From the Guidelines
The recommended duration of doxycycline treatment for hidradenitis suppurativa (HS) is typically 8 to 12 weeks, as seen in combination therapies, although doxycycline's independent treatment duration is not clearly defined in the provided evidence. When considering treatment for HS, it's crucial to weigh the benefits and risks of various antibiotics, including doxycycline. According to the North American clinical management guidelines for hidradenitis suppurativa 1, systemic antibiotics like doxycycline play a role in managing HS, especially in mild disease or as adjunctive therapy in advanced disease. Key points to consider when treating HS with doxycycline include:
- The standard dosage is 100 mg twice daily, which may be adjusted based on response and tolerability.
- Doxycycline's mechanism in HS involves reducing inflammation, rather than solely acting as an antibiotic.
- Patients should be advised on proper administration to minimize side effects, such as taking the medication with food and using sun protection due to increased photosensitivity.
- Regular follow-up is essential to assess treatment response and manage potential side effects, with consideration of alternative treatments if there's no improvement after 12 weeks. Given the lack of direct evidence on doxycycline's independent treatment duration for HS, a treatment course of 8 to 12 weeks is a reasonable approach, based on the duration of other antibiotic combination therapies 1.
From the Research
Duration of Doxycycline Treatment for Hidradenitis Suppurativa (HS)
- The recommended duration of doxycycline treatment for HS varies across studies, with treatment periods ranging from 12 weeks to several months 2, 3, 4.
- A prospective study found that oral doxycycline 100 mg twice daily for a mean duration of 4.3 months was effective in improving HS symptoms, with a significant reduction in Hidradenitis Suppurativa Score (HSS) 2.
- Another study compared the efficacy of subantimicrobial, modified-release doxycycline (MR-DC) to regular-release doxycycline (RR-DC) for 12 weeks, finding that both treatments were effective in reducing HS symptoms 3.
- A retrospective observational study found that doxycycline 100 mg twice daily for 1-2 weeks and then once daily for up to 12 weeks was a common treatment choice for mild-to-moderate HS 4.