Reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Acne can vary in severity, from occasional breakouts of blackheads and whiteheads to severe inflammatory acne or cystic acne that never seems to go away, no matter how much you wash your face or apply topical acne treatments.
If you have severe or stubborn acne that doesn’t improve on its own, your healthcare provider may recommend using doxycycline to treat it.
Doxycycline is a prescription antibiotic that works by killing acne-causing bacteria. It’s a highly effective medication for moderate acne and serious breakouts, particularly when it’s combined with other acne treatments.
Below, we’ve talked about what doxycycline is, how it works and listed the typical doxycycline dosage for acne.
We’ve also discussed how long you should use doxycycline to treat acne breakouts, potential side effects and interactions with other medications that you should be aware of before adding doxycycline to your acne prevention toolkit.
Doxycycline is an oral, prescription antibiotic. It belongs to a class of antibiotics referred to as tetracyclines. Doxycycline is available in several dosage forms, including as a capsule, tablet and as an oral solution.
Acne develops when your hair follicles, or pores, become clogged due to the buildup of sebum and dead skin cells.
Sebum is a type of oil that’s produced by your sebaceous glands. The production of sebum is controlled by numerous factors, including your levels of androgen hormones. When hormone levels fluctuate, your sebum production may increase, resulting in hormonal acne breakouts.
Dead skin cells are produced as part of your skin’s natural turnover process. On average, your epidermis — the outermost layer of your skin — “turns over,” or replaces itself, once every 40 to 56 days.
Bacteria don’t cause acne. However, when certain types of bacteria multiply inside clogged pores, they can cause your acne lesions to become inflamed, swollen and painful, resulting in severe acne breakouts.
As an oral antibiotic, doxycycline works by killing the bacteria that can cause inflamed, painful facial acne breakouts, such as Propionibacterium acnes (P. acnes). It also lowers your sebum production, reducing your risk of developing clogged pores.
This helps to make your existing acne lesions less inflamed and reduce your risk of developing acne breakouts in the future.
Doxycycline and other forms of antibiotic therapy for acne breakouts typically aren’t prescribed on their own. Instead, doxycycline is almost always used with other acne medications, such as topical retinoids and/or benzoyl peroxide.
Our full guide to doxycycline goes into more detail about what doxycycline is, how it works and its benefits as a treatment for acne.
A normal dosage of doxycycline for acne is 50mg to 100mg, taken twice per day. This dosage of doxycycline helps to treat existing acne and prevent new acne breakouts, all without damaging the normal skin flora.
If you’re prescribed doxycycline for acne, your healthcare provider will select the most suitable dosage for you based on the severity of your acne, your response to other treatments and your general needs.
It’s important to take doxycycline at the exact dosage prescribed by your healthcare provider. If you use doxycycline at an excessively high dosage or for a long period of time, you may have a higher risk of developing antibiotic resistance or GI-related side effects.
If you need to use doxycycline to treat your acne, your healthcare provider will usually prescribe it for at least three to four months.
It’s important to take doxycycline for the full treatment period recommended by your healthcare provider, even if you notice your inflammatory lesions and other acne clearing after a few weeks of treatment.
Stopping doxycycline too early may increase the risk of your acne coming back and make your breakouts harder to treat in the future.
Doxycycline is generally a safe and effective medication when it’s used as prescribed. However, like all medications, doxycycline can potentially cause adverse effects, including some that may require help from your healthcare provider.
Skin rash/itchy skin
Photosensitivity (increased sensitivity to sunlight)
Severe side effects from doxycycline are uncommon. However, they can happen. Make sure to contact your healthcare provider or seek medical attention if you experience any of the following adverse effects while using doxycycline:
Shortness of breath
Fast or irregular heart rate
Throat irritation and/or difficulty swallowing
Intracranial hypertension (build-up of pressure around your brain)
Inflammation of your esophagus and/or esophageal ulcerations
Dysuria (discomfort or a burning sensation while urinating)
Hemolytic anemia (anemia due to red blood cell breakdown)
Leukopenia (low white blood cell count)
Doxycycline can interact with other medications and health products, including over-the-counter medications, prescription medications and dietary supplements.
Medications that can interact with doxycycline include isotretinoin, aminolevulinic acid and some vaccines used to provide protection against bacterial infections.
Make sure to inform your healthcare provider about all medications you currently use or recently used before using doxycycline.
Our full guide to doxycycline interactions offers more information about medications to avoid while taking doxycycline to treat acne.
Doxycycline should not be used while pregnant or breastfeeding. Using doxycycline while you’re pregnant or breastfeeding may harm your child and cause issues such as permanent damage to your child’s teeth.
Inform your healthcare provider right away if you are pregnant, breastfeeding or plan to become pregnant in the near future while using doxycycline.
Used effectively, doxycycline can help to get rid of your acne breakouts and prevent them from coming back. Like with other medications, it’s important to take doxycycline correctly to get the best results.
Use the tips below to get the best possible results while using doxycycline:
Use other acne medications with doxycycline. Your healthcare provider will typically give you other medications, such as topical treatments, to use with doxycycline. Make sure to use all of the medication you’re prescribed for the full treatment period.
Using doxycycline alone may increase your risk of developing antibiotic resistance and reduce the effectiveness of your acne treatment plan.
Clean your skin twice a day, as well as after sweating. Sweating can make your acne worse and increase bacterial growth. Keep your skin clean and free of acne by cleansing twice a day, as well as after exercise.
Be gentle with your skin. Scrubbing your skin, using irritating products or washing with a sponge or washcloth can irritate your skin. This may make your acne worse and stop doxycycline and other treatments from working at full efficacy.
Take a gentle approach to skin care. Replace harsh products with gentle alternatives like our Facial Cleanser for Acne, and use your fingertips to carefully apply acne medications instead of scrubbing aggressively with a washcloth.
Take doxycycline with a glass of water. For every single dose of doxycycline you take, try to drink a glass of water. Let your healthcare provider know if your stomach starts to feel upset after taking doxycycline.
Ask your healthcare provider about using doxycycline with dairy products. Taking doxycycline with milk and other dairy products can reduce absorption and may affect the plasma concentration of doxycycline in your body.
Talk to your healthcare provider before taking doxycycline with milk, or if you consume a lot of dairy products as part of your regular diet.
Protect yourself from the sun. Doxycycline can make your skin more sensitive to direct sunlight. You can reduce your risk of sunburn by wearing protective clothing, applying an SPF 30+ sunscreen, spending time in the shade and avoiding tanning beds.
Follow up with your healthcare provider. Your healthcare provider may ask you to see them for follow-up appointments while using doxycycline. These appointments help your healthcare provider check that your treatment plan is working.
Make sure to attend any follow-up appointments scheduled by your healthcare provider while you’re using doxycycline.
After stopping doxycycline, keep using other acne treatments. In order to prevent your breakouts from coming back, you’ll likely need to keep using acne treatments after you stop doxycycline.
Your healthcare provider may prescribe a form of topical therapy for acne “maintenance” treatment. Make sure to use any medications you’re prescribed to stop your acne from making an unwanted comeback.
Our guide to reducing acne shares other tips and techniques that you can use to clear up your skin and prevent acne breakouts from returning while you’re using doxycycline and other acne medications.
Acne can range from mild and easy to treat to severe and stubborn. If your acne is inflamed, persistent or just doesn’t respond to topical treatments alone, your healthcare provider might recommend using doxycycline.
Make sure to use doxycycline at the dosage prescribed by your healthcare provider and to let them know if you develop any concerning side effects.
When it comes to successfully dealing with acne breakouts, doxycycline and other antibiotics are one piece of the puzzle. Other acne treatments include retinoids such as tretinoin, topical cleansers and other products for unclogging pores and preventing breakouts.
Not sure where to get started? You can learn more about your options for cleaning away acne, controlling your skin’s oil production and maintaining clear skin throughout the year with our full guide to the best science-based acne treatments.