Doctor’s Note: Your Essential Guide to Doxycycline

As dermatologists, we often prescribe doxycycline for its effective results in treating skin conditions like acne, rosacea, and certain infections. Doxycycline works not only as an antibiotic but also has anti-inflammatory effects that help calm redness and irritation. In this guide, we’ll explore how doxycycline works, its benefits, potential side effects, and what to expect while taking it.

Watch the video to the right, or read on for more!

What is Doxycycline?

Doxycycline is an antibiotic that belongs to the tetracycline family, a group of antibiotics that fight bacteria and reduce inflammation. In dermatology, doxycycline is often prescribed for conditions like acne, rosacea, and certain infections. By targeting specific bacteria and calming inflammation, doxycycline helps improve skin conditions that cause redness, pimples, and infection.

Doxycycline

How Does Doxycycline Work?

Doxycycline works in two main ways:

  1. Antibacterial Action: Doxycycline stops bacteria from growing, making it effective against bacterial skin infections and acne. By reducing bacteria, doxycycline helps clear up active breakouts and prevents new ones from forming.

  2. Anti-Inflammatory Properties: In addition to fighting bacteria, doxycycline also reduces inflammation. This is especially useful for conditions like rosacea, where redness and inflammation are common. The anti-inflammatory effects help soothe the skin, reduce redness, and make it feel more comfortable.

Uses of Doxycycline in Dermatology

Acne

Acne

Doxycycline is commonly prescribed for moderate to severe acne. It’s often used in combination with topical treatments to reduce bacteria, decrease inflammation, and prevent scarring. In acne, we use doxycycline for both its antibacterial and anti-inflammatory effect.

Sensitivity

Rosacea

Rosacea causes redness, visible blood vessels, and sometimes acne-like breakouts on the face. Doxycycline is often used to manage rosacea because of its anti-inflammatory properties, which help reduce redness and prevent flare-ups. In rosacea, we use doxycycline for its anti-inflammatory effect (since there’s no infection in rosacea!!).

Infection

Infections

Doxycycline can be prescribed for certain bacterial infections that affect the skin, such as Staphylococcus aureus infections. By stopping bacterial growth, doxycycline helps clear up infections and prevent them from spreading. In infections, we use doxycycline for its antibacterial effect.

Doxycycline Dosing: Regular and Low-Dose (Submicrobial)

Doxycycline can be prescribed at different doses depending on the skin condition being treated. For acne and infections, regular doses are 100 mg once or twice daily. This higher dose is strong enough to kill bacteria and reduce inflammation, making it good for short-term use to treat infections or significant breakouts.

For long-term use, dermatologists may recommend low-dose (“submicrobial”) dosing, which is about 40 mg per day. At this lower dose, doxycycline doesn’t kill bacteria but still reduces inflammation. This makes it a helpful choice for conditions like rosacea and inflammatory acne, where calming redness, swelling, and irritation is the main goal. Submicrobial dosing is safer for longer use because it’s less likely to lead to antibiotic resistance or disrupt healthy bacteria in the body.

Often, a dermatologist might start with a regular dose to quickly improve symptoms, then switch to a low dose for long-term care. This way, doxycycline can control inflammation over time without the side effects of high-dose antibiotics.

How to Take Doxycycline

  • Follow Your Doctor’s Instructions. Take doxycycline exactly as your doctor or dermatologist prescribed. Don’t change the dose or how often you take it without asking your doctor.

  • Take with Food. Doxycycline can sometimes irritate your throat, so it’s best to take it with food. Avoid lying down for at least 30 minutes after taking it.

  • Timing. Doxycycline is usually taken once or twice a day. Try to take it at the same time each day for the best results.

  • Avoid Dairy Products. Dairy can make doxycycline less effective. Try not to take it with milk, yogurt, or other dairy foods.

  • Complete the Full Course. Even if your skin improves, it’s important to finish the full course of doxycycline. This helps fully eliminate the bacteria and prevents antibiotic resistance.

Doctor's Note

Potential Side Effects of Doxycycline

While doxycycline is generally safe, like all medications, it can have side effects. Common side effects include:

  • Stomach Upset: You might experience nausea, vomiting, or an upset stomach, especially if you take doxycycline on an empty stomach.

  • Sun Sensitivity: Doxycycline can make your skin more sensitive to sunlight, increasing the chance of sunburn. Be sure to use sunscreen daily and avoid staying in the sun for long periods.

  • Esophageal Irritation: Doxycycline can irritate your esophagus. Taking it with food and staying upright for at least 30 minutes after can help prevent this.

  • Yeast Infections: Antibiotics like doxycycline can disrupt the balance of bacteria in your body, which may lead to yeast infections. If you notice symptoms, talk to your doctor.

  • Tooth Discoloration in Children: Doxycycline is not recommended for children under 8, as it can cause permanent tooth discoloration.

If you have severe side effects like difficulty breathing, a severe headache, or vision changes, stop taking doxycycline and get medical help right away.

Sun

Precautions When Taking Doxycycline

To get the best results and avoid complications, keep these precautions in mind:

  • Avoid Prolonged Sun Exposure: Doxycycline can make you more sensitive to the sun. Be sure to use sunscreen daily and wear protective clothing if you’ll be outside for long periods.

  • Take with Food, but Not Dairy: Dairy products can reduce how well doxycycline is absorbed. It’s best to take it with other food and avoid dairy close to your medication time.

  • Check for Interactions: Doxycycline may interact with other medications, like antacids, iron supplements, and certain blood thinners. Let your doctor know about any other medications or supplements you’re taking.

  • Limit Alcohol Consumption: Drinking alcohol can affect how doxycycline works, possibly making it less effective.

  • Pregnancy and Breastfeeding: Doxycycline is generally not recommended during pregnancy or breastfeeding. If you’re pregnant, planning to become pregnant, or breastfeeding, talk to your doctor about other treatment options.

Best Sunscreens for Your Skin Type

Brand Name Doxycycline: Oracea

Oracea is a brand-name form of doxycycline, specially formulated as a 40mg delayed-release capsule often used to treat rosacea (Oracea = Rosacea).

Unlike regular antibiotics, Oracea mainly works as an anti-inflammatory, which means it targets the redness, swelling, and bumps caused by rosacea without acting strongly against bacteria. This makes it a good choice for long-term use, as it helps manage rosacea flare-ups with less risk of disrupting healthy bacteria or causing antibiotic resistance.

Oracea is taken once a day and can be effective in calming rosacea symptoms with fewer side effects than stronger doses of doxycycline. Always follow your dermatologist’s instructions for the best results with Oracea.

Oracea

Doxycycline FAQs

How long does it take to see results with doxycycline for acne?

Results can vary, but most people start to see improvement within 2 to 4 weeks. Full effects may take up to 3 months. Be patient and continue using any topical treatments your dermatologist has prescribed.

Can I wear sunscreen while taking doxycycline?

Yes, and it’s highly recommended. Doxycycline increases sun sensitivity, so wearing sunscreen with at least SPF 30 and reapplying every two hours is important.

Can doxycycline cause acne to worsen before it improves?

Some people may experience a slight worsening of acne when they first start doxycycline, but this usually improves as the body adjusts. If acne worsens significantly, talk to your dermatologist.

Can I use other acne treatments with doxycycline, like Accutane?

Combining doxycycline with Accutane (isotretinoin) is generally not recommended, as both are strong medications for acne. Taking both may increase the risk of side effects. Your dermatologist will guide you on which treatment is best suited for you and whether to use these medications at different times.

What should I know about doxycycline and laser hair removal?

Because doxycycline increases skin sensitivity, it’s recommended to avoid laser hair removal treatments while on the medication. Laser treatments can irritate sensitive skin, so it’s best to discuss timing with your dermatologist to avoid complications.

Is it safe to drink coffee with doxycycline?

Drinking coffee in moderation is generally safe with doxycycline, but be mindful that coffee is acidic, which can sometimes upset the stomach. For best absorption, it may be helpful to space coffee and doxycycline by at least an hour.

Can doxycycline be used for hair loss?

Doxycycline isn’t typically prescribed for hair loss, as it doesn’t directly stimulate hair growth or address common hair loss causes. However, if hair loss is related to a scalp infection, doxycycline may help by treating the infection.

What should I know about doxycycline and IVF?

If you’re undergoing IVF treatment, talk to your doctor about doxycycline. Antibiotics like doxycycline are sometimes used before IVF to treat infections, but your doctor will guide you based on your specific needs.

Can you smoke weed on doxycycline?

There is limited information on the effects of using weed while on doxycycline, but smoking in general may affect healing and immune response. It’s best to consult your healthcare provider for personalized advice.

Is it safe to take doxycycline for dry eyes?

Doxycycline is sometimes used in low doses for dry eyes, especially in conditions related to inflammation, like rosacea. It helps reduce inflammation in the oil glands of the eyelids, which can improve eye dryness and comfort.

Can doxycycline treat H. pylori infections?

Yes, doxycycline can be used as part of combination therapy to treat Helicobacter pylori (H. pylori) infections, which are a common cause of stomach ulcers. However, it’s usually combined with other antibiotics and medications to ensure effective treatment.

Can I take doxycycline with lactic acid bacillus capsules?

Yes, lactic acid bacillus capsules (probiotics) can be taken with doxycycline to help maintain gut health. Antibiotics like doxycycline may disrupt the balance of bacteria in the gut, so probiotics can support digestive health during treatment.

Can I take prednisone and doxycycline together?

Yes, prednisone and doxycycline are sometimes prescribed together, especially for inflammatory conditions or infections. However, both can have side effects, so it’s important to follow your doctor’s instructions closely.

What is doxycycline esophagitis?

Doxycycline esophagitis is irritation or inflammation of the esophagus that can occur if doxycycline tablets aren’t swallowed with enough water. To avoid this, always take doxycycline with a full glass of water and avoid lying down for 30 minutes afterward.

Is hydroxyzine and doxycycline succinate the same thing?

No, hydroxyzine and doxycycline succinate are not the same. Hydroxyzine is an antihistamine used to treat allergies and anxiety, while doxycycline succinate is an antibiotic used for infections and certain skin conditions.

Can you take doxycycline during pregnancy?

Doxycycline is generally not recommended during pregnancy, especially after the first trimester, as it can affect fetal development. If you are pregnant or planning to become pregnant, discuss alternatives with your healthcare provider.