FRIDAY, March 21, 2025 (HealthDay News) – Relative to high-dose doxycycline, low-dose doxycycline is comparably effective but more tolerable for lymphocytic scarring alopecias, according to a research letter published online March 18 in the _Journal of the American Academy of Dermatology_.
Carli Needle, from the New York University Grossman School of Medicine in New York City, and colleagues evaluated the efficacy and tolerability of low- (20 mg twice daily \[BID\], 40 mg daily, and 50 mg daily) versus high-dose (50 mg BID, 100 mg daily, and 100 mg BID) doxycycline for lymphocytic scarring alopecias in a retrospective review. The analysis included 241 adults treated between 2009 and 2023.
The researchers found that high-dose doxycycline was associated with significantly higher rates of adverse effects (AEs), most commonly gastrointestinal symptoms and photosensitivity/rash. One in five (20.4 percent) of high-dose patients and 9.1 percent of low-dose patients reduced/discontinued doxycycline due to AEs. Doxycycline use was associated with improvement in inflammation severity, regardless of dose, when adjusting for the presence of at least one adjunctive anti-inflammatory medication. There was no significant difference seen between the groups for progression of hair loss or improvement in number of scalp symptoms. For patient-reported outcomes, there were no significant differences between dose groups after controlling for adjunctive therapies.
"This study highlights the benefits of low-dose doxycycline for lymphocytic scarring alopecias, showing comparable efficacy and improved tolerability relative to high doses," the authors write.
[Abstract/Full Text (subscription or payment may be required](https://www.jaad.org/article/S0190-9622(25)00304-4/abstract))