What Is It?
Doxycycline is an oral antibiotic that works by fighting bacteria in the body, including in the skin, and also reduces inflammation. It should be used only short term (max. 3 months).
Strength of Evidence
Average 56% reduction in acne after 12 weeks
- Moore, A., Ling, M., Bucko, A., Manna, V. & Rueda, M.-J. Efficacy and safety of subantimicrobial dose, modified-release doxycycline 40 mg versus doxycycline 100 mg versus placebo for the treatment of inflammatory lesions in moderate and severe acne: a randomized, double-blinded, controlled study. J Drugs Dermatol 14, 581–586 (2015).
- Leyden, J. J. et al. A randomized, phase 2, dose-ranging study in the treatment of moderate to severe inflammatory facial acne vulgaris with doxycycline calcium. J Drugs Dermatol 12, 658–663 (2013).
- Maleszka, R., Turek-Urasinska, K., Oremus, M., Vukovic, J. & Barsic, B. Pulsed azithromycin treatment is as effective and safe as 2-week-longer daily doxycycline treatment of acne vulgaris: a randomized, double-blind, noninferiority study. Skinmed 9, 86–94 (2011).
- Toossi, P., Farshchian, M., Malekzad, F., Mohtasham, N. & Kimyai-Asadi, A. Subantimicrobial-dose doxycycline in the treatment of moderate facial acne. J Drugs Dermatol 7, 1149–1152 (2008).
- Thiboutot, D. M. et al. Combination therapy with adapalene gel 0.1% and doxycycline for severe acne vulgaris: a multicenter, investigator-blind, randomized, controlled study. Skinmed 4, 138–146 (2005).
- Kus, S., Yucelten, D. & Aytug, A. Comparison of efficacy of azithromycin vs. doxycycline in the treatment of acne vulgaris. Clin Exp Dermatol 30, 215–220 (2005).
- Skidmore, R. et al. Effects of subantimicrobial-dose doxycycline in the treatment of moderate acne. Arch Dermatol 139, 459–464 (2003).
- Gruber, F. et al. Azithromycin compared with minocycline in the treatment of acne comedonica and papulo-pustulosa. J Chemother 10, 469–473 (1998).
- Ólafsson, J. H., Gudgeirsson, J., Eggertsdóttir, G. E. & Kristjánsson, F. Doxycycline versus minocycline in the treatment of acne vulgaris: A double-blind study. Journal of Dermatological Treatment 1, 15–17 (1989).
- Plewig, G., Petrozzi, J. W. & Berendes, U. Double-blind study of doxycycline in acne vulgaris. Arch Dermatol 101, 435–438 (1970).
Medium-high side effects and adverse reactions
Acne.org's Real World Take
Antibiotics should be used for a maximum of 3 months, provide only moderate benefit and only to some people, and may lead to side effects and strains of resistant bacteria. Studies do show doxycycline can reduce severe acne in the short term, and as far as oral antibiotics are concerned, it’s usually the go-to, but approach with caution and stay your own advocate.