Skip to main content
SpringerLink
Log in

Subantimicrobial-dose doxycycline monohydrate in dermatology

Doxyzyklinmonohydrat in subantimikrobieller Dosierung in der Dermatologie

  • review
  • Published:
Wiener Medizinische Wochenschrift Aims and scope Submit manuscript

Summary

Subantimicrobial doxycycline is an anti-inflammatory drug that decreases cathelicidin, kallikrein 5, reactive oxygen species, nitric oxide, and matrix metalloproteinases. Clinical trials demonstrated a comparable efficacy to 100-mg doxycycline in papulopustular rosacea with improvement of inflammatory lesions, quality of life, and improved safety profile. Case series and case reports suggested efficacy in other inflammatory skin diseases. The response of papulopustular rash during targeted anticancer therapies is mixed. Further studies are needed.

Zusammenfassung

Subantimikrobiell-dosiertes Doxyzyklin ist anti-entzündlich und reduziert Cathelicidin, Kallikrein 5, reaktive Sauerstoff-Spezies, Stickstoffmonoxid und Matrix-Metalloproteinasen. Klinische Studien zeigten eine vergleichbare Wirksamkeit mit 100 mg Doxyzyklin bei papulopustulöser Rosazea mit einer Verminderung inflammatorischer Läsionen, Verbesserung der Lebensqualität und einem günstigeren Nebenwirkungsprofil. Fallserien und Fallberichte sprechen für eine Wirksamkeit auch bei anderen entzündlichen Dermatosen. Beim papulopustulösen Exanthem unter zielgerichteten (Targeted) Therapien ist das Ansprechen gemischt. Weitere Studien sind erforderlich.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Griffin MO, Ceballos G, Villarreal FJ. Tetracycline compounds with non-antimicrobial organ protective properties: possible mechanisms of action. Pharmacol Res. 2011;63:102–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Sloan B, Scheinfeld N. The use and safety of doxycycline hyclate and other second-generation tetracyclines. Expert Opin Drug Saf. 2008;7:571–7.

    Article  CAS  PubMed  Google Scholar 

  3. Di Caprio R, Lembo S, Di Constanzo L, Balato A, Monfrecola G. Anti-inflammatory properties of low and high doxycycline doses: an in vitro study. Mediators Inflamm. 2015;2015:329418.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Thomas J, Walker C, Bradshaw M. Long-term use of subantimicrobial dose doxycycline does not lead to changes in antimicrobial susceptibility. J Perdontol. 2000;71:1472–83.

    Article  CAS  Google Scholar 

  5. Del Rosso JQ. A status report on the use of subantimicrobial-dose doxycycline: a review of the biologic and antimicrobial effect of the tetracyclines. Cutis. 2004;74:118–22.

    PubMed  Google Scholar 

  6. Berman B, Perez OA, Zell D. Update on rosacea and anti-inflammatory-dose doxycycline. Drugs Today (Barc). 2007;43:27–34.

    Article  CAS  Google Scholar 

  7. Kanada KN, Nakatsuji T, Gallo RL. Doxycycline indirectly inhibits proteolytic activation of tryptic kallikrein-related peptidases and activation of cathelicidin. J Invest Dermatol. 2012;132:1435–42.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Wollina U. Recent advances in the understanding and management of rosacea. F1000Prime Rep. 2014;6:50.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Del Rosso JQ, Webster GF, Jackson M, et al. Two randomized phase III clinical trials evaluating anti-inflammatory dose doxycycline (40-mg doxycycline, USP capsules) administered once daily for treatment of rosacea. J Am Acad Dermatol. 2007;56:791–802.

    Article  PubMed  Google Scholar 

  10. Del Rosso JQ. Effectiveness and safety of doxycycline 40 mg (30-mg immediate-release and 10-mg delayed-release beads) once daily as add-on therapy to existing topical regimens for the treatment of papulopustular rosacea: results from a community-based trial. Cutis. 2010;86(5 Suppl.):16–25.

    PubMed  Google Scholar 

  11. Del Rosso JQ, Preston NJ, Caveney SW, Gottschalk RW. Effectiveness and safety of modified-release doxycycline capsules once daily for papulopustular rosacea monotherapy results from a large community-based trial in subgroups based on gender. J Drugs Dermatol. 2012;11:703–7.

    CAS  PubMed  Google Scholar 

  12. Johnson SM, LeVine P. Self-reported treatment impressions and satisfaction of papulopustular rosacea patients treated with doxycycline, USP, 40 mg capsules. J Drugs Dermatol. 2011;10:1376–81.

    CAS  PubMed  Google Scholar 

  13. Webster GF. An open-label, community-based, 12-week assessment of the effectiveness and safety of monotherapy with doxycycline 40 mg (30-mg immediate-release and 10-mg delayed-release beads). Cutis. 2010;86(5 Suppl.):7–15.

    PubMed  Google Scholar 

  14. Wollina U, Verma SB. Rosacea and rhinophyma: not curse of the Celts but Indo Eurasians. J Cosmet Dermatol. 2009;8:234–5.

    Article  PubMed  Google Scholar 

  15. Alexis AF, Webster G, Preston NJ, Caveney SW, Gottschalk RW. Effectiveness and safety of once-daily doxycycline capsules as monotherapy in patients with rosacea: an analysis by Fitzpatrick skin type. J Drugs Dermatol. 2012;11:1219–22.

    CAS  PubMed  Google Scholar 

  16. Baldwin HE. A community-based study of the effectiveness of doxycycline 40 mg (30-mg immediate-release and 10-mg delayed-release beads) on quality of life and satisfaction with treatment in participants with rosacea. Cutis. 2010;86(5 Suppl.):26–36.

    PubMed  Google Scholar 

  17. Fowler JF Jr. Combined effect of anti-inflammatory dose doxycycline (40-mg doxycycline, usp monohydrate controlled-release capsules) and metronidazole topical gel 1 % in the treatment of rosacea. J Drugs Dermatol. 2007;6:641–5.

    PubMed  Google Scholar 

  18. Del Rosso JQ, Bruce S, Jarratt M, Menter A, Staedtler G. Efficacy of topical azelaic acid (AzA) gel 15 % plus oral doxycycline 40 mg versus metronidazole gel 1 % plus oral doxycycline 40 mg in mild-to-moderate papulopustular rosacea. J Drugs Dermatol. 2010;9:607–13.

    PubMed  Google Scholar 

  19. Fender AB, Ignatovich Y, Mercurio MG. Pyoderma faciale. Cutis. 2008;81:488–90.

    PubMed  Google Scholar 

  20. Smith LA, Meehan SA, Cohen DE. Rosacea fulminans with extrafacial lesions in an elderly man: successful treatment with subantimicrobial-dose doxycycline. J Drugs Dermatol. 2014;13:763–5.

    CAS  PubMed  Google Scholar 

  21. Pfeffer I, Borelli C, Zierhut M, Schaller M. Treatment of ocular rosacea with 40 mg doxycycline in a slow release form. J Dtsch Dermatol Ges. 2011;9:904–7.

    PubMed  Google Scholar 

  22. Sobolewska B, Doycheva D, Deuter C, Pfeffer I, Schaller M, Zierhut M. Treatment of ocular rosacea with once-daily low-dose doxycycline. Cornea. 2014;33:257–60.

    PubMed  Google Scholar 

  23. Thestrup-Pedersen K, Hjorth N. Red scalp: a previously undescribed disease of the scalp? Ugeskr Laeger. 1987;149:2141–2.

    CAS  PubMed  Google Scholar 

  24. Oberholzer PA, Nobbe S, Kolm I, Kerl K, Kamarachev J, Trüeb RM. Red scalp disease—a rosacea-like dermatosis of the scalp? Successful therapy with oral tetracycline. Dermatology. 2009;219:179–81.

    Article  PubMed  Google Scholar 

  25. Macdonald JB, Macdonald B, Golitz LE, LoRusso P, Sekulic A. Cutaneous adverse effects of targeted therapies: part I: inhibitors of the cellular membrane. J Am Acad Dermatol. 2015;72:203–18.

    Article  CAS  PubMed  Google Scholar 

  26. Macdonald JB, Macdonald B, Golitz LE, LoRusso P, Sekulic A. Cutaneous adverse effects of targeted therapies: part II: inhibitors of intracellular molecular signaling pathways. J Am Acad Dermatol. 2015;72:221–36.

    Article  CAS  PubMed  Google Scholar 

  27. Sanlorenzo M, Choudhry A, Vujic I, et al. Comparative profile of cutaneous adverse events: BRAF/MEK inhibitor combination therapy versus BRAF monotherapy in melanoma. J Am Acad Dermatol. 2014;71:1102–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Sibaud V, Tournier E, Roché H, Del Giudice P, Delord JP, Hubiche T. Late epidermal growth factor receptor inhibitor-related papulopustular rash: a distinct clinical entity. Clin Exp Dermatol. 2015. doi:10.1111/ced.12675.

  29. Shibata M, Katsuyama M, Onodera T, Ehama R, Hosoi J, Tagami H. Glucocorticoids enhance Toll-like receptor 2 expression in human keratinocytes stimulated with Propionibacterium acnes or proinflammatory cytokines. J Invest Dermatol. 2009;129:375–82.

    Article  CAS  PubMed  Google Scholar 

  30. Vaubel J, Livingstone E, Schadendorf D, Zimmer L. Retarded low-dose doxycycline for EGFR or MEK inhibitor-induced papulopustular rash. J Eur Acad Dermatol Venereol. 2014;28:1685–9.

    Article  CAS  PubMed  Google Scholar 

  31. Rathi SK, Kumrah L. Topical corticosteroid-induced rosacea-like dermatitis: a clinical study of 110 cases. Indian J Dermatol Venereol Leprol. 2011;77:42–6.

    Article  PubMed  Google Scholar 

  32. Tempark T, Shwayder TA. Perioral dermatitis: a review of the condition with special attention to treatment options. Am J Clin Dermatol. 2014;15:101–13.

    Article  PubMed  Google Scholar 

  33. Rosso JQ. Management of papulopustular rosacea and perioral dermatitis with emphasis on iatrogenic causation or exacerbation of inflammatory facial dermatoses: use of doxycycline-modified release 40 mg capsule once daily in combination with properly selected skin care as an effective therapeutic approach. J Clin Aesthet Dermatol. 2011;4:20–30.

    PubMed Central  PubMed  Google Scholar 

  34. van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MM, Charland L. Interventions for rosacea. Cochrane Database Syst Rev. 2015;4:CD003262.

    PubMed  Google Scholar 

  35. Yoo SE, Lee DC, Chang MH. The effect of low-dose doxycycline therapy in chronic meibomian gland dysfunction. Korean J Ophthalmol. 2005;19:258–63.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany

    Uwe Wollina

Authors
  1. Uwe Wollina
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Uwe Wollina.

Ethics declarations

Conflict of interest

The author declares that there are no actual or potential conflicts of interest in relation to this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wollina, U. Subantimicrobial-dose doxycycline monohydrate in dermatology. Wien Med Wochenschr 165, 499–503 (2015). https://doi.org/10.1007/s10354-015-0399-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10354-015-0399-9

Keywords

Schlüsselworter

Search

Navigation