Is Acticlate (Doxycycline) Safe For Acne In Children?

Our pharmacist answers the latest question regarding whether or not it is okay to use doxycycline in children.

Sep 29, 2017

Alison asked

My 11 year old daughter was prescribed acticlate 150mg 1 per day for her acne. Is this a safe dosage and a safe medication for her? Thank you

Answer

Acticlate is also known as Doxycycline. Doxycycline is an antibiotic with a variety of uses and it is often used as an add on therapy for the treatment of acne. Antibiotics taken by mouth are typically only prescribed for those who have moderate to severe inflammatory acne and they are always prescribed as past of a combination with topical therapies. 
In terms of why they are useful, they are used to reduce the colonization of a specific bacteria known a P. Acnes. They can take one to two months to begin working and once new acne lesions are no longer forming, the antibiotics are typically stopped.
Now safety is typically a huge concern for people taking these antibiotics. In general, they are well tolerated and considered safe. Having said that, there are always things that I mention regarding them.
First of all, doxycycline is contraindicated and should absolutely be avoided in children under 8 years old. This is because doxycycline may have a serious effect on the bones and teeth in young children. This is because doxycycline is incorporated into bones and teeth that are undergoing calcification. This may cause permanent yellow or brown discoloration and enamel under development in developing teeth. Except when other therapy is ineffective, use in infants and children to the age of 8 years, should be avoided. Since your daughter is 11, this probably is of no concern unless she has issues with any kind of bone development.
The most common side effects with doxycycline are GI related. Diarrhea, nausea, vomiting, dyspepsia and abdominal pain are all possible gastric side effects. If any of these do happen, they tend to get better with prolonged use of the drug. 
While the dose of doxycycline for acne is typically lower than the dose used for infections, it can possibly cause an overgrowth of certain bacteria and cause additional stomach problems or increase the likelyhood of other infections such as yeast infections. Again, this isn't very common with the dose for acne but it is possible.
Something you certainly want to be aware of is photosensitivity. It tends to make people burn or redden easier in the sun. Care you be taken to protect yourself from the sun.
To conclude here, I want to say that it is very important to take doxycycline the correct way. 
  • To reduce the risk of esophageal irritation, ​it should be ​administered​ with adequate amounts of fluid.
  • ​Certain minerals (such as calcium) ​significantly affect absorption of the drug​. It should not be taken at the same time as multivitamins, oral iron supplements, or antacids.
​In terms of the dosage your daughter is taking, it is within the usual dosage range for acne. 
  • ​The most common dosage is 100-150 mg once daily. 

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