Quick Q: What do malaria, anthrax infections, and adult acne have in common?
If you answered: things I absolutely want to avoid at all costs—well, fair. But those conditions are also linked by one pretty powerful antibiotic: doxycycline.
The drug—which goes by the brand names Oracea, Monodox, and Doryx, among others—can be used to treat infections like malaria, Lyme disease, and even UTIs, but it’s most commonly used to help with inflammatory skin conditions like acne and rosacea, says Joshua Zeichner, M.D., director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City.
“Doxycycline can both kill bacteria, which cause infections, but it completely independently has anti-inflammatory properties, which can explain its usefulness in treating acne and rosacea,” says Zeichner.
Inflammatory acne occurs when bacteria clogs your pores, which your skin reacts to as a threat, causing redness and swelling; rosacea, on the other hand, is when your facial blood vessels get bigger, which can make you look flushed.
“Doxycycline helps reduce levels of acne-causing bacteria within the follicles which promote inflammation, and it’s been shown to decrease activity of signals in your immune system that lead to the extra inflammation seen in the skin of rosacea patients,” says Zeichner.
While any drug that helps lessen acne and rosacea sounds pretty awesome, doxycycline does come with some less exciting side effects. (There’s that whole thing about antibiotic resistance being a major issue in the U.S. too.) Before you look to this med as a miracle solution, read up on these doxycycline side effects.
You’re pretty sure your stomach hates you.
Nausea, vomiting, diarrhea, or an upset stomach are common side effects of antibiotics, and doxycycline is no exception. That’s because the strong dose of meds kills not just the bad bacteria, but the good bacteria in your gut that keeps you healthy, says Zeichner.
Taking the medication with food can help reduce the risk of stomach upset. But there’s one caveat: Dairy can lessen the drug’s effects. “Dairy can significantly reduce the amount absorbed, so you should take it two hours after eating dairy and continue avoiding dairy for one hour afterward,” says Zeichner.
Your throat is on fire.
The chemicals in doxycycline can wreak havoc on your esophagus too. In fact, esophageal erosion is one of the most common side effects of the drug, according to a review published in the journal Clinical Therapeutics.
“Make sure to take it with a full glass of water and at least 30 minutes before bed,” says Zeichner. “It’s important not to take the medication and then lie down immediately afterwards,” he adds; staying upright can help lessen irritation.
You don’t even want to look at food.
Considering the GI issues that doxycycline can cause—especially nausea and vomiting—it shouldn’t come as too much of a surprise that the drug can also lead to loss of appetite. That’s likely because it disrupts the amount of good bacteria in the gut, says Zeichner.
The good news: It’s typically a short-term side effect. but if your stomach issues aren’t going away, you can simply ask your doctor to take you off the drug and try another medication.
You’re super-sensitive to sunlight.
It’s technically called photosensitivity, sometimes referred to as a sun allergy, and it has to do with how the chemicals in the drug react with the sun’s UV rays once they’re inside your body.
“Doxycycline can make you sensitive to the sun, so it’s important to wear sunscreen while taking it,” says Zeichner. Even better: Try to stay covered up and out of the sun as much as possible, as you could end up with just a sunburn-like sensation and slightly reddened skin, or a larger-scale photodermatitis issue, like a rash, blisters, or scaly patches.
You look pale and feel feverish.
This can be caused by drug-induced immune hemolytic anemia—a condition in which your immune system attacks its own red blood cells (they carry oxygen, so you kinda need those).
This can cause you to look pale or yellow-y; feel feverish, weak, dizzy, or confused; experience an elevated heart rate; or feel super fatigued, according to the National Institutes of Health. But those symptoms are kind of vague, so it’s important to communicate with your doctor about how you feel and when any symptoms started while taking doxycycline.
Your head hurts and you feel dizzy.
Scientists aren’t sure why this occurs, but tetracyclines—the drug class doxycycline belongs to—have long been linked with headaches, dizziness, and blurred vision, according to an editorial in the BMJ.
These issues typically clear up as soon as you stop taking the drug. If you’re experiencing new headaches since starting doxycycline, definitely loop in your doctor.
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