resistance.

Duration of Use

Short-term use of doxycycline is the goal, which can be about three to four months. Your healthcare provider will take you off doxycycline once your skin has improved. You’ll then stay on topical treatments long-term to keep breakouts away.

Some people, though, may need to use doxycycline for longer periods of time to keep acne under control. It all depends on your situation.

Who Should Not Take Doxycycline

Doxycycline is only prescribed for some people. It's not the answer in these cases:

• Pregnancy: Doxycycline can harm a developing fetus. There are better acne treatments for pregnant moms, so make sure you let your healthcare provider know if you’re expecting.
• Age: Doxycycline shouldn't be used by children younger than 8 years old. That's because it can affect growth and cause permanent tooth discoloration.
• Allergy: Doxycycline is a tetracycline antibiotic, so you can't safely use it if you're allergic to tetracyclines.

Don't worry if doxycycline isn't an option for you. There are other antibiotics to treat acne that your healthcare provider can prescribe.

Doxycycline Side Effects

Your healthcare provider or dermatologist will give you a rundown of all possible side effects when prescribing your medication, but here are some of the most common.

Upset Stomach and Diarrhea

Doxycycline can cause nausea and stomach upset. Taking the pill with food can help, but avoid dairy. It makes doxycycline less effective, so try to wait at least an hour before having any dairy products.

Dairy may also help cause acne because of hormones in milk products. One theory is that dairy foods increase inflammation in the body, leading to worse breakouts.

Indigestion and Esophagus Pain

Doxycycline can irritate your esophagus, the tube that connects your throat to your stomach. It may hurt to swallow, or you may have heartburn-like pain. It's best to take your pill with a big glass of water.

Also, don’t lie down for about an hour after taking it. Plan on taking your medicine well before bedtime. 

Sensitivity to Sunlight

Doxycycline can make the skin all over your body more sensitive to the sun. While you're taking doxycycline, this photosensitivity means you're more prone to sunburn.

Always wear sunscreen and reapply it often whenever you’re spending time outside. It's a good idea to wear sunscreen daily anyway, to help keep your skin healthy and protect you from skin cancer.

Doxycycline Interactions

Doxycycline can interact with certain drugs and supplements and affect how they work. This includes antacids and supplements that contain magnesium, iron, calcium, or sodium bicarbonate. Birth control pills may also not work as well when taking doxycycline.

Let your healthcare provider know about any prescription or over-the-counter medications or supplements you're taking. This can help reduce the chance of a drug interaction while taking doxycycline.

Alternative Antibiotics

If there's a chance you might have a drug interaction or contraindication, your dermatologist might prescribe an alternative antibiotic to doxycycline. According to the American Academy of Dermatology, possible antibiotics for acne include:

• Tetracycline
• Amzeeq (minocycline)
• Erythromycin
• Azithromycin

Your dermatologist will work with you to determine which one would work best for you.

Summary

Doxycycline is a good choice of antibiotic for treating acne and some other skin infections, but you'll likely use it in combination with other drugs. It's not for everyone, though, and may cause side effects even in people who can take it.

If you have any questions about treating your acne with doxycycline, talk to your healthcare provider or dermatologist.