Doxycycline and azelaic acid gel

Take doxycycline once daily, ideally with a meal and a full glass of water. Sit or stand while taking it, and avoid lying down for at least 30 minutes afterwards so it’s less likely to irritate your stomach. 

How to apply azelaic acid gel:

1. Wash your skin with a mild, non‑foaming face wash and pat dry.

2. Apply a pea sized amount (0.5g) in a thin layer over the affected areas twice daily.

3. Let it absorb into your skin before you use moisturiser (or put on make‑up). 

4. Wash your hands.

Use daily for smoother skin, reduced redness and fewer breakouts. If the gel stings or tingles at first, switch to just the evening application for about a week. 

Once your skin feels comfortable (no lasting redness, burning or peeling), add the morning dose so you’re back to the usual twice‑daily schedule. If irritation comes back when you introduce the second application, go back to once daily or take a short break. You could check with your doctor or clinician before increasing it to twice daily again.

Doxycycline is an antibiotic that reduces the amount of acne-causing bacteria on your skin and calms inflammation. 

To help shrink spots and improve skin tone by fading lingering dark marks from acne, azelaic acid gel has a dual action: 

• Works to exfoliate dead skin and trapped sebum (oil) inside pores.

• It’s antibacterial, lowering bacteria levels and calming inflammation.

Combining the two increases the chance of getting smoother, less inflamed skin by tackling different acne triggers at the same time.

It usually takes around 6 weeks before oral antibiotics like doxycycline make a noticeable improvement in your skin. 

Most people who use azelaic acid see clearer, calmer skin by week 4 and the benefits can increase right up to the 12 week mark. In clinical studies, azelaic acid  gel  clears inflammatory acne about as well as 5% benzoyl peroxide while causing less burning or irritation.

Doxycycline may make your skin more sensitive to sunlight, so use a non-oily sunscreen and avoid using sunbeds. Other possible side effects include nausea, dizziness, an upset stomach or diarrhoea. Always let your doctor or clinician know if you get severe or persistent symptoms. 

Typical azelaic acid  gel side effects are mild itching, tingling or dryness where you apply it. These usually ease as your skin adapts. If you keep getting irritation, only apply the gel once a day or stop using it for a day to give your skin a break. 

Severe reactions are rare. If you notice a widespread rash or swelling, stop using the gel and seek medical advice Overall, azelaic acid gel side effects are gentler than with many other prescription-strength acne treatments. In particular it generally causes less dryness and sensitivity to sunlight than topical retinoids.

Full details on use and safety are in the doxycycline and azelaic acid gel patient information leaflets.