From the Guidelines
Doxycycline is typically prescribed at a dose of 50-100 mg once or twice daily for acne treatment, with the most common regimen being 100 mg once daily or 50 mg twice daily, taken with food to reduce stomach upset 1. The treatment usually continues for 8-12 weeks, though some patients may require longer courses of 3-6 months. Some key points to consider when prescribing doxycycline for acne include:
- Lower doses, such as 40 mg daily of doxycycline modified-release, can be effective with fewer side effects 1.
- Doxycycline should be taken with a full glass of water, and patients should remain upright for 30 minutes after taking it to prevent esophageal irritation.
- It works by reducing inflammation and killing Propionibacterium acnes bacteria that contribute to acne formation.
- Common side effects include photosensitivity (increased sun sensitivity), so sunscreen use is essential.
- Doxycycline is often combined with topical treatments like benzoyl peroxide or retinoids for better results 1.
- It should be avoided in pregnant women and children under 8 years due to potential effects on bone development and tooth discoloration. The most recent guidelines recommend doxycycline as a strong option for acne treatment, with a focus on limiting systemic antibiotic use and combining with topical therapies 1.
From the FDA Drug Label
Adults: The usual dose of oral doxycycline is 200 mg on the first day of treatment (administered 100 mg every 12 hours) followed by a maintenance dose of 100 mg/day The dose of doxycycline for acne is not explicitly stated in the provided drug label. However, based on the general dosage information, the usual maintenance dose of doxycycline is 100 mg/day.
- The usual dose for adults is 200 mg on the first day, followed by 100 mg/day.
- No specific dosage for acne is provided in the label 2
From the Research
Doxycycline Acne Dose
- The recommended dose of doxycycline for acne treatment varies, but studies suggest that subantimicrobial doses (20-mg tablets taken twice daily) can be effective in reducing inflammatory lesions 3, 4, 5.
- A study published in the Journal of Drugs in Dermatology found that subantimicrobial-dose doxycycline administered twice daily for 3 months resulted in an 84% reduction in the number of papules and a 90% reduction in the number of pustules 3.
- Another study published in The Journal of Family Practice proposed that moderate acne may be treated with doxycycline in subantimicrobial doses (20-mg tablets taken twice daily), which was well-tolerated and moderately effective in reducing skin lesions 4.
- Higher doses of doxycycline (100 mg or above) may increase the risk of phototoxic eruptions, with an incidence of 3% at a dose of 100 mg daily 6.
- A comparative study published in Der Hautarzt found that a daily dose of 50 mg doxycycline was as effective as 100 mg of minocycline daily in treating acne vulgaris 7.