Subantimicrobial Dosing of Doxycycline for Acne and Rosacea

Subantimicrobial Dosing of Doxycycline for Acne and Rosacea - A Snapshot

- Subantimicrobial dosing of doxycycline is an emerging approach for treating acne and rosacea, relying on the anti-inflammatory properties of doxycycline rather than its antibacterial effects.

- Doxycycline at subantimicrobial doses (40 mg once daily) is available in various formulations overseas, but not in Australia. In the United States, Oracea® (40 mg doxycycline) is a common commercial product. In Australia, such dosing and extended release formulations require compounding.

- Doxycycline at subantimicrobial doses exerts its effect primarily by inhibiting matrix metalloproteinases (MMPs) and reducing pro-inflammatory cytokines, which play a crucial role in the pathogenesis of acne and rosacea. This dosing strategy avoids the development of antibiotic resistance, often preferred by patients.

- A study by Moore A et al compared the efficacy and safety of subantimicrobial-dose doxycycline 40 mg and doxycycline 100 mg in treating moderate acne and found that both doses were effective, but the lower dose had fewer side effects.

- Subantimicrobial doxycycline is administered as a daily oral dose of 40 mg, typically taken in the mornings with food.

- Patients treated with subantimicrobial doxycycline often experience a reduction in inflammatory lesions and erythema associated with acne and rosacea within 6 weeks.