How to be sun safe while taking doxycycline

In this article:

• Doxycycline and sun exposure
• What does it feel like?
• How long does it last?
• How to protect your skin
• What to do if you already have a reaction
• Sensitivity by use
• Doxycycline cost
• Expert takeaway

In this article

• Doxycycline and sun exposure
• What does it feel like?
• How long does it last?
• How to protect your skin
• What to do if you already have a reaction
• Sensitivity by use
• Doxycycline cost
• Expert takeaway

If you’ve been prescribed doxycycline, a generic antibiotic used to treat a variety of infections and prevent malaria, a healthcare provider might have warned you to stay out of the sun. One of the most common side effects of doxycycline is significant sun sensitivity that can lead to severe burns, even on overcast days. Anyone taking this medication, especially those on vacation in sunny places, must take extra precautions to protect their skin from sun damage.

Does doxycycline make you sensitive to the sun?

Yes, doxycycline makes you more sensitive to both sunlight and other ultraviolet (UV) light. The drug label contains a warning for photosensitivity and exaggerated sunburn, according to DailyMed. Sun sensitivity reactions from doxycycline are considered phototoxic (UVA light damage at the cellular level), not photoallergic (an immune system response to UVA light).

Doxycycline belongs to a class of medications called tetracycline antibiotics. “Tetracyclines as a whole are photosensitizing due to their chemical structure, which is capable of absorbing UVA radiation,” says Kara Wada, MD, FAAAAI, a board-certified allergist and immunologist and founder of the Immune Confidence Institute in central Ohio. “Think of it like turning the volume up on the sun. A small amount of sun exposure can cause a burn that’s much worse than you’d normally get.”

Both forms of doxycycline (doxycycline monohydrate and doxycycline hyclate) can cause photosensitivity. Photosensitivity can occur as early as the first dose, and research shows the risk rises with higher doses.

RELATED: List of sun sensitive medications

What does doxycycline sun sensitivity feel like?

Medication-related sun sensitivity can cause a phototoxic reaction, which feels like a sudden or severe sunburn. The reaction can occur within minutes of UV exposure, according to the Cleveland Clinic. ​

Dr. Wada says a phototoxic reaction is “a chemically amplified sunburn” that develops even after limited UV exposure. “People report a burning, itching, and some swelling to the areas exposed to the sun,” says Jennifer L. Armendariz, FNP-C, AOCNP, a family nurse practitioner and certified lifestyle medicine practitioner in El Paso, Texas. Erythema (redness) is common.​

Unlike some antibiotics, doxycycline can be prescribed for prolonged periods. It is often prescribed for several weeks or months to treat acne or to prevent malaria. Patients on doxycycline long-term may be especially prone to facial sunburns if they are unaware of sun sensitivity as a continuing side effect.

Even so, “This is not a drug allergy,” says Mary W. Chang, MD, FAAD, a board-certified dermatologist at the University of Connecticut and member of the Society for Pediatric Dermatology. “It can happen to anyone on a high enough dose of the antibiotic, coupled with enough sunlight exposure. Phototoxic skin reactions are limited to sun-exposed skin, whereas allergic rashes such as hives typically spread beyond the sun-exposed area.

How long does doxycycline photosensitivity last?

The effects of doxycycline, including photosensitivity, don’t go away immediately after the last dose of medication. The medication’s half-life is 18 to 22 hours. It takes up to 22 hours for half the medication to be cleared from the body. The medication is eliminated from the body gradually for days after that.

Photosensitivity from doxycycline begins with the very first dose. For those on long-term doxycycline courses, it’s important to remember that photosensitivity persists throughout the entire course of treatment. You will not build up tolerance over time.

Consult a healthcare provider for specific recommendations on when it is safe to resume sun exposure after stopping doxycycline.

How to protect your skin from the sun while taking doxycycline

The best way to practice sun safety while taking doxycycline is to completely avoid all UV exposure. That includes the sun, tanning beds, and UV lamps used in nail salons and certain workplace environments. Whether or not you think you’re steering clear of UV rays, Dr. Wada recommends using broad-spectrum sunscreen that covers both UVA and UVB light. 

Other sun protection strategies to use while taking doxycycline include:

• Don’t forget to reapply. Dr. Chang recommends reapplying sunscreen frequently, generally, every two hours. 
• Wear protective clothing. This includes wide-brimmed hats, gloves, and clothing made from fabrics with a high ultraviolet protection factor (UPF) rating. “I have seen a lot of people with burned scalps along the part of their hair, so please wear a hat,” Dr. Chang says. 
• Limit sun exposure time. This includes time spent in the car, near windows, or outside on cloudy days. If the sun is up, the UV rays are out. Avoid going outside during peak sun hours (mid-morning to mid-afternoon).
• Be aware of reflective surfaces. Water, glass, and glossy surfaces can reflect UV light, exposing your skin even if you’re in a shaded area.

For teens and young adults on doxycycline for acne, Dr. Chang recommends discussing alternative treatment or a break from treatment before vacationing in a sunny place. “Talk to your dermatologist about switching to a different strategy of acne management. Nowadays, all acne can be cleared with the right regimen,” she says. 

What to do if you already have a sun reaction from doxycycline

The first step is to get out of the sun immediately. After that, Dr. Wada recommends attending to the sun reaction with cool compresses and aloe vera. She says it’s also okay to take a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen to reduce pain and inflammation.

In most cases, it is not recommended to stop doxycycline before checking with a healthcare provider. Dr. Wada tells her patients that there are a few situations that warrant stopping doxycycline immediately.

These include:

• Skin blistering on sun-exposed skin
• Widespread, severe, painful redness
• Skin peeling or sloughing (this could indicate a severe drug reaction, according to Dr. Wada).
• Mouth sores or eye redness in addition to the sunburn
• Fever
• Nail changes, such as nails lifting from the nail bed.

If your sunburn peels, carefully keep the underlying skin clean to prevent skin infections. If you develop a sun reaction from doxycycline, tell your healthcare provider as soon as possible. They can offer medical advice on whether to discontinue treatment or simply avoid the sun. “The symptoms from the reaction usually will subside about 10-14 days after stopping the medication,” Armendariz says.

Does sun sensitivity differ based on why you’re taking doxycycline?

No, photosensitivity can occur regardless of why you’re taking doxycycline. The medication has the same chemical structure whether it’s prescribed for an infection, acne, or malaria prophylaxis.

​That said, anyone taking doxycycline for malaria prevention in a tropical location may be at a higher risk due to sunnier conditions. Those taking doxycycline for acne may also have a higher risk. Because long-term, cumulative treatment presents more opportunity for doxycycline side effects to occur.​

People with Lyme disease, chlamydia, respiratory infections, urinary tract infections, and other bacterial infections are prescribed shorter courses of doxycycline. According to DailyMed, short courses typically run seven to 10 days, though treatment for certain conditions may extend to 14 days.  Shorter courses mean shorter windows of photosensitivity risk, but the risk is still present from the very first dose.

The hyclate and monohydrate formulations are interchangeable for most uses, and pricing may vary by form. The doxycycline dosage is usually one oral capsule or tablet taken once or twice daily.

Sun sensitivity risk by doxycycline use case
Use case	Typical duration	Primary concern	Key precaution
Acne	Varies; weeks to months	Facial sunburn; awareness that photosensitivity persists throughout treatment	Avoid direct exposure to UV light; wear broad-spectrum sunscreen
Malaria prophylaxis	Varies; dosage begins 1-2 days before travel and continues for up to 4 weeks after	Travel to areas with high UV exposure; awareness that photosensitivity persists throughout treatment	Wear sun-protective hats and clothing; wear broad-spectrum sunscreen
Lyme disease, respiratory/other bacterial infections	5-14 days	Sunburn to any UV-exposed areas	Avoid direct exposure to UV light; wear broad-spectrum sunscreen

How much does doxycycline cost?

Doxycycline is a commonly prescribed, low-cost generic antibiotic. Without insurance, doxycycline hyclate costs $37.33 for 14, 100 mg capsules, and doxycycline monohydrate costs $16.85 for 14, 100 mg capsules. 

A free SingleCare coupon can significantly reduce the cost of doxycycline at most major pharmacies. For instance, you can use a SingleCare coupon to reduce the cash price of doxycycline hyclate to $10.65 for 14, 100 mg capsules.

Expert takeaway

Doxycycline is an inexpensive, effective antibiotic that is often prescribed for a variety of infections. Leslie Greenberg, MD, Associate Professor of Community and Family Medicine at University of Nevada Reno Family Medicine Residency Program, advises her patients who are taking doxycycline to wear sun protection and broad-spectrum sunscreen for both UV-A and UV-B rays.