Small amounts of doxycycline can curb symptoms of lymphocytic scarring alopecia, a new study shows.
Physicians typically treat this chronic disorder with relatively high doses of doxycycline, often for prolonged periods of time. However, the drug can trigger nausea, vomiting, and rashes and may discourage patients from continuing to take it, the study authors say. As a result, the team set out to determine whether lower doses could work instead.
The findings in 241 men and women treated for several forms of lymphocytic scarring alopecia revealed that lower doses (usually 20 milligrams taken twice daily) and higher doses (as much as 100mg taken twice daily) of doxycycline were equally effective. Specifically, the researchers found no significant difference between the two groups on evaluations of scalp inflammation, patients’ perception of the severity of their hair loss, and clinical measurements of hair density, hair-shaft diameter, and hairline recession.
In addition, while 23% of those on the high-dose regimen experienced common negative side effects of doxycycline, only 12% of those taking smaller doses of the drug did so. Another key finding was that while 25% of the high-dose group stopped taking doxycycline altogether due to gastrointestinal issues, only 16% of the low-dose group stopped treatment due to this side effect.
“Our findings suggest that physicians can prescribe lower doses of doxycycline to patients struggling with lymphocytic scarring alopecia without compromising the efficacy and anti-inflammatory benefit of the therapy,” says co-lead author Carli Needle, BA, a medical student at NYU Grossman School of Medicine, in a news release.
The new study is the first to directly compare the efficacy of different-size doses of doxycycline to treat lymphocytic scarring alopecia, says Needle.
A report on the findings is publishing March 18 in the Journal of the American Academy of Dermatology.
For the study, the research team collected data from electronic medical records of patients with scarring alopecia treated at NYU Langone Health between 2009 and 2023. Of these, about 27% had been prescribed low doses of doxycycline and nearly 73% were on traditional high-dose regimens. Next, the team ran a statistical analysis to compare the two groups. The researchers discounted from their analysis any effects of other medications that commonly accompany this treatment, such as the hair-growth drug minoxidil.
According to the authors, a further advantage of reducing doxycycline doses is that experts have linked the drug to the rise of dangerous bacterial populations that can survive antibiotic treatments. Clinicians worldwide are now seeking to combat such antibiotic resistance by limiting how often and in what quantities they prescribe these drugs, a practice called antibiotic stewardship.
“Our results offer another avenue for healthcare providers to protect patients from harm caused by unnecessary antibiotic use and address the rise of drug-resistant strains of microbes,” says study co-lead author Anna Brinks, BA, a medical student at NYU Grossman School of Medicine.
“Alopecia can have a devastating effect on self-image and can lead to social judgment, depression, and anxiety,” adds study co-senior author Kristen Lo Sicco, MD. “Studies that advance the management of these conditions are critical to addressing not only hair loss itself, but also the psychological and social consequences that accompany it.”
Lo Sicco, MD, an Associate Professor in the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine, says that the researchers next plan to repeat their work in a larger and more diverse group, as the study patients were mostly White.
In addition, she says the team intends to explore the triggers that cause lymphocytic scarring alopecia, which remain poorly understood.
PHOTO CREDIT: DermNet
