From the Research
Doxycycline is a recommended treatment for Confluent and Reticulated Papillomatosis (CARP), as evidenced by a recent case report 1 that suggests its effectiveness in clearing lesions with a more favorable side effect profile compared to minocycline. The treatment of CARP with doxycycline typically involves a dose of 100 mg twice daily for 6-12 weeks, as this extended course is necessary to address both bacterial factors and keratinization abnormalities that require time to normalize 1. Key considerations for patients taking doxycycline include:
- Taking the medication with a full glass of water and avoiding lying down for 30 minutes after taking it to prevent esophageal irritation
- Taking the medication with food to minimize gastrointestinal side effects, but avoiding dairy products, antacids, and iron supplements within 2 hours of dosing as they can reduce absorption
- Using sun protection while on doxycycline due to increased photosensitivity risk Improvement is typically gradual, with initial results often visible after 2-4 weeks, though complete resolution may require the full treatment course 1. If doxycycline is ineffective or poorly tolerated, alternative treatments include minocycline, azithromycin, or topical retinoids, as suggested by various studies 2, 3, 4, 5. However, the most recent and highest quality study 1 supports the use of doxycycline as a first-line treatment, making it the preferred choice for CARP.