I was prescribed 100mg/day doxycycline around 3-4 months ago to help keep teen acne under control. I couple it with nightly Retin-A to help my skin replace itself faster. Are there any long-term concerns with this medicine? I’m not sure how long the dermatologist will have me on it, but I have always been hesitant about taking medication and I’m just wondering. I know that it makes me photosensitive and I don’t want to get toasted every time I go outside this summer.
Outside of the potential photosensitivity, I don’t have any other significant concerns here. Most people do just fine with doxy.
Thanks Dr. Baraki,
Should antibiotic resistance be of any concern as I have taken it since November I believe and will probably be on it for a few more months. Antibiotic resistance has always been a concern of mine.
Antibiotic resistance is always a possibility when exposing individuals to antibiotics. I will say that doxycycline resistance is not typically of great concern in people who are otherwise healthy, but we still try to use the lowest dose possible for that shortest duration possible to achieve the desired effect.
There are always trade-offs to consider when it comes to medical interventions. The trade-off here is a low risk for certain complications against the benefits of improved control of your acne. If, from your perspective, the risks are unacceptable, you would either need to pursue alternative therapy for your acne or accept that the acne will be less controlled.
Brodge - For reducing acne, you might explore the carnivore diet. This site has several people’s testimonials about the carnivore fixing their acne
I did the carnivore for a year and it worked well for me.
We would strongly disagree with recommending the carnivore diet, as it would be very difficult to meet the current dietary pattern recommendations and adhere to a carnivore diet at the same time. It also has precisely ZERO evidence supporting it for any particular health outcome.
There’s also no plausible mechanism for it to improve acne outside of weight loss, which can occur via a number of different diets. Low carb diets do not produce more weight loss or better adherence than any other type of diet. Additionally, acne waxes and wanes over time - making uncontrolled observations by a self-selected group of folks who “saw results” on a website like “MeatRx” questionable at best.
Pathogenesis of acne is currently unknown. Next time I’ll cite clinical evidence. This 2007 controlled study is all I found in a brief search. The measure was insulin sensitivity and acne lesion counts A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial - PubMed
This is not exactly true. While there are certain gray areas, there are several established pathogenic factors involved in the development of acne (follicular hyperkeratinization, sebum production, P. acnes infection/colonization and associated inflammation).
What is your interpretation / assessment of this trial and its applicability to the current discussion?
Also, changes in insulin sensitivity have relatively little to do with carbohydrate content of a diet.
My assessment of this study.
Strength of Scientific Evidence: Level 3, Good to Fair
Type of Study: Small-sample RTC
N = 43
Age: 15 – 25
Gender: Male
Length of study: 12 weeks
Experimental Group N=23: 25% energy from protein and 45% from low-glycemic-index carbohydrates, 30% from fats.
Control Group N=20: Carbohydrate-dense foods without reference to the glycemic index.
Primary Endpoints: changes in inflammatory lesion counts (papules, pustules, and nodules) and total lesion counts (inflammatory lesions and noninflammatory lesions) after 12 wk.
Secondary Endpoints: changes in anthropometric measures and insulin sensitivity indexes.
My assessment is this was a well-controlled dietary study, but it could’ve been stronger if it was blinded. At least the dermatology registrar was blinded, which was a good thing. I liked that all participants were provided the same topical cleanser to control for washing your face. However, acne improved in the control group, which might be due to the control group regularly using the topical cleanser on a regular basis. Also, I liked that they did a secondary statistical analysis to account for changes in BMI. My overall assessment is there is positive association between nutritional-related factors and pathogenesis of acne. But this association may be more related to changes in BMI vs. insulin resistance. To further support the strength of their conclusion, the researches cite that the role of insulin in acne development is also supported by the high prevalence of acne in women with polycystic ovary syndrome (PCOS).
| Level of Evidence | Category | Type of Study | Strength of Evidence |
|---|---|---|---|
| 1 | Experimental | Meta-analyses of RTC | Good |
| 2 | Experimental | Large-sample RTC | |
| 3 | Experimental | Small-sample RTC | |
| 4 | Experimental | Non-randomized controlled prospective trial | |
| 5 | Experimental | Non-randomized controlled retro prospective trial | |
| 6 | Observational | Cohort studies | Fair |
| 7 | Observational | Case-control studies | |
| 8 | Observational | Non-controlled clinical series, descriptive studies | Poor |
| 9 | Observational | Anecdotes or case reports | |
| Jovell and Navarro-Rubio |