How Doxycycline Helps Treat Acne

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
December 9, 2021

Doxycycline is a common antibiotic that may be prescribed to treat acne.

If your dermatologist or doctor has prescribed it to help address your severe acne, this article will explain how doxycycline works, how you should take it, and what side effects you might experience.

You’ll also know what you should not do while you’re taking doxycycline.

Need antibiotics?

Our physicians can prescribe antibiotics for various conditions, but only if necessary. Chat with a provider to see which treatment option is best for you.

Get Started
Bottle image

How Doxycycline Treats Acne

Most people expect to leave acne behind them when they exit high school.

However, for some, acne can be a persistent problem that extends beyond even their 20s or 30s.

There are different types of acne and often, over-the-counter acne treatment is used to get to the cause of the problem.

For some, topical creams, soaps, and gels can resolve the issue, but for others, antibiotics like doxycycline may be needed.

The types of acne

  • Acne vulgaris: Characterized by whiteheads and blackheads, this type of acne is the most common and simplest form to treat. It tends to be caused by clogged pores, which is what makes it more common during puberty. But it can happen at any age. These kinds can also happen because of bacteria that are present on the skin or as a result of hormone changes. “Hormonal acne” is often caused by the normal fluctuations in the menstrual cycle.
  • C. acnes or P. acnes: This type of acne includes nodules, papules, or pustules and may also include inflammatory acne. This type tends to be a chronic problem or frequently recurs because it is caused by bacteria (the C. acnes or P. acnes that it is named for). This bacteria may typically live on the skin’s surface, but when it mixes with your skin oil, it can start replicating in the surrounding skin tissue. This can lead to recurrent breakouts and may need to be treated with an antibiotic gel or lotion, or oral antibiotics like doxycycline, to decrease the amount of bacteria on the skin.
  • Cystic acne: The most severe acne, cystic acne can be hard to treat because the infection goes deep into the surface of the skin. It also typically involves pus-filled cysts that can lead to infection in the surrounding skin tissues. A dermatologist may be needed to treat this form of acne.

When doxycycline is prescribed for acne, it works by preventing the replication of bacteria that can lead to breakouts.

It can also help to decrease the number of bacteria that are present on the skin, which can head off future acne infections.

How to Use Doxycycline for Acne

Doxycycline comes in several different brand names, doses, and formulations.

  • Common brand names: Acticlate, Avidoxy, Doryx, Morgidox, others
  • Doses: Between 50-500 mg
  • Formulations: Tablet, capsule, or suspension (liquid)

Your pharmacy will provide you with a prescription insert label that will give you specific instructions on how to take your doxycycline.

It is important to take doxycycline exactly as directed.

All brand names and generic doxycycline are equally effective.

Dosage

Your dosage of doxycycline will be determined by the cause of your treatment, how long you will be on the antibiotic, and other factors.

Most doses range between 50 to 150 mg and it is usually taken once to two times per day.

If you are prescribed tablets, you may be allowed to crush them or break them up if you struggle to swallow them.

Capsules should never be opened but should be swallowed whole.

If you have trouble swallowing pills, be sure that your doctor and pharmacist are aware.

They may recommend crushing a table or prescribe a liquid form.

For acne, the dosage of doxycycline is typically lower than for other purposes.

You may need to take doxycycline longer.

Courses of doxycycline for acne may range from a few weeks to a few months.

Missed dose

If you miss a dose of doxycycline, do not double up.

Either take your next dose as close to the missed one as possible or skip the dose and resume your normal antibiotic course with your next regularly scheduled dose.

Taking too much doxycycline can be dangerous. If you take too much, call Poison Control at 1-800-222-1222 or seek emergency medical care.

How Long Does Doxycycline Take to Treat Acne?

While antibiotics may start to improve respiratory infections or other similar infections within 1-2 days, acne is different.

It may take up to 2 weeks before you notice improvements and you may need to take doxycycline for up to 12 weeks to address the bacteria that are causing it.

How to Deal With the Purging Stage

Some acne treatments may worsen your skin before it gets better.

This is called the purging stage. If you experience this, you should let your doctor or prescriber know how your skin is doing.

Sometimes things won’t get better for 4-6 weeks after starting treatment.

However, if things get a lot worse, it could be because the treatment is not working or you are having a reaction to it.

Don’t stop taking doxycycline unless your doctor or provider tells you to, and make sure to let them know if things get worse or if you have concerns.

During the purging stage, you’ll want to take extra gentle care of your skin.

Try to avoid wearing heavy make-up, keep up with a gentle, mild skincare routine, and change your pillowcase frequently to decrease the presence of face oil contact.

Doxycycline, unlike other acne treatments, may not cause a purging stage at all.

Potential Side Effects of Doxycycline

Like many other antibiotics, doxycycline may have some common side effects.

These can include:

More serious side effects can occur, including intracranial hypertension (headaches, vision changes), hives or allergic reactions, bleeding/bruising, and more.

If you notice any of these, let your health care provider know right away.

Your pharmacist will go over potential side effects and risks with you.

Who Should Not Take Doxycycline?

You should not take doxycycline if you are allergic to tetracycline-class antibiotics.

Children under age 8, pregnant women, and breastfeeding women should not take doxycycline for acne.

It can cause permanent damage and changes to teeth in children or unborn babies.

Doxycycline can interact with numerous drugs.

If you take any of the following medicines or supplements, be sure to let your pharmacist or doctor know:

  • Anticoagulants (blood thinners)
  • Penicillin
  • Antacids
  • Iron
  • Magnesium
  • Oral contraceptives
  • Anti-epileptics

Other Doxycycline Uses

In dermatology, doxycycline is also used to treat other types of skin conditions or infections besides acne.

These include:

  • Rosacea
  • Hidradenitis suppurativa
  • Bullous pemphigoid
  • Perioral dermatitis
  • Neutrophilic dermatoses
  • Sarcoidosis
  • SAPHO syndrome
  • Bacillary angiomatosis
  • Kaposi sarcoma
  • Prurigo pigmentosa
  • Cold urticaria
  • Acquired perforating dermatosis

Doxycycline is not only used for skin conditions.

It is a broad-spectrum antibiotic that is also used to address multiple types of infections.

It is widely prescribed for chlamydia or pelvic inflammatory disease caused by chlamydia, eyelid infections, bacterial respiratory illness, gastrointestinal infections, and malaria.

It is also prescribed by some physicians for preventing or treating Lyme disease, as well as other bacteria that may be transmitted by insect or animal bites.

Need antibiotics?

Our physicians can prescribe antibiotics for various conditions, but only if necessary. Chat with a provider to see which treatment option is best for you.

Get Started
Bottle image

How K Health Can Help

Acne can be frustrating. It may be challenging to find the right medical care—and maybe you didn’t even know that doctors can help treat your acne.

Did you know you can access online urgent care with K Health?

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

K Health’s AI-powered app is HIPAA compliant and is based on 20 years of clinical data.

Frequently Asked Questions

Is doxycycline good for acne?
There are several types of antibiotics that can be prescribed for acne. Doxycycline is beneficial because, compared to other common antibiotic classes, doxycycline shows a decreased potential for antibiotic resistance.
Does doxycycline make acne worse at first?
Some acne treatments worsen your skin before it gets better. While this may happen for the first 4-6 weeks of treatment, doxycycline is not typically associated with a significant purging stage.
How quickly will doxycycline work?
Doxycycline takes some time to slow the spread of the bacteria that cause acne. It may take 2 weeks before you notice improvements, and you may need to take doxycycline for up to 3 months.
How effective is doxycycline for hormonal acne?
Hormonal acne is not always treated with antibiotics, but if it is, it is typically paired with birth control pills. The combination works like this: doxycycline prevents the replication and spread of the bacteria that cause acne, while birth control helps to decrease the presence of excess oil that may create a prime situation for acne breakouts. This combination can have some side effects, so you should work with your doctor to tell them how you are feeling, and whether or not you feel that the benefits outweigh the side effects.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

K Health logo (used on certain page templates)