From the Guidelines
Yes, doxycycline does cause photosensitivity, as evidenced by the most recent and highest quality study 1, which highlights the risk of photosensitivity as a common side effect of doxycycline. This common side effect makes your skin more sensitive to sunlight, increasing the risk of severe sunburns even with brief sun exposure. While taking doxycycline, you should protect your skin by:
- Applying broad-spectrum sunscreen (SPF 30 or higher)
- Wearing protective clothing like long sleeves and wide-brimmed hats
- Avoiding direct sunlight, especially during peak hours (10 AM to 4 PM) The photosensitivity occurs because doxycycline accumulates in the skin and absorbs UV radiation, which triggers the release of free radicals that damage skin cells. This reaction can happen quickly and may persist for several days after stopping the medication. If you experience a severe sunburn while taking doxycycline, seek medical attention and discuss with your healthcare provider whether you should continue the medication or switch to an alternative antibiotic, as also suggested by 1 and 1. It is essential to note that doxycycline is more photosensitizing than minocycline, and the risk of photosensitivity can be minimized by taking the drug in the evening and using sunscreens that absorb long-wave ultraviolet (UVA) radiation, as mentioned in 1.
From the FDA Drug Label
Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. Patients apt to be exposed to direct sunlight or ultraviolet light should be advised that this reaction can occur with tetracycline drugs, and treatment should be discontinued at the first evidence of skin erythema. to avoid excessive sunlight or artificial ultraviolet light while receiving doxycycline and to discontinue therapy if phototoxicity (e.g., skin eruption, etc.) occurs.
Doxycycline can cause photosensitivity, as evidenced by an exaggerated sunburn reaction in some individuals taking the drug. Patients should be advised to avoid excessive sunlight or artificial ultraviolet light and discontinue therapy if phototoxicity occurs 2, 2.
- Key points:
- Photosensitivity is a potential side effect of doxycycline
- Patients should avoid excessive sunlight or artificial ultraviolet light
- Therapy should be discontinued if phototoxicity occurs
From the Research
Photosensitivity and Doxycycline
- Doxycycline has been reported to cause photosensitivity in some patients, with symptoms ranging from itching and burning sensations to transient mild erythema of sun-exposed skin 3, 4.
- The frequency of photosensitivity reactions varies, with one study reporting an incidence of 1.9% in patients treated with doxycycline for erythema migrans 3.
- Clinical manifestations of doxycycline-induced photosensitivity can include light sunburn-like sensation, burning, erythema, and onycholysis 4.
- The triggering UV spectrum for doxycycline-induced photosensitivity seems to consist mainly of UVA1 (340-400 nm), highlighting the importance of using UV-protective products that cover this range 4.
- Factors that may influence the risk of photosensitivity reactions include the duration of treatment, with longer treatment durations potentially increasing the risk 3, and gender, with women being more often affected than men 3.
- Prevention measures, such as avoiding sun exposure and using UV-protective products, are crucial for patients taking doxycycline, especially those traveling to tropical countries for malaria prophylaxis 4.