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.
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.
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.
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:
- Acid reflux
- Loss of appetite
- Rectal or vaginal itching
- Sore throat
- Swollen tongue
- Dry mouth
- Back pain
- Changes to the color of skin, scars, nails, eyes, or mouth
- Sun sensitivity (sunburn more easily from sun exposure or tanning beds)
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)
- Oral contraceptives
Other Doxycycline Uses
In dermatology, doxycycline is also used to treat other types of skin conditions or infections besides acne.
- Hidradenitis suppurativa
- Bullous pemphigoid
- Perioral dermatitis
- Neutrophilic dermatoses
- 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.
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.
You can get affordable primary care with the K Health app.
All you have to do is download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.
Frequently Asked Questions
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.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Oral Doxycycline in the Management of Acne Vulgaris: Current Perspectives on Clinical Use and Recent Findings with a New Double-scored Small Tablet Formulation. (2015).
Propionibacterium acnes: Disease-Causing Agent or Common Contaminant? Detection in Diverse Patient Samples by Next-Generation Sequencing. (2016).
Acneiform eruptions. (2021).
Effective and safe combination therapy for severe acne vulgaris: a randomized, vehicle-controlled, double-blind study of adapalene 0.1%-benzoyl peroxide 2.5% fixed-dose combination gel with doxycycline hyclate 100 mg. (2010).
Doxycycline, an antibiotic or an anti-inflammatory agent? The Most Common uses in dermatology. (2020).
The Antibiotic Susceptibility Profile of Cutibacterium Acnes in Maltese Patients with Acne. (2020).