How do I go about getting doxycycline hyclate injections for malar edema/festoons?

Question

I've come across several academic papers on small trials trying the improvement of malar edema and lower eyelid festoons following Direct Doxycycline Hyclate Injections.However, I can't find any providers offering this treatment despite the successful results noted in the trial. How do I go about acquiring this treatment since it does not appear to be widely adopted or available? Thanks, Alison

James M. Economides, MD, FACS · Answer

Alison, it's great that you've done some research into this treatment. Doxycycline Hyclate injections for malar edema and festoons are still in the experimental or investigational phase, which is why you may not find many providers offering it as a standard treatment. Here are some steps you can take to pursue this option:

1. Consult with a Specialist:
Reach out to Oculoplastic or Plastic Surgeons: Specialists who focus on the periorbital area, such as oculoplastic surgeons or dermatologists with expertise in facial aesthetics, are most likely to be aware of newer treatments. Some providers might be familiar with the research, even if they aren’t currently offering the treatment.
Ask About Off-Label Use: Since Doxycycline is an FDA-approved antibiotic, some providers may be willing to use it off-label for injections if they feel confident about its safety and efficacy in your case. Be prepared to discuss the studies you’ve found with your provider and ask if they’d consider this option.
2. Contact Clinical Researchers:
Reach Out to Researchers or Study Authors: Since you've already encountered academic papers, try reaching out to the researchers or institutions involved in those studies. Sometimes, they may be conducting ongoing trials or offering the treatment in a limited capacity.
Investigate Clinical Trials: While small trials might not be widely advertised, clinical trial databases (like ClinicalTrials.gov) may list ongoing or upcoming studies that you could potentially join.
3. Specialty Clinics and Research Centers:
Some research-based medical centers or academic hospitals may adopt new treatments faster than private practices. If you're near a large city or university hospital, explore whether they have providers who are exploring this technique.
4. Second Opinions from Pioneering Clinics:
If you’re willing to travel, seek out clinics known for being early adopters of new treatments. Providers in major cosmetic surgery hubs or teaching hospitals might be more inclined to offer or explore cutting-edge treatments.
5. Alternative Treatments:
While waiting for the wider adoption of this treatment, you may want to discuss alternative treatments for malar edema and festoons with your provider, such as laser therapy, radiofrequency, or less invasive options that are more widely available.

Anna Chacon, MD, FAAD · Answer

Thank you for your question regarding doxycycline hyclate injections for malar edema and festoons. While there have been some promising small trials exploring this treatment, it is not yet widely adopted or available in clinical practice. Here are a few steps you can take to explore this treatment option further:

Consult a Dermatologist or Plastic Surgeon: Schedule a consultation with a board-certified dermatologist or plastic surgeon who has experience in treating malar edema and festoons. They may be aware of current research and emerging treatments and can provide guidance on the best course of action for your condition.

Academic Medical Centers: Consider reaching out to academic medical centers or universities that conduct clinical research. They may be conducting clinical trials or have more information on where such treatments are available.

Clinical Trials: Look for ongoing clinical trials that you may be eligible to participate in. Websites like ClinicalTrials.gov can provide information on current studies and how to enroll.

Professional Societies: Contact professional societies such as the American Academy of Dermatology (AAD) or the American Society of Plastic Surgeons (ASPS). They may have resources or be able to connect you with specialists who are familiar with this treatment.

Second Opinions: If you have already consulted with a local provider, consider seeking a second opinion from another expert who may have different insights or access to experimental treatments.

It's important to have a thorough discussion with your healthcare provider about the potential benefits and risks of any treatment, especially those that are not yet widely adopted.

How do I go about getting doxycycline hyclate injections for malar edema/festoons?

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