Doxycycline for Acne

Doxycycline
Photo: T-Pool / Getty Images

Doxycycline is an antibiotic that belongs to a group of antibiotics called tetracyclines. Doxycycline is the most commonly prescribed oral antibiotic for acne and rosacea.

Doxycycline is used to treat moderate to severe inflammatory acne, or mild inflammatory acne that isn’t getting better with other treatments. Doxycycline is also used to treat many types of bacterial infections, from UTIs to gum disease.

It's an oral medication, so you'll take it by mouth in pill or capsule form. This makes it a good choice if you have back or body breakouts where it's hard to reach to put topical medications.

How Doxycycline Works

Doxycycline works by controlling bacteria. Although acne isn’t an infection, and it’s not contagious, antibiotics can help clear up breakouts by reducing the amount of acne-causing bacteria on the skin – in this case, Propionibacterium acnes.

Doxycycline also reduces inflammation, so it helps reduce those red, swollen breakouts.

It won’t treat non-inflamed breakouts, like blackheads or milia, though. You'll need a different type of acne treatment to get those blemishes under control.

Other Names It's Known By

Doxycycline is sold under the brand names Doryx, Vibramycin, Oracea, Adoxa, and much more. It’s also sold as generic doxycycline.

How To Use It

You'll take doxycycline once or twice a day, 50 to 100 mg per dose, as determined by your physician.

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

Doxycycline does a good job at reducing inflammation and bacteria, but these aren't the only factors that trigger breakouts. Acne is also caused by excess oil forming a plug, called a comedo, in the pore.

This plug is the beginning of every acne blemish. Doxycycline doesn't stop these plugs from forming, but medications like topical retinoids and benzoyl peroxide do.

Plus, using doxycycline along with a non-antibiotic topical acne medication helps reduce the chance of developing antibiotic resistance.

Short-term use of doxycycline is the goal. Once your skin has improved noticeably, your doctor will take you off doxycycline. You’ll continue to use topical acne 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 specific situation.

It May Not Be Not the Right Treatment for You 

Doxycycline is only prescribed in certain cases, and it might not be the right treatment for you if:

You’re pregnant. Doxycycline can harm a developing fetus. There are better acne treatment medications for pregnant moms, so make sure you let your dermatologist know if you’re expecting.

You (or your child) is under 8 years old. Doxycycline shouldn't be used by young children because it can affect growth and cause permanent tooth discoloration.

You’re allergic to tetracyclines. Doxycycline is a tetracycline antibiotic, so you can't safely use it if you're allergic to tetracyclines.

If doxycycline isn't an option for you, no worries. There are other antibiotics that treat acne that will be more appropriate for you.

Possibly Side Effects of Doxycycline

Your 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/or diarrhea. Doxycycline can be hard on your tummy. Taking it with a meal can help.

Indigestion or pill esophagitis. Doxycycline can irritate your esophagus, causing heartburn-like pain and making it hurt when you swallow. 

To avoid this, take your pill with a big glass of water.

Also, don’t lay down for about an hour after taking.  Plan on taking your medication well before bedtime. 

Photosensitivity. Here’s a side effect that you probably didn’t consider. Doxycycline can make your skin more sensitive to the sun.

While you're taking doxycycline you'll be more prone to sunburn, so take care. Wear sunscreen every day and reapply frequently whenever you’re spending time outside.

It's a good idea to wear sunscreen daily anyway. It keeps your skin looking younger and helps protect you from skin cancer. 

A Word from Verywell

It can take two to three months of using doxycycline before you really start seeing results. During this time, it's normal to continue to see new breakouts. Don't let this discourage you. Try to be patient and continue using your medication.

Of course, if you have any questions or concerns about treating your acne with doxycycline, your dermatologist is always available to help you out. So don’t be shy; if you have questions, give your dermatologist a call.

Sources:

Del Rosso JQ. "Oral Doxycycline in the Management of Acne Vulgaris: Current Perspectives on Clinical Use and Recent Findings with a New Double-scored Small Tablet Formulation." Journal of Clinical and Aesthetic Dermatology. 2015 May; 8(5): 19–26.

Eichenfield LF, Krakowski AC, Piggott C, et al. "Evidence-based recommendations for the diagnosis and treatment of pediatric acne." Pediatrics. 2013;131(Suppl 3): S163–186.

Titus S, Hodge J. “Diagnosis and Treatment of Acne.” American Family Physician. 2012 Oct 15;86(8):734-740.

Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et. al. "Guidelines of Care for the Management of Acne Vulgaris." Journal of the American Academy of Dermatology. 2016 May;74(5):945-73.e33.