Downside to Doxycycline Treatment for Acne

The antibiotic doxycycline is considered to be a kinder, gentler alternative to minocycline, an antibiotic more often used to treat acne in the United States. Canadian and European doctors often prescribe doxycycline for their teenage and young adult patients because it is less likely to leave black or blue stains on the teeth at the gum line, a problem that has been known to occur in users of minocycline up to 22 years old. The use of doxycycline for acne is being called into question, however, with an upsurge in cases of inflammatory bowel disease connected to the drug.

Why Doctors Choose Doxycycline

Doxycycline, which is dispensed under the trade names Doryx, Bio-Tab, and Vibramycin, has many advantages over other antibiotics for acne. It’s better absorbed into the bloodstream than the older antibiotics for acne such as tetracycline and oxytetracycline, and it’s equally well absorbed as minocycline. It can be taken with food, even with milk. It gets into the bloodstream twice as fast as other antibiotics, and stays in the bloodstream three times as long. It does not interfere with oral contactives (at least the brands most commonly prescribed in the United States), and in much of the world it only costs about US $10 a month or the equivalent.

Doxycycline usually gets rid of about 2/3 of blemishes in 2 to 3 months. That is not as much anti-acne action as many over-the-counter products claim, but it is better than most prescription medications or over-the-counter products deliver. Just about the only known downside to using doxycycline until recently has been a problem with skin discoloration when users go out into the sun, especially if they have Asian skin tones. The specter of inflammatory bowel disease, however, puts doxycyline use in a new light.

Doxycycline and Inflammatory Bowel Disease

Inflammatory bowel disease includes a variety of conditions of intestinal inflammation including ulcerative colitis and Crohn’s disease. These conditions tend to be insidious. They cause severe fatigue and vague pain until they present a crisis, sometimes a life-threatening crisis, as severe inflammation of the bowel closes the lower digestive tract to the passage of food and sometimes even stops circulation of blood.

The concern about doxycycline and inflammatory bowel disease arises from a recently released study of 99,487 acne patients in the United Kingdom. Doxycycline is a popular treatment for acne in the UK, and about 1/5 of these patients, who were tracked for 5 years, received doxycycline. Researchers were alarmed when they noticed that acne patients who got doxycycline were 225% more likely to develop inflammatory bowel disease than those who did not.

Since some kinds of acne are made worse by bacterial overgrowth in the small intestine, it is possible that the people who most need antibiotics are also those at greatest risk for developing bowel problems. It is even possible that the FD and C blue No.1, FD and C yellow No. 6, and D and C yellow No. 1 dyes used to color the capsule contribute to bowel inflammation, or the sodium laureth sulfate used to help the medication break up in the stomach causes severe inflammation in the bowel in some susceptible users. But it appears that doctors need to be on the lookout for early signs of Crohn’s disease in their acne patients who use doxycycline for one month or more.

Doxycycline Not the Only Acne Medication Linked to Bowel Disease

Doxycycline, it turns out, is not the only acne medication that has been linked to bowel disease. The use of Accutane has been linked to another kind of inflammatory bowel disease known as ulcerative colitis.

Ulcerative colitis is an autoimmune disease that causes severe inflammation to the lining of the colon. Open sores in the colon can bleed into the stool. The blood tends to be dry and black rather than fresn and red. Ulcerative colitis causes severe diarrhea and severe pain, but it tends to come and go. It is not related to diet, but it can be relieved by changes in diet.

Crohn’s disease is also an autoimmune disease that can cause severe inflammation to the lining of the colon, but unlike ulcerative colitis, it can cause sores to break out anywhere in the digestive tract from the mouth to the anus. It can also cause joint pain and rashes on the face that look a little like especially red spots of rosacea.

Either condition has life-altering and life-threatening consequences. And they are caused by the two medications most often used to treat acne in Europe, doxycycline and isotretinoin. So what can acne sufferers who use these treatments do to minimize their risk of digestive complications?

Taking Steps to Minimize Drug Side Effects

If you are 15 years of age or older, ask your doctor about alternatives to doxycycline treatment for acne. In Canada and Europe, dermatologists prescribe doxycycline to be especially sure that antibiotic treatment does not cause tooth discoloration, and they usually prescribe it to patients up to the age of 22. Your doctor may not give you minocycline, but limocycline may help keep acne under control without risk of tooth discoloration.

It also helps to use topical retinoids rather than oral retinoids, that is, using tretinoin on your skin rather than taking an isotretinoin pill. The tretinoin creams and gels do not cause bowel problems and they do not cause birth defects when taken by mothers in the first trimester of pregnancy. They require a little more effort than downing a doxycycline capsule once a day, but they don’t carry the risk of inducing inflammatory bowel disease and many other complications.

Even if you have been taking these medications, there is still no need to panic. In a 5-year period, about 2/10 of 1% of the population is diagnosed with either ulcerative colitis or Crohn’s disease. Among people who have taken these medications for acne, about 1/2 of 1% will get an inflammatory bowel disease diagnosis. The conditions are severe enough that it is important to take care to avoid them, but over 99% of people who don’t take precautions will not develop the disease.

Related acne articles:

  1. How to Treat Acne Using Oral Medications Popping a pill usually is not a cure for acne. The right medications used in the right way, however, can greatly accelerate progress in healing...
  2. Finding The Very Best Teen Acne Treatment System Teenage acne is not like acne at other times of life. Teens are more likely to get acne than any other age group, but they...
  3. Treating Bacterial Overgrowth May Relieve Rosacea Nearly 50% of people who have rosacea also have a condition known as small intestine bacterial overgrowth, or SIBO. In one small study, 100% of...
  4. The Facts On Treating Acne With Doryx Doryx, or doxycycline, is an antibiotic pill used to treat acne and many other kinds of bacterial infection. It is the acne treatment of choice...
  5. Top Prescription Acne Medications Reviewed Prescription acne medication is a must for the most severe cases of acne. For mild to moderate common acne, however, other combinations of treatments sometimes...

{ 10 comments… read them below or add one }

rosan March 7, 2012 at 7:53 am

hi thank you for the heads up. I cant find when this article was written, so are they’re any changes or improvements on this drug since then?
Also how is it in the case of taking erythromycin?

Reply

Martin March 22, 2012 at 9:15 am

Hi Rosan, The articles on this site are fairly new (fall 2011). I don’t know, however, if there are any changes or improvements. What I recommend you do is read our article on acne antibiotics.

Reply

Former Doryx User April 3, 2012 at 10:00 pm

I used to take Doryx for my acne. I used it for a year so from 16-17 years old. I am now 18 years old and suffering from Ulcerative Colitis. It’s been the worst experience of my life and I would never want to wish this upon anyone else. I highly suggest that you do not take any Doryx acne medicine. My doctor said I may never fully overcome this illness.

Reply

Martin April 4, 2012 at 8:00 am

I’m really sorry to hear it. That is just terrible. You may already have done research, but I’d like to share what I know about treating Ulcerative Colitis. Just know that I’m not a doctor and what I tell you now should not be considered medical advice. You see, the wife of one of my friends suffered UC for a long time with the typical fatigue and bloody stools. We came to talk about it fairly recently because my mom was actually diagnosed with a type of IBD called Collagenous Colitis, which is very similar to UC, but without the bloody stools. My friends wife completely cured her Ulcerative Colitis with VSL#3. Because it’s a probiotic it’s considered completely safe to use. My friends wife experienced some discomfort as her stools began to return to normal. Because of some remaining inflammation, the more normal stools created some discomfort in the lower intestine and colon but as the inflammation decreased so did the discomfort. Of course, you can get a little gassy at first, but it will pass in a few days. The point is, she no longer suffers from UC. All symptoms are gone and have not returned.

My mom cured her CC with probiotics (incidentally, not vsl3 ) combined with a very strict diet. She especially made an effort to stay away from gluten, milk products, and sugar, but also did not touch coffee, wine, beer, wheat flour, and citrus fruits for a period of three months. It was recommend to her that she take fish oil daily as well as slippery elm. Obviously, that’s a strict diet, but alot is at stake and fortunately her efforts paid of. It worked and her symptoms have not returned either. I also really recommend you buy Healing Without Medication by Robert Rister and read the section of Inflammatory Bowel Disease. I really hope this helps.

Reply

Jeremy July 4, 2013 at 3:24 pm

Hi Martin,

Interesting to read that your friend’s wife is cured of UC. However, i do believe UC is not a curable disease only managed. I was diagnosed with UC last year.

One question that I have is whether your friend’s wife is also under some other form of medication (other than the VSL#3). Doctors will normal prescribe medication to suppress the immune system etc. Can you please find out and also please provide me with an update on your friend’s wife’s condition.

Is your mum cured as well? or under management? Also was she under any form of medication?

Would be great to hear back from you.

I am not in the USA. Wondering how i can get my hands on some VSL#3.

Thank you.
Jeremy.

Reply

susan March 7, 2013 at 12:53 pm

hi,i been taking doxyciline for about 2 month 2 weeks now,and the effect is not so obvious i can said,from what i been searching i find there is a lot of side effect that might show up,right now i am thinking to stop taking it,but antibiotic can’t be stop otherwise my acne will getting worse than before right,what can i do right now,please help me

Reply

Becca April 20, 2013 at 5:06 am

This is an interesting article. I was on Minocycline for 5 years on and off.. mostly on. Towards the end most of 2011-2012 I was extremely sick thought I did have Crohns or IBD of some sort. I went to numerous Drs and hospital visits I think bills were over $60,000 thank god my insurance paid for most. They found basically nothing which was good but gave me no answers. Long story short after much researching myself online I realized it may be the Mino. I stopped taking it and coincidentally at the same time I was treated for sinus infection with Levaquin and shortly after bacterial vaginosis with Metronizadole. After that I was fine after a almost two years of constant pain, nausea, diarrhea daily it was just gone. I’m convinced it was the Minocycline and found out that Metronizadole and Levaquin are the main treatment used for Bacterial Overgrowth of the Small Intestine. I’m sure it was caused by the long term use of this drug. I now also have constant yeast infections still. I believe it has also cause yeast overgrowth which the symptoms are very similar. It has now been 8 months though and my stomach is much better still working on the yeast issue. I’m now switched to Accutane which also is scary but I feel since its short term I actually feel safer on it, maybe of my friends have been on it without issue and my Dr has started me low dose and slowly increasing me carefully. Sorry for the long post but after all I have been through I really hope this post helps someone else maybe get some answers.

Reply

Liam June 22, 2013 at 2:48 pm

Hi there. I have just the one quick question, I’ve found a few sites online that back up the theory that doxycycline can cause IBD but I have been wondering if anybody knows how long you would have to be taking it for it to have a lasting impression, I took it for 9 days and then stopped as my body wasn’t doing well on it, I have since been having some stomach issues and was wondering if this very short treatment would have had this effect or whether it is simply something else such as IBS. I would imagine a three year course or something similar would have this effect, any news would be appreciated.

thanks

Reply

Christy Neal February 7, 2014 at 2:19 am

I just found out in Novemember that I have Chrons. I also have rosacia . I have break outs and one I got about three weeks ago had place on face that got infected. It looks like a boil . Can’t see dermatolist until Feb 24, so they called me in some doxycycline at my request. It was what I took when had break out year ago. Dr actually ordered me Oracia think that name, but my insurance said too expensive so they sub the doxycycline. I just took first pill and started reading the reactions.. That when I saw the reaction and maybe cause of Chrons . I’m 65 so not a baby. Any recommendation for what I can do to clear face up.. It looks awful and embarrassing .

Reply

Giorgosdil June 11, 2014 at 5:05 pm

Hello, I’m doing a research about vibramycin. I go to the doctor 25days before and he told me to follow a therapy for my acne. I don’t have terrible acne like cystic or anything else I just have some red scars from old pimples and sometimes i have white pimples. So my doctor said he will see me in 40days. As I said I take this pill for 25 days and I don’t see big changes in my face. Can please someone tell me how many days I’ m going to see results? I do want acne like everybody else… So my question is when I will see the big results… How many months? :/

Reply

Leave a Comment