Can You Safely Combine A Acid and Doxycycline for Acne Treatment? - Dermatology

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The use of retinoic acid (A acid) in conjunction with tetracycline?


Hello Doctor,
Due to my oily skin, I tend to have a lot of acne.
I previously took tetracycline for a while, but after a period of improvement, I stopped taking it about five months ago.
Recently, my acne has returned and shows no signs of improvement.
Therefore, I visited a dermatologist again and asked if I could take retinoic acid.
The doctor agreed but instructed me to take one capsule of Doxycycline in the morning and evening from Monday to Friday, and on the weekends, to take one capsule of Roaccutane at specific times (without Doxycycline).

I found some information indicating that these two medications should not be taken simultaneously to avoid the risk of intracranial hypertension.
Given the treatment plan prescribed by my doctor, would this be considered simultaneous use? Thank you for your time in clarifying this for me.

Mr. Li, 20~29 year old female. Ask Date: 2016/07/29

Dr. Li Yufen reply Dermatology


Hello: Regarding the precautions for oral isotretinoin, you can refer to the articles by Dr.
Hong Chen-Bang and Dr.
Wang Hsiu-Han at http://epaper.ntuh.gov.tw/health/201508/child_2.html and http://www.skin168.net/2013/09/oral-isotretinoin-effect-adverse.html?m=1.
If you have any questions about the medication you are currently using, it is recommended that you return for a consultation with a dermatologist.
Thank you!

Reply Date: 2016/07/29

More Info


Combining medications for acne treatment can be complex, especially when considering potential interactions and side effects. In your case, you are asking about the safety of using isotretinoin (commonly known as A Acid or Roaccutane) alongside doxycycline, an antibiotic often prescribed for acne.
First, it’s important to clarify the concerns regarding the concurrent use of these two medications. Isotretinoin is a powerful retinoid that works by reducing oil production in the skin, preventing clogged pores, and has anti-inflammatory properties. Doxycycline, on the other hand, is a tetracycline antibiotic that helps reduce acne by targeting the bacteria that contribute to acne formation and by reducing inflammation.

The primary concern with combining isotretinoin and doxycycline is the potential for increased intracranial pressure, a condition known as pseudotumor cerebri. This condition can lead to symptoms such as headaches, vision changes, and other neurological issues. While the risk of this interaction is generally considered low, it is still a valid concern, particularly in patients who may already be at risk due to other factors, such as obesity or certain medications.

In your specific treatment plan, your dermatologist has prescribed doxycycline to be taken daily from Monday to Friday, while isotretinoin is to be taken on weekends. This regimen does not constitute simultaneous use of both medications, as they are not being taken at the same time. However, it is essential to communicate openly with your healthcare provider about your concerns regarding this treatment plan. If you feel uncomfortable or uncertain about the potential risks, it is advisable to discuss alternative options or adjustments to your regimen.

Moreover, it’s crucial to monitor for any side effects while on these medications. If you experience any unusual symptoms such as severe headaches, vision changes, or other neurological symptoms, you should contact your healthcare provider immediately. Regular follow-ups with your dermatologist are also essential to assess the effectiveness of the treatment and to make any necessary adjustments.

In addition to medication, consider discussing lifestyle factors that can influence acne, such as diet, skincare routines, and stress management. Sometimes, a holistic approach that includes topical treatments, lifestyle changes, and medication can yield the best results.

In summary, while your current treatment plan does not involve the simultaneous use of isotretinoin and doxycycline, it is essential to remain vigilant about potential side effects and to maintain open communication with your healthcare provider. If you have any lingering concerns, do not hesitate to seek a second opinion or further clarification from your dermatologist. Your health and safety should always come first in any treatment plan.

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