Minocycline and Acne

Although acne is linked to diet and hormones, the actual acne bumps themselves are the result of bacteria beneath the skin.

For cases of mild acne, washing you face with a cleanser is generally enough to clear off the acne from your skin. But when your acne is less controlled, you may need something stronger to reduce bacterial buildup and prevent acne outbreaks.

For that, many doctors recommend minocycline for acne – one of the many tetracycline broad spectrum antibiotics for acne.

What is Minocycline?

Minocycline is a broad spectrum antibiotic – meaning that it is designed to eliminate all types of bacteria rather than a specific bacteria subtype.

It's a member of the tetracycline family, which is a larger group of antibiotics used to clear up a number of different bacteria related diseases. While many people use minocycline for acne, the prescription drug may be prescribed for several types of disease including:

• Anthrax
• Pneumonia
• Bubonic Plague
• Rosacea
• Urinary Tract Infections
• Cholera
• Rocky Mountain Spotted Fever

These are just a few of the potential uses of this powerful antibiotic. However, while broad spectrum antibiotics may be valuable for curing more dangerous diseases, it can also be used for less serious diseases, which is why many doctors prescribe minocycline for acne.

Acne and Minocycline

Many antibiotics in the tetracycline family are considered effective for treating acne, and minocycline is no different. In fact, acne is the most common reason that minocycline is prescribed.

Like other antibiotics, minocycline works by eliminating bacteria that builds up on the skin.

Minocycline works very quickly, and some report a faster response to minocycline than to other antibiotics, particularly in the tetracycline family. Minocycline is also not generally combined with other topical treatments, although your doctor may decide that an additional topical treatment may be useful.

Most people report success in clearing up their acne with minocycline, even compared to other tetracycline antibiotics.

Side Effects of Minocycline for Acne

The primary issue with minocycline is its side effects.

Many people report side effects while taking minocycline. More side effects, in fact, than many of the other antibiotics in the same family. While all medications have their own risks, minocycline appears to have side effects that are more pronounced than other available options.

Common side effects of this medication include:

• Diarrhea
• Vomiting
• Nausea/Upset Stomach
• Drowsiness
• Headache
• Dizziness

These side effects may be more common in minocycline than in other acne tetracycline medications. A not-insignificant amount of people taking minocycline for acne reported severe nausea and vomiting as a result of taking the drug.

Like other medications in the tetracycline family, minocycline also creates a sensitivity to light. This may result in easily burnable skin (getting a sunburn more easily than in the past) or in an allergic reaction to sunlight, known as photosensitivity. Sun bathing and extended periods of time in the sun without sunscreen is not advised.

An unusual side effect of minocycline is a blue/gray skin and tissues. Many people report blue or gray skin discoloration in their skin or gums. It can take a very long time for this blue color to fade.

In some cases, exposure to sun can cause a brown skin discoloration. This may be permanent.

Minocycline for acne has also been linked to more serious conditions like liver damage and hepatic lupus (lupus of the liver). These conditions are rare, but have been linked to both short and long term minocycline use.

Minocycline may also be linked to dizziness, personality changes, and possibly some cancers – although research into these areas is lacking.

The FDA is currently monitoring minocycline as a result of these high numbers of side effects.

It should also be noted that minocycline, like other broad spectrum antibiotics, kills good bacteria as well as bad bacteria. It doesn't discriminate between bacteria subtypes. This means that you may be at risk for developing infections as a result of lost "good" bacteria, such as a yeast infection.  

Minocycline and Bacterial Resistance

Another issue with minocycline use is bacterial resistance.

All antibiotics – both those taken according to correct dosing schedules and those taken incorrectly – are at risk of developing bacterial resistance.

Bacterial resistance occurs when bacteria adapts to the medicine and becomes immune to it. Eventually, this causes bacteria to grow despite of the medication, and the medication essentially stops working.

Bacterial resistance can happen at any time – or not at all. For some, it happens right away, and immediately your acne will grow back. Often it takes longer than a few months, but long term minocycline use often leads to bacterial resistance, which in turn means your acne is no longer able to be kept at bay by the medicine.

Another issue, though rare, is resistance to more serious bacterial infections. It's possible to catch more dangerous bacteria that becomes immune to minocycline, reducing one possible treatment option. This is one of the reasons that antibiotic use without an illness is generally discouraged; in order to prevent more serious bacteria from becoming immune to antibiotic treatments.

Despite these issues, doctors still often prescribe minocycline to those suffering from moderate to severe acne.

How to Use Minocycline for Acne

Minocycline is an oral prescription medication. It does not come in topical form, because the chemical itself tends to become damaged when it interacts with air and water. Pharmaceutical companies are trying to develop a minocycline topical treatment but have yet to have success.

Because of the side effects of minocycline, doctors recommend several techniques in order reduce the symptoms and improve absorption.

Note: Each minocycline drug comes with its own set of instructions. Review your doctor's information and the pamphlet on how to use minocycline for acne that came with your medication. The following is simply a reference.

Generally, the minocycline dosing for acne is either 50 or 100mg tablets, taken once or twice a day. It's recommended that you drink at least a full glass of water with the medication – 8 ounces or more.

You should try taking minocycline without food. You can take it with food if you experience nausea or an upset stomach when taking minocycline, but this reduces the potential benefits of the medicine so it is not recommended.

Minocycline for acne needs to be taken at roughly the same time every day to keep a constant level of the drug in your system. Many drug pamphlets also recommend that you do not lie down for at least 10 minutes after taking the drug to prevent side effects and ensure comfort. You should also avoid taking any medications with calcium, aluminum, magnesium, antacids, or vitamin/mineral supplements. These can all counter the efficacy of the drug.

Minocycline needs to be taken exactly as prescribed by your doctor to not only cure acne, but also to ensure that bacteria does not become resistant to the drug. Any variation in your dosing schedule can increase the likelihood of bacterial resistance.

The Relationship Between Acne and Minocycline

It should also be noted that minocycline does not cure all acne. While some report a 100% acne reduction, most generally see somewhere between 50% to 80% of their acne reduced, with a few seeing less. You should still expect some acne buildup.

Also, minocycline does not prevent against scarring. Broken acne can create scars, which in turn may lead to the appearance of acne without acne being present.

Overall, minocycline is an effective antibiotic. However, the risk of side effects can be fairly severe – more so than other antibiotics in the tetracycline group, and far more than acne washes, supplements and other potential acne treatments.

As such, it is strongly recommended that you consider other options first before taking one of these powerful prescription medications. You should also never take minocycline without a prescription, and always take the correct dose at the correct time while following the user guide to the letter to ensure there are no ill effects.

Only if your doctor decides that minocycline is the best available treatment for your acne should you consider using the powerful prescription drug. Otherwise, it may be in your best interests to consider alternative options.