How Doxycycline Can Help with Acne

Key Takeaways

Experimenting with acne treatments can be difficult and frustrating with all of the information and options available. But clear skin doesn't have to be complicated.

If you’re feeling stuck or maybe you’ve exhausted all over-the-counter solutions, a doctor may choose to prescribe you an oral antibiotic called doxycycline for acne. It’s a safe and common medication that’s reserved for those with mild to severe inflammatory acne, but it’s not a fit for everyone. 

Here, we take a deep dive into what the medication is, how it works to treat acne, and some things you should be aware of in case you and your doctor decide to start a prescription. 

What is doxycycline?

Doxycycline is part of the tetracycline family of antibiotics that’s most commonly used to treat moderate to severe acne. It’s a bacteria fighter that can help those struggling with inflammatory acne that cannot otherwise be treated with topical ointments. It’s also used to treat severe acne in other areas, such as on the chest or back. 

Doxycycline is one of the most commonly prescribed oral antibiotics used to treat acne because of its effectiveness and minimal list of side effects. While doxycycline is the generic name, it’s also found under brand names such as Doryx, Vibramycin, Oracea, and Adoxa.

How does doxycycline help with acne? 

Doxycycline works to treat acne by reducing the occurrence of Propionibacterium acnes — let’s go with P. acnes for short. This is the bacteria that causes the dreaded sore, red, inflamed pustules and cysts. When our oil glands begin to build up, the p. acnes multiply and become inflamed spots.

While doxycycline reduces the bacterial load on the skin, and it is also an anti-inflammatory which reduces inflammation that is completely separate from its ability to kill bacteria. 

How long does it take for doxycycline to work?

It all depends on your skin and the severity of your inflammation and breakouts — everyone’s different! For some, all you may need is to take the prescribed dosage once or twice daily for as little as two weeks. For others, it can take up to three months to work. If you reach the three month mark and you’re unsure about your results, check in with your doctor to see if it’s safe for you to continue using.

As a heads up, it’s normal to experience new breakouts during the course of the medication, so try not to let that be discouraging. Like all good things, be patient and trust the process in order to reap the benefits of doxycycline for acne treatment. 

Looking for a tell-tale sign it’s working? Your breakouts have cleared and are not making a comeback — that’s the goal! Unlike some other acne treatments, you will not get worse before you get better.

Potential side effects 

Doxycycline is considered to be one of the safer antibiotic treatments for inflammatory acne when it comes to serious side effects, so before you read on, take comfort in knowing that.

Doxycycline does have the potential to cause the following side effects:

  • Inflammation of the esophagus
  • Nausea
  • Vomiting
  • Indigestion
  • Heartburn
  • Sun sensitivity (load up on the SPF for your body and face!) 
  • In some more serious cases, development of ulcers. It’s been noted that the higher the dosage you’ve been prescribed, the higher the chances are of developing more serious side effects. 

Depending on the dosage you’re prescribed, your doctor may recommend that you take your meds once or twice daily. As your pharmacist and doctor will explain, it’s important to take the medication with a full glass of water and/or a meal as the medication can be hard on your gastrointestinal system. By doing so, you’ll significantly lessen the chances of experiencing side effects, or at the very least, they can be milder. 

It’s also advised to take your medication at least 30 minutes before bedtime if you’re taking it in the evening as this will reduce the potential for developing heartburn.

Some very serious but rare side effects known of doxycycline include the yellowing of teeth and Stevens-Johnson Syndrome (AKA SJS), and what’s called TEN — toxic epidermal necrolysis. The symptoms of these side effects usually pop up anywhere from week one to week three of use. If you notice a rash anywhere above your shoulders or within your upper body in tandem with a fever, headache, or cough, check in with a doctor immediately. 

To put their occurrence into perspective, SJS occurs in as little as one in a million people, while TEN is closer to one in two million. Those are pretty good odds if you ask us, but it’s always good to be prepared.

If you’re ever worried about side effects or medication interactions during the course of taking your prescribed medication, don’t hesitate to reach out to your doctor or pharmacist.

Medication interactions 

As mentioned earlier, doxycycline is not prescribed lightly. It’s reserved for people who experience moderate to severe breakouts or suffer from inflammatory acne. It should not be taken if you are pregnant, are a child, or are allergic to tetracyclines. If you fall into any one of these categories, don’t sweat it — you can absolutely speak to a doctor about the types of acne medication available for you. 

Although it may sound strange, dairy products and vitamin supplements that are high in calcium or iron can actually make doxycycline less effective as they can prevent absorption. In some cases, they can actually cause further stomach upset if they interact. 

You will want to time those dairy products and supplements about an hour before taking your meds or about two hours after taking them. It’s important to read through ingredient lists as some unexpected supplements or foods may actually contain iron and calcium in them, especially multivitamins!

Note that these are some of the more common interactions and the list is not exclusive to these three ingredients. It’s important that your doctor and pharmacist are aware of any and all medications you may currently be taking, as well as any medications you’ve had a reaction to in the past to ensure that doxycycline is safe for you.

Topical treatment

Your healthcare practitioner will likely prescribe a topical acne treatment to go along with your doxycycline prescription to help fast track you on your way to clear, healthy skin and say goodbye to inflammatory acne for good. 

The use of benzoyl peroxide or retinoids are common aids and serve as effective acne treatment. Doxycycline on its own can’t prevent our pores from getting clogged, which is one of the root causes of pimples, but topical retinoids do help with keeping our pores clear. 

What are retinoids? 

They’re a powerful ingredient found in some of the most effective skincare products. They’ve got great anti-aging properties, have the ability to lessen the appearance of fine lines and wrinkles, and they can help with improving texture as well. Retinoids expedite the cell turnover process, keeping our pores squeaky clean. 

And benzoyl peroxide?

Benzoyl peroxide is a common acne-fighting ingredient that treats and prevents breakouts by killing the bacteria which lay under the skin. Benzoyl peroxide is also used to rid pores of dead skin cells and remove excess oil to prevent build up.

Like most antibiotic treatments, the goal is to be as quick and effective as possible — we don’t want to (and shouldn’t be) taking them forever. A typical use period for oral antibiotics is around three months. As soon as you’ve achieved your skin goals, it’s time to go off of the medication (under your doctor’s recommendation, of course). 

It is recommended, however, that you continue using retinoid or benzoyl peroxide beyond your doxycycline treatment as this will help to maintain your newfound clear and beautiful skin. 

Looking for some advice on which acne treatment might be right for you? Get started by completing an online visit with a healthcare practitioner to explore your options.

Medically reviewed by


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