NEW YORK, March 18, 2025 — New research from NYU Langone Health show small doses of a common antibiotic could help manage hair loss with fewer side effects. The study focus on lymphocytic scarring alopecia, where the immune system attacks hair follicles, leading to hair loss and scarring.
Doctors normally treat this condition with high doses of doxycycline, which can lead to nausea and rashes, making many patients abandon their treatment. But the new study reveals that lower doses of doxycycline (20 mg taken twice daily) are just as effective as higher doses (up to 100 mg twice daily), according to research involving 241 patients.
“Our findings suggest that physicians can prescribe lower doses of doxycycline to patients struggling with lymphocytic scarring alopecia without compromising efficacy,” said Carli Needle, BA, co-lead author of the study. She emphasized that patients tolerated low doses better, with only 12% experiencing negative side effects compared to 23% with high doses.
The study evaluated scalp inflammation and hair density, and researchers saw no significant differences between the two groups. Only 16% of patients on the low dose ceased treatment due to gastrointestinal issues, suggesting lower doses may not just prevent side effects but also preserve gut health, which can be compromised by antibiotics.
“This is the first study to directly compare different doses of doxycycline for this condition,” Needle noted. The team analyzed medical records from 2009 to 2023, finding that about 27% of the patients were on lower doses, while 73% received traditional higher doses.
Lower doses might also help fight antibiotic resistance, an emerging global health issue as more bacteria survive treatment. Anna Brinks, BA, another co-lead author, stated, “Our results offer another avenue for healthcare providers to protect patients from harm caused by unnecessary antibiotic use.”
Doctor Kristen Lo Sicco, a co-senior author, raised concerns over the psychological ramifications of alopecia, which can lead to depression and anxiety. “Advancements in management for hair loss conditions are important,” she said. The research team aims for broader studies to verify their findings across diverse populations, addressing healthy gut bacteria concerns tied to doxycycline.
The Journal of the American Academy of Dermatology will publish their results today. NYU Langone Health receives funding for ongoing research in this field, ensuring continuous improvement in patient care.
