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The usual dosage of oral doxycycline for treating acne is 50 mg-100 mg twice daily. This agent presumably works by decreasing the population of the skin bacterium Propionibacterium acnes, which is thought to be an important element in the pathogenesis of acne. Previous research has suggested other potential actions of doxycycline, including down-regulation of inflammatory mediators and inhibition of P. acnes-derived lipase, with a resultant reduction in levels of follicular free fatty acids. These effects may occur at doses of doxycycline that are too low to inhibit bacterial growth. In this manufacturer-sponsored, multicenter, double-blind study, investigators examined the effect on moderate facial acne of a 6-month course of 20-mg doxycyc…