Doxycycline Treatment of Skin Disorders
Doxycycline – a form of tetracycline, is an antibiotic taken internally for the treatment of acne and other skin conditions such as rosacea, perioral dermatitis, and rosaceaform dermatitis. Because doxycycline does not cure but only suppresses these skin disorders, the antibiotic needs to be continued until the disease runs its course. It may be necessary to continue taking doxycycline for months or years. Long-term treatment with doxycycline is remarkably safe; we have had over 40 years of experience with it. Use the smallest dose necessary to get the condition under control, and then gradually decrease the amount of Doxycycline used – even discontinuing, if the condition clears. Dosages under 25mg twice daily are often very effective and cause minimal side effects. Most of the results with this type of treamtne are due to the anti-inflammatory (rather than antibiotic) effect of Doxycycline and other tetracyclines.
Patients differ in the amount of doxycycline they need. The amount necessary to control your skin disorder may be as little as one pill a day or as many as 4 pills a day. Whatever the total amount of pills, take them as directed with a full glass of water. Tetracyclines are not absorbed well with calcium. So avoid calcium containing foods when taking doxycycline. Take half the total daily amount on arising, and the other half in the midafternoon or early evening, always with a full glass of water. A good system is to count out the entire daily amount ﬁrst thing in the morning when you are in the bathroom. Take half of that dose immediately and put the other half in a small glass or dish in a prominent place in your bathroom. This serves as a “memory device,” reminding you to take your second dose in the afternoon or evening. Tetracycline can irritate your esophagus (the tube between your mouth and stomach) if taken at bedtime or without ﬂuid. Avoid taking tetracycline at bedtime. Always take it with a full glass of water.
Tetracycline should be taken on an empty stomach, because food—especially dairy products— interferes with the absorption of tetracycline into the blood. Dairy products form an insoluble calcium-tetracycline complex, preventing the medicine from getting into your blood. You may take tetracycline 1 hour before or 1.5 hours after meals. The morning is an exception: If you take your tetracycline on arising with a full glass of water, you may have breakfast in 30 minutes. If you forget to take your tetracycline on an empty stomach, don’t skip the dose; take it on a full stomach.
Doxycycline (Tetracycline) is a remarkably safe medicine. Many people take it continuously for many years without problems. However, no medicine is without side effects; please read the following precautions:
1. Tetracyclines may interact with birth control pills, and may possibly cause birth control pills to fail. Birth control pills are not 100 percent effective; there have been pregnancies even when they were taken faithfully. We don’t know whether tetracycline or other antibiotics used in treating acne signiﬁcantly increase this failure rate. For many years, women have successfully combined birth control pills with a tetracycline in treating their acne. Most dermatologists continue to prescribe tetracyclines for women taking birth control pills, but suggest you use another form of contraception, such as a condom, as well. If tetracyclines are used during the time in pregnancy when the teeth are being developed, it may cause yellowing of the deciduous baby teeth. It is best to stop all medication that is not absolutely necessary when pregnant. Be sure to let your Obstetrician know all meds you are using and consult with him or her about the safety of anything you are taking while pregnant.
2. Doxycycline may make you sunburn more easily. The sun sensitivity depends on the amount of doxycycline you are taking. With one or two pills a day, there is little increase in sun sensitivity. With four pills a day, it’s wise to be cautious at the beach, when skiing, or at other times of intense sun exposure. Use a sunscreen if you are going to be exposed to strong sunlight or if you will be outside in spring or summer, even on an overcast day. Ultraviolet light, which causes sunburn, passes through clouds.
3. Doxycycline causes a vaginal yeast overgrowth in one of eight women; it may result in genital itching and a vaginal discharge. This side effect is annoying but harmless. It responds promptly to treatment with over-the-counter antiyeast suppositories or cream while you continue your tetracycline. A single oral dose of the prescription medicine ﬂuconazole (Diﬂucan) is also effective. If your vaginitis does not respond to the over-the-counter remedies, please consult your gynecologist. It could be another type of vaginal condition.
4. Stomach and intestinal side effects may occur. A little nausea or mild cramps may disappear as you get used to the medicine. However, if abdominal pain,vomiting, severe cramps, or diarrhea occur, you should stop the medicine. If you have a personal or family history of intestinal problems (e.g. GERD, Chrohn’s, Colitis, etc.), consult with your gastroenterologist before beginning these antibiotics.
5. Tetracycline interacts in the digestive tract with calcium, iron, and antacids to form insoluble compounds. As a result, you do not absorb the tetracycline, and you do not beneﬁt from the iron, calcium, or antacids. If you are taking iron, calcium, or antacids, be sure you allow at least 2 hours between taking tetracycline and any of these medicines.
REASONS FOR NOT TAKING TETRACYCLINE
2. Nursing an infant.
3. Age under 8 years, because tetracycline may cause permanent discoloration of the teeth.
4. Taking barbiturates or phenytoin (Dilantin), because tetracycline interacts with them.
5. Lithium or any other medication known to interact with tetracycline and become less effective.
6. Intestinal conditions known to be made worse by doxycycline or other tetracyclines.
7. Sensitivity to any form of tetracycline.