Doxycycline hyclate vs monohydrate: which one is better for acne?

Table of Content:
3 Key Differences | Brand Names | Side-effects and warning | Considerations when taking Doxycycline | Which one is better for acne? | How long does it take to start working? | How to get doxycycline?

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Doxycycline is a tetracycline antibiotic used to treat different bacterial infections and a very common treatment for acne¹ and rosacea²; it comes in two formulations: doxycycline hyclate and doxycycline monohydrate. In this article you will learn about the similarities between these two medications and decide with your online dermatologist if doxycycline is the right acne treatment for you.

Although acne is not considered an infection, certain antibiotics such as doxycycline or Seysara can decrease the amount of P. acnes bacteria on the skin reducing inflammation and painful breakouts³.

In addition to oral antibiotics, your online dermatologist may also prescribe you with topical retinoids used in the treatment of acne such as trifarotene, tretinoin, adapalene, tazarotene.

3 main differences between doxycycline hyclate and monohydrate in acne treatment

Doxycycline monohydrate and doxycycline hyclate are variations of the same drug, and they are both used to treat acne and rosacea.

• Doxycycline monohydrate is less acidic and more gentle on the stomach⁴
• Doxycycline monohydrate is considerably cheaper than hyclate in the U.S.
• Doxycycline hyclate is water-soluble⁵, while doxycycline monohydrate is not

Doxycycline monohydrate brand names:

• Vibramycin
• Monodox
• Oracea
• Efracea

Doxycycline hyclate brand names:

• Acticlate
• Doryx
• Periostat

Side-effects of doxycycline monohydrate or hyclate

Common side-effects of doxycycline

• Mild diarrhea 
• Photosensitivity  
• Nausea  
• Vomiting 
• Skin rashes
• Headaches 
• Tooth discoloration 

Severe side-effects of doxycycline

• Bloody diarrhea 
• Leukopenia
• Migraines 
• Hemolytic anemia 
• Throat irritation or trouble swallowing 
• Chest pain 
• Exacerbation of systemic lupus erythematosus  
• Shortness of breath 
• Irregular or fast heart rate 
• Dysuria  
• Intracranial hypertension 
• Ulcerations in the esophagus, if taken without water⁶

Warning when taking doxycycline monohydrate or hyclate for acne 

People who are allergic to doxycycline or other tetracycline antibiotics (demeclocycline, minocycline, tetracycline, or tigecycline) should not take doxycycline monohydrate or hyclate⁷.

Women who are pregnant or breastfeeding should avoid doxycycline as it may harm the unborn baby or cause permanent tooth discoloration. Doxycycline can pass into breast milk and may affect bone and tooth development in a nursing infant⁸. 

Young individuals should avoid taking doxycycline as it may cause permanent yellowing or graying of the teeth⁹.

Doxycycline can make birth control pills less effective, ask your doctor about using a non-hormonal birth control to prevent pregnancy¹⁰.

Another important question is: Can you have alcohol while taking doxycycline? This important topic is covered in detail in our in-depth article, “Doxycycline and Alcohol: Can I Drink If I Take Doxycycline?” by Dr. Carolina Fernandez.

Considerations when taking doxycycline for acne

Take doxycycline exactly as instructed by your healthcare provider

Use all the different medicines in your acne treatment plan and for the exact number of days they have been prescribed. If the treatment is not exactly followed as prescribed by your provider, your acne may develop a resistance to antibiotics¹¹. 

To increase efficacy and reduce the time needed to treat and thereby the likeliness of antibiotic resistance, your healthcare provider will most probably prescribe other acne medications such as Tretinoin, together with Doxycycline.

Use gentle skin products

By using gentle skin care products and implementing a good skin care routine for acne prone skin in combination with your prescribed antibiotics, should help clear your skin in a few weeks’ time.

Follow-up with your healthcare provider

To ensure your treatment is working and continues to do so in the future, it is extremely important that you schedule periodic appointments with your healthcare provider.

Follow your maintenance plan

Once your skin clears, it is extremely important that you continue with the maintenance plan your healthcare provider has prescribed you to avoid new breakouts. Most people can keep their skin clear by using a combination of topical solutions such as gels and creams. Using the maintenance acne treatment will help you keep your skin clear and decrease the need for stronger medications such as antibiotics.

FAQ About doxycycline for acne