Doxycycline Dosing for Scalp Folliculitis
For adult scalp folliculitis, doxycycline 100 mg twice daily for 7-14 days is the recommended treatment regimen, based on standard dosing for bacterial skin and soft tissue infections. 1, 2
Standard Adult Dosing
- The FDA-approved dosing for doxycycline in bacterial infections is 200 mg on the first day (100 mg every 12 hours), followed by 100 mg daily maintenance dosing 2
- However, for more severe infections including chronic skin infections, 100 mg every 12 hours (twice daily) is specifically recommended 2
- The Infectious Diseases Society of America recommends doxycycline 100 mg twice daily for 7-14 days for MRSA skin infections, with duration based on clinical response 1
Treatment Duration Considerations
- Treatment should continue for 7-14 days depending on severity and clinical response 1
- In a documented case of scalp folliculitis (folliculitis decalvans), successful remission was achieved with doxycycline 100 mg twice daily for one month combined with topical therapy 3
- The therapeutic antibacterial serum activity typically persists for 24 hours following recommended dosing 2
Administration Guidelines
- Administer with adequate fluid to reduce risk of esophageal irritation and ulceration 2
- If gastric irritation occurs, give with food or milk—absorption is not significantly affected by simultaneous food or milk ingestion 2
- Patients should avoid lying down for 1 hour after taking doxycycline to prevent esophagitis 1
Important Clinical Considerations
- The maximum daily dose should not exceed 200 mg (100 mg twice daily) for bacterial skin infections, as exceeding this dose increases side effects without demonstrated additional efficacy 1
- Doxycycline is contraindicated in pregnancy and children under 8 years of age due to dental staining and bone growth effects 1
- For gram-negative folliculitis (which can occur after prolonged tetracycline use), isotretinoin may be more appropriate than continuing doxycycline 4