Question: Hello, I have suffered from moderate cystic acne for several years. In early 2012, I began taking 100 mg of doxycycline. A few weeks after I began taking the drug, I noticed that my cystic acne had been tamed. The drug worked throughout the remainder of the summer, so much so that I decided to take myself off it around October (roughly seven months after I began taking it). Well, about three weeks after I went off the doxy, my cystic acne came back in full force! Large, red nodules (that were incredibly painful) began forming around my chin and jawline -- even worse than before. I began using epiduo as a topical solution to treat the cysts, but it seemed as if whenever one went away, a new one would pop up. I eventually made a an appointment with my dermatologist, who prescribed me doxy once again. However, this time when I began taking the drug, it didn't have the same effect. In fact, it seemed like the cystic acne never went away! I've read that after you stop taking doxy, your body develops an immunity to it, which I'm guessing is what happened. That said, after about a year of dealing with cystic acne all over my jawline and chin, my dermatologist prescribed me 100mg of minocycline. That was back in September of 2013, and since then, my cystic acne has once again been tamed. However, during my last visit back in November, my dermatologist told me that I should use the minocycline sparingly -- and not take it everyday. I want to follow his instructions but I'm afraid that if I stop taking the minocyline, my cystic acne will come back in full force. I realize I can't take this antibiotic forever (and I do have a prescription that's good until early May), so what should I do? Will my cystic acne return even worse than it did before if I stop taking the minocycline? What are the long-term effects if I do take minocycline for an indefinite period of time? I don't want my chin and jawline to be covered in painful cysts, but I also don't want to have long-term health problems over some acne. Mind you, I'm a 32-year-old man, and I've read that hormonal acne usually only effects women. Are there other ways to prevent cystic acne without taking an antibiotic? Thanks in advance for your help.

Thanks for the speedy follow-up! I've attached a few photos for you to look at. I realize the zits aren't that bad and I probably shouldn't be agonizing over them but I had such a horrible yearlong breakout last year that I just want to do everything in my power from preventing that from happening again. That said, in addition to the 100mg of minocycline I'm taking daily, I also use epiduo if I feel a new cyst sprouting up. Some other questions I have, if you miss a dose of minocycline, will that cause a new cyst to form? And is stress a factor in forming cysts? Because it seems like the minocycline was working extremely well last month, when I was stressing out about things, but now I have a lot to stress about, and a few new ones have formed. Also, when my prescription of minocycline runs out in May, will my cysts come back if I stop taking them? Thank you again and I look forward to hearing your response!