Can Doxycycline be combined with Spironolactone for adult cystic acne?

i am under impression that it need to be one or the other but not both.

Doctor Answers 3

Doxycycline and Spironolactone may be taken at the same time for cystic acne in women

Doxycycline is the antibiotic most commonly used for acne, as it offers the best response with a favorable safety profile. 

As you may know, spironolactone is not an antibiotic pill nor a birth-control pill. It is a mild diuretic that is FDA-approved as a treatment for high blood pressure and commonly used to treat hormonally-influenced acne in women.  It may be continued for months/years if well-tolerated. It is not safe for pregnant women.

Although these pills may be taken together, it is best to start one oral medication at a time, in order to assess how your body tolerates one medication before adding another.

Typically, I would begin the antibiotic first, as it acts more quickly, and then in a couple weeks, add the spironolactone, if needed. However, spironolactone may be started first if preferred—and some patients find they do not need the antibiotic. 


San Diego Dermatologist
5.0 out of 5 stars 1 review

Adult cystic acne

Both can be taken simultaneously if needed. There is no interaction. I often like to use lasers for this problem too. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Spironolactone and Doxycycline for Acne...

Thank you for your question.  I am unsure where you got that impression, but there are no known interactions between Doxycycline and Spironolactone so indeed they can be taken together.  Additionally, you should be on oral contraceptives when taking these medications.  If these are not effective you can consider Flutamide as an alternative hormonal therapy for acne.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

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