How long to take Doxycycline for hidradenitis suppurativa?

Question

Hello doctor,

I was prescribed 60 capsules (100 mg) of Doxycycline for hidradenitis suppurativa flares. The instructions state to take one capsule twice daily as needed for flares. However, there is no listed duration explaining how many days in a row the medication should be taken.

I was prescribed sixty capsules so that they can be used as needed over a longer period of time to help keep chronic flares under control, but I am unsure how many consecutive days I should take them when a flare occurs.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

It is understandable that the chronic nature of hidradenitis suppurativa (HS) can be painful and distressing, especially when recurrent flares and scarring occur. Although there is currently no permanent cure for hidradenitis suppurativa (HS), the condition can often be effectively controlled with appropriate treatment and flare management. Early treatment of flares is important to reduce inflammation and limit the risk of scarring.

In hidradenitis suppurativa (HS):

Doxycycline is commonly prescribed because it has both antibacterial and anti-inflammatory effects. When doctors prescribe 100 milligrams twice daily as needed for flares, it usually means starting the medication when a flare begins, such as when painful nodules, swelling, redness, or drainage appear.
In most cases, Doxycycline is taken for about seven to 14 consecutive days during a flare, or until the inflammation clearly improves.
Taking the medication for only one or two days is usually not effective because Doxycycline works mainly through anti-inflammatory mechanisms that require several continuous days of treatment.
Many doctors recommend at least seven days per flare, and if the flare is more severe, the treatment may be continued for 10 to 14 days, unless the prescribing doctor provides different instructions.

The prescription of 60 capsules is often provided so that multiple flares can be treated over time without requiring a new prescription for each episode.

For safe use, the capsule should be taken with a full glass of water, and it is advisable to remain upright for at least 30 minutes after taking the medication to reduce the risk of irritation of the esophagus. Doxycycline may also increase photosensitivity, meaning the skin can become more sensitive to sunlight, so excessive sun exposure should be avoided, and sun protection should be used.

If flares occur very frequently, do not improve after 10 to 14 days of treatment, or start happening every few weeks, it is advisable to follow up with a dermatologist. In such cases, longer-term treatment options or additional medications may be required to better control hidradenitis suppurativa (HS).

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.