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How Do I Treat a Doxycycline Rash?

By Susan Abe
Updated Mar 06, 2024
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Doxycycline, a widely used antibiotic in the tetracycline class, is crucial in combating various bacterial infections, including anthrax, and serves as a prophylactic for malaria. However, its use is not without risks. Multiple studies have confirmed that antibiotics like doxycycline can cause photosensitivity, leading to skin reactions in 3-6% of individuals exposed to sunlight while on the medication. 

Distinguishing between an allergic reaction and a photosensitivity-induced doxycycline rash is vital, as the latter may present with a rash after sun exposure. For those seeking clarity, doxycycline rash pictures can be a helpful resource to compare symptoms and understand potential side effects. Prioritizing accurate diagnosis and safe sun practices is essential for individuals on long-term doxycycline therapy.

An allergic doxycycline rash usually occurs early in the course of a given treatment, often on the second or third day of therapy, although it may clinically present itself sooner. A rash associated with doxycycline may be allergic in origin, newly arisen, even if the patient has been treated with the medication in the past and without incident. Antibiotic allergy rashes can present as scattered red pinpoints, hives, or welts. The first step in treatment is to discontinue doxycycline and call the treating physician. A second choice antibiotic will probably be prescribed in its place.

Discontinuation of the medication will not have an immediate effect on an existing allergic doxycycline rash. If possible to use, oral antihistamines may help decrease the systemic allergic reaction. Over-the-counter anti-inflammatory agents, aspirin or acetaminophen can help the swelling. If the doxycycline rash is itchy or irritating, gently bathe the area in a warm oatmeal bath and pat the area dry with a soft towel. Anti-itch ointments and lotions can also be applied to the local area to prevent scratching and subsequent skin breakdown.

Another type of doxycycline rash that may require your attention occurs secondary to sun exposure. The easiest way to deal with this rash is by prevention: use hats, visors, sun umbrellas and sunscreen liberally. In the event that you are overexposed to the sun, treat any resulting sunburn or rash with ointments and lotions to decrease the inflammation and soothe the irritated skin. The difficulty in treating this type of doxycycline rash is that you may be permanently at risk for its development as chronic use of this antibiotic can result in permanent skin photosensitivity.

How Long Doxycycline Rashes Last

One of the common side effects of Doxycycline is the manifestation of skin rashes that often appear within nine days of using the antibiotics. The rashes predominantly appear on sun-exposed skin parts such as the forearms, face, chin, and neck since sunlight exacerbates them. 

Secondary skin rash patches may also appear in the non-exposed areas of the skin, such as the back and chest.

The rashes disappear when the antibiotic's dose discontinues, and the administration of oral antihistamines such as Loratadine and Hydroxyzine commences. These medicines are usually administered alternately in the morning and evening. 

After a week of this administration, there should be a tremendous decline in the Doxycycline-induced rashes. The rashes should completely disappear after two weeks of treatment.

However, a few factors may contribute to how long the rashes last. Exposure to sunlight may cause the rashes to increase, thus taking longer to disappear. Therefore, if you keep the rashes away from sunlight, they may not last as long.

Other Symptoms Accompanying Doxycycline Rashes

Although Doxycycline prescriptions manage infections and various conditions, they may induce allergic reactions in some patients. These reactions are not limited to skin rashes and may result in other symptoms that indicate that a patient should discontinue the medication.

Besides the rashes, other common side effects you may experience from Doxycycline include headaches, stomach upsets, nausea, and vomiting

However, there are practical coping mechanisms you can use to deal with these issues. For instance, you can take painkillers, rest, and upscale your fluid intake to deal with the headaches. Similarly, you should avoid spicy foods and hydrate regularly to cope with the stomach-related side effects. 

If these symptoms persist, consult your doctor to ascertain the way forward.

In some rare occurrences, a patient on Doxycycline may experience severe side effects. These usually occur in 1 in 1,000 patients and include:

  • Inexplicable bleeding and bruising. Doxycycline may cause random bruises and cause bleeding, such as nosebleeds with unexplained origins. These are usually indications of blood problems that may cause the patient to feel fatigued.
  • Diarrhea. Patients may experience diarrhea containing blood or mucus, accompanied by severe stomach cramps.
  • Stained teeth. This symptom usually occurs in children below eight years old. The medicine may lead to teeth stains causing them to appear grayish.
  • Unusual excretion. Patients on Doxycycline may excrete dark urine and pale bodily waste when they visit the bathroom. These symptoms may indicate liver damage, especially if the patient's eyes and skin turn yellow.
  • Inflamed food pipe. The mouth may appear swollen and feel sore. Similarly, patients may experience a severe sore throat, making it difficult to ingest food, leading to a decreased appetite.

Patients who experience these symptoms should stop taking the Doxycycline dose and seek medical assistance immediately to prevent the symptoms from becoming aggravated.

How To Prevent Doxycycline Rashes When Under Medication

Doxycycline often causes rashes on a patient's skin since the antibiotic increases your skin's sensitivity to sunlight. Exposure to sunlight while under the medication, even for a few minutes, can cause rashes, itching, or other skin-related sensitivity issues. 

Therefore, it's a good idea to do what you can to limit your exposure to sunlight while you're taking this medication.

You may lower your risk of developing Doxycycline rashes by remaining indoors to avoid direct sunlight, especially from 10 AM to 3 PM. If you must step into the sunlight at these times, ensure you take protective measures to minimize your exposure. You could wear hats, sunglasses, and other clothing that provides UV protection..

Similarly, you can apply sunblock products with a protection factor of at least 15. However, people with sensitive skin may need products with a higher protection factor. Consult your doctor or dermatologist for the right sunblock product while taking Doxycycline.

Alternative Antibiotics in Place of Doxycycline

Doxycycline is a commonly prescribed antibiotic to combat various bacterial infections and illnesses. However, it may cause allergic reactions in some instances, necessitating alternative medications.

Minocycline is a common alternative used to combat some conditions. It is an effective alternative in fighting Lyme disease prophylaxis, skin and soft-tissue infections, and respiratory tract infections such as Mycoplasma pneumoniae.

Similarly, other tetracycline antibiotics such as Amoxicillin, Azithromycin, Cephalexin, and Ciprofloxacin provide alternative options to Doxycycline in different scenarios. Your doctor will prescribe the best alternative antibiotic based on your illness.

FAQ on Doxycycline Rash

What is a doxycycline rash and what are its common symptoms?

A doxycycline rash is a skin reaction that can occur as a side effect of taking the antibiotic doxycycline. Common symptoms include redness, itching, or hives on the skin. In some cases, the rash may be a sign of a more serious reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, which require immediate medical attention. It's important to monitor the rash and consult a healthcare provider if it worsens or is accompanied by other symptoms like fever or difficulty breathing.

How can I treat a doxycycline rash at home?

To treat a mild doxycycline rash at home, you can apply cool compresses to the affected area to soothe irritation. Over-the-counter antihistamines may help reduce itching and swelling. It's also important to avoid sun exposure, as doxycycline can make your skin more sensitive to sunlight, potentially worsening the rash. However, if the rash is severe or persistent, it's crucial to seek medical advice rather than relying solely on home treatment.

When should I see a doctor for a doxycycline rash?

You should see a doctor for a doxycycline rash if the rash is severe, covers a large area of your body, or is accompanied by other symptoms such as fever, blistering, or difficulty breathing. Additionally, if the rash does not improve with home treatment or continues to spread, medical evaluation is necessary to rule out more serious conditions and to potentially adjust your medication regimen.

Can a doxycycline rash be prevented?

While not all rashes can be prevented, minimizing your risk of developing a doxycycline rash involves taking the medication exactly as prescribed and avoiding excessive sun exposure by wearing protective clothing and using sunscreen. It's also important to inform your healthcare provider of any known drug allergies or previous reactions to antibiotics before starting doxycycline. If you have a history of drug-induced rashes, your doctor may choose an alternative medication.

Is a doxycycline rash contagious?

No, a doxycycline rash is not contagious. It is a reaction to the medication and not caused by an infectious agent that can be transmitted to others. However, if the rash is a symptom of an underlying infection that is being treated with doxycycline, it's important to consider whether the infection itself is contagious and take appropriate precautions.

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Discussion Comments

By anon936053 — On Feb 27, 2014

I had the same rash and I went to a walk in clinic and they gave me a shot in my butt with prednisone, I think, and the rash was gone in two or three days. The itching stopped within an hour from the shot.

By anon933483 — On Feb 16, 2014

I've been on these for five days and this rash has spread from my armpits, down my arms to my hands. It is also around my groin area now and is also on my abdomen. I only need to take them for a couple of days more so I might ride it out.

Good emollient cream seems to take away most of the itching. It just looks unsightly!

By anon926863 — On Jan 21, 2014

Can I take an antihistamine while taking doxycycline? I have peri oral dermatitis and am having an itchy flare up.

By SteamLouis — On Oct 04, 2013

@fify-- Also, stay out of sunlight and wear long clothing. I thought that I had a regular allergic rash from doxycycline but it turned out to be a sun rash. Doxycycline makes skin so sensitive to sunlight that even a little exposure can cause a sun rash with red spots, weird discoloration and even sores.

I though that I would be fine as long as I had sunblock on but that is not the case. Long clothes and a large hat are a must when going outside. Even then, stay in the shade!

The rash goes away on its own as long as you avoid the sun. Pure aloe vera gel is helpful.

By ZipLine — On Oct 04, 2013

@fify-- Is your course of doxycycline over or are you still on it? If you're still on it, then you need to see a doctor so that the doctor can decide whether to continue treatment with it or not. If the rash is not severe, then he will probably have you finish it. But if the rash is bad and getting worse or if you have other symptoms like trouble breathing, you have to quit the medication and go to the hospital right away. Allergic reactions are nothing to mess with, they can be dangerous.

If your treatment is over and if the rash is not getting worse, go ahead and pick up an over the counter steroid cream like a corticosteroid cream. You might also want to take a tablet medication for allergies. Ask the pharmacist for a recommendation.

By fify — On Oct 03, 2013

I've developed a mild rash from doxycycline. I don't think that it's serious enough to see a doctor about. I just have hives on my legs and chest, along with redness. Will an over the counter steroid cream from the pharmacy be enough to treat it?

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