COMPARATIVE EFFICACY OF ORAL DOXYCYCLINE AND MONTELUKAST IN TREATMENT OF MILD TO MODERATE INFLAMMATORY ACNE

Abstract

Objective: To compare the mean change in acne severity index with oral doxycycline and oral montelukast in treatment of mild to moderate inflammatory acne.

Methods: This quasi-experimental study was instituted at a  dermatology department of  Combined Military Hospital ( CMH) ,Abbottabad, KPK from July 2025 to October 2025, 58 patients with moderate acne were initially enrolled. The study sample was divided into two groups, 28 patients in the Montelukast group and 30 in the Doxycycline group. Baseline characteristics, including age, gender, and Global Acne Grading System (GAGS) scores, were comparable between groups. Patients received either oral Doxycycline or Montelukast for 8 weeks, and outcomes were assessed in terms of changes in acne severity (GAGS), acne-related quality of life (AQL), and treatment-related adverse events.

Results: Both therapies effectively alleviated acne symptoms while contributing to improvements in quality of life. The Doxycycline group showed a greater reduction in GAGS scores (mean change 4.5 ± 1.2) compared with the Montelukast group (1.8 ± 0.6, p < 0.001). Quality of life improved in both groups, with the Doxycycline group showing a more substantial decrease in AQL scores (18.4 ± 3.1 to 14.4 ± 2.8, p < 0.001) than the Montelukast group (19.1 ± 3.0 to 15.2 ± 3.3, p = 0.04). Adverse events were mild, including gastrointestinal upset and headache in Doxycycline group  .

Conclusion: Doxycycline demonstrated superior efficacy in reducing acne severity and improving quality of life compared with Montelukast. However, considerations such as antibiotic resistance, side effects, and patient preference should guide treatment selection. Montelukast, with a favorable safety profile, may serve as a useful adjunct or alternative therapy.