Doxyderma

Doxyderma is an oral antibiotic containing the active ingredient doxycycline that is marketed specifically for dermatological indications. Doxycycline belongs to the tetracycline class and is used for moderate to severe inflammatory acne.

Compared with classic tetracycline, doxycycline has the advantage of better bioavailability and can be taken with meals. In addition, taking it once daily is sufficient.

Besides its antibacterial action, doxycycline also has anti-inflammatory effects, which are particularly relevant in acne treatment. Even low doses can have an anti-inflammatory effect.

Doxycycline has antibacterial and anti-inflammatory effects:

Antibacterial action:

• Inhibits bacterial protein synthesis
• Bacteriostatic against Cutibacterium acnes
• Better tissue penetration than tetracycline

Anti-inflammatory action:

• Inhibits matrix metalloproteinases (MMP)
• Reduces neutrophil migration
• Inhibits cytokine production
• Also works at subantibiotic doses

Pharmacokinetic advantages:

• Good oral bioavailability (90-100%)
• Can be taken with food
• Longer half-life (once daily)

Doxyderma is suitable for:

• Moderate to severe inflammatory acne
• Acne that does not respond adequately to topical therapy
• Adults and adolescents aged 12 years and older

Always in combination with:

• Topical therapy (benzoyl peroxide and/or retinoid)

Not suitable:

• Pregnancy and breastfeeding
• Children under 8 years of age
• Mild acne (treat topically)

Doxyderma tablets:

• 50 mg or 100 mg doxycycline
• Recommended: 100 mg once daily or 50 mg 2x daily
• Treatment duration: 6-12 weeks, max. 3 months

Note on resistance:

• Even 50 mg doxycycline daily has an antibiotic effect
• Longer-term use may occasionally lead to overgrowth of resistant germs, including fungi

How to take:

• With enough water (at least 200 ml)
• Can be taken with a meal (better tolerability)
• Remain upright for 30 minutes after taking
• Not immediately before going to bed

Important:

• Use sun protection! Doxycycline increases sensitivity to light
• Do not take at the same time as antacids or iron supplements
• Keep at least 2 hours apart from dairy products

Additionally:

• Always together with topical therapy
• Probiotics can reduce gastrointestinal side effects

Contraindicated in:

• Pregnancy (teratogenic, tooth discoloration)
• Breastfeeding
• Children under 8 years of age
• Severe hepatic insufficiency

Use with caution in:

• Risk of esophagitis
• Myasthenia gravis

Contraception: An additional method of contraception may be recommended if you are taking the pill at the same time.

Common:

• Gastrointestinal complaints (nausea, diarrhea)
• Photosensitization (susceptibility to sunburn)
• Vaginal yeast infections

Uncommon:

• Headache
• Esophagitis (if taken incorrectly)
• Skin rash

Rare:

• Pseudotumor cerebri
• Hepatotoxicity
• Phototoxic onycholysis (nail separation)

Prevention: Enough water, SPF 50+ sun protection, take in an upright position.

Interactions:

• Antacids, calcium, iron, magnesium – reduced absorption
• Oral contraceptives – possibly reduced effectiveness
• Isotretinoin – do NOT combine (pseudotumor cerebri!)
• Warfarin – increased tendency to bleed

Keep a time gap: At least 2 hours from antacids and mineral supplements.