Cream
Acne Cream
Triple-action topical for acne: antibiotic (clindamycin + erythromycin) and antifungal (ketoconazole). Covers bacterial and fungal acne.
Starting at $101/mo
AcneOral antibioticModerate to severe
Doxycycline
RxPrescription onlyTaken by mouth · Once a day · 20–50 mg · Acne · Oral antibiotic · Moderate to severe
Starting at $99/mo
Doxycycline: oral antibiotic for moderate to severe acne. Reduces bacteria and inflammation. Often combined with topical treatments.
How many doses per month?
MonthlyEvery 3 months
30 dosesper month
You'll receive 30 doses per month. $119 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Oral antibiotic effective against acne bacteria
- Anti-inflammatory effect beyond bacteria reduction
- Combines with topical tretinoin or salicylic acid
Every plan includes
- Personalized, physician-guided plan
- 30 doses per month, monthly and 3-month
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is doxycycline for acne?
(broad-spectrum oral antibiotic)
Doxycycline is an antibiotic that kills acne-causing bacteria and reduces skin inflammation. It is prescribed for moderate to severe acne, usually alongside topical treatments like tretinoin or salicylic acid. Typical doses are 50-100 mg daily; results take 4-8 weeks.
- How it is taken
- Taken by mouth
- How often
- Once a day
- Dose range
- 20–50 mg
- Form
- Acne · Oral antibiotic · Moderate to severe
Oral
antibiotic with proven efficacy in moderate to severe acne
Do not take with dairy or calcium supplements (reduces absorption). Sun sensitivity increases; SPF 30+ is essential. Avoid during pregnancy.
How it works,
week by week.
Week 1
Start with acne cream or low-dose tretinoin. Mild irritation and initial breakout may occur (normal; hang on).
Week 2–4
If using doxycycline, bacteria count decreases. Topical treatment continues; acne begins to flatten.
Week 4–8
New comedones form less frequently. Redness fades. Results become visible.
Month 2–3+
Acne significantly improved. Reduce oral antibiotic if prescribed. Continue topical treatment indefinitely at lower frequency for maintenance.
What you may notice,
and when.
Initial breakout possible
normal with tretinoin; usually resolves by week 4
Patience required
acne improvement takes 4-8 weeks minimum
Steady improvement
new spots form less often; existing marks fade
Sun protection essential
tretinoin and doxycycline increase photosensitivity
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Topical acne treatments are generally well tolerated; salicylic acid and tretinoin can cause dryness, peeling, and irritation, especially at first. Tretinoin is absolutely contraindicated in pregnancy. Doxycycline is an antibiotic; inform your physician of other medications or allergies, and avoid dairy and calcium supplements (they reduce absorption). Doxycycline increases sun sensitivity, so daily SPF 30+ is essential. Tell your physician about any isotretinoin use history (Accutane). Stop and seek care for severe irritation, signs of allergic reaction, or persistent worsening of acne.
The research behind
doxycycline.
Doxycycline is a tetracycline antibiotic used for acne at 50 mg and, at a lower sub-antimicrobial dose, for gum disease. The evidence in acne is mostly comparisons and add-on trials, and the JAMA review names it among the most effective systemic options.
- Acne reviewnamed as most effective
A 2021 JAMA review of acne management lists oral antibiotics such as doxycycline or minocycline among the most effective options for more severe disease.
Eichenfield et al., JAMA 2021;326(20):2055-67 - Add-on trial-69.1 vs -48.1 lesions
A 12-week double-blind trial in severe facial acne: trifarotene plus oral doxycycline 120 mg (133 people) against vehicle plus doxycycline placebo (69 people). Change in total lesion count was -69.1 vs -48.1. The comparison is of the combination, so it does not isolate doxycycline's own effect.
Trifarotene plus doxycycline RCT, J Clin Aesthet Dermatol 2022;15(7):E53-9 - 20 mg dosebetter gum measures
In periodontitis patients, the sub-antimicrobial 20 mg dose added to non-surgical therapy improved gingival index and pocket depth more than placebo added to the same therapy. This is a dental trial, not an acne one.
Emingil et al., Dent J (Basel) 2019;7(1):9
What the studies found
- Named by a 2021 JAMA review among the most effective oral options for more severe acne (Eichenfield et al., JAMA 2021).
- Added to trifarotene, total acne lesions fell by 69.1 vs 48.1 over 12 weeks in severe acne; the combination, not doxycycline alone (J Clin Aesthet Dermatol 2022).
- At 20 mg, adjunct to non-surgical gum treatment improved gingival index and pocket depth more than placebo (Emingil et al., Dent J 2019).
Trial results are for doxycycline at antibiotic doses (50 mg in the acne trials) and at the 20 mg sub-antimicrobial dose in the dental trial. The product here is the pharmacy's version of the same drug; compounded versions were not studied.
What this does not say
- Doxycycline is an antibiotic; the evidence supports using it for acne alongside topical treatment rather than alone, and we did not verify the current guideline wording here.
- We did not find a head-to-head trial against minocycline with clear results in this search; the comparisons we read were small.
- We did not find an acne trial of the 20 mg dose.
The research
behind it.
Doxycycline reduces Cutibacterium acnes populations and decreases inflammatory cytokines. It is effective in combination with topical retinoids.
Your physician prescribes based on acne severity and considers duration (often 3-6 months, then discontinue if acne improves).
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Doxycycline?
Taken by mouth, once a day. The starting prescription is 1 tablet (20 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Doxycycline come in?
The pharmacy carries 2: 20 mg, 50 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
Do I take doxycycline indefinitely?
No. Typical courses are 3-6 months. Once acne clears, you usually stop the antibiotic and continue topical treatment. Prolonged use increases antibiotic resistance risk. Your physician sets a timeline and reassesses every 8 weeks.
Can I use all four treatments together?
No. Typical layering: salicylic acid or tretinoin topically, plus doxycycline orally if moderate/severe, plus Clarity for healing. You don't need all four. Your physician chooses a layered plan based on acne severity.
When do I know if a treatment is working?
Give topical treatments 4 weeks and oral antibiotics 8 weeks before deciding if they work. Acne cycles naturally; don't switch treatments too quickly. If no improvement after 8 weeks, your physician will adjust.
What if I develop antibiotic resistance?
Doxycycline courses are typically 3-6 months, then stopped to minimize resistance risk. Continuing topical treatment (tretinoin or salicylic acid) maintains results and prevents relapse.
Can I use acne treatments if I'm using other topicals?
Space them: tretinoin at night, vitamin C or niacinamide in morning. Avoid mixing tretinoin with benzoyl peroxide or retinol. Your physician advises on layering safely.
Doxycycline educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
Cream
Acne Cream with Tretinoin
Acne treatment combining antibiotics (clindamycin/erythromycin/ketoconazole) with tretinoin for faster clearance and post-acne healing.
Starting at $101/mo
Cream
Brightening Cream
Stronger prescription cream for stubborn melasma and dark spots: hydroquinone 6% with tretinoin, hydrocortisone, kojic acid and vitamins C and E. A short course, usually up to 8 weeks.
Starting at $109/mo
Cream
Clarity Cream
Acne and post-acne formula combining azelaic acid, niacinamide, clindamycin, and tretinoin. Anti-inflammatory and cell-renewing.
Starting at $109/mo
References
- 1.Tretinoin in acne: efficacy, retinization, and long-term maintenance. J Clin Aesthet Dermatol, 2017
- 2.Doxycycline in moderate acne: antibiotic and anti-inflammatory mechanisms. Antibiotics, 2019
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.