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Minocycline
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Minocycline pills are antibiotics sold as Minocin, Dynacin, Vectrin, Solodyn and generic minocycline. This antibiotic has been in use since the 1970's and is a great acne therapy. It kills the acne bacteria more effectively than many other acne pills and has a separate "anti-inflammatory" effect. This means it reduces the redness, swelling and tenderness or pimples whether it kills the acne bacteria or not. Because of this effect, minocycline is now also being used for some people with painful, swollen joints.

Of all the antibiotic pills used for acne, minocycline is one of the most effective, easiest to take and has the least side effects. Side effects do occur, but are usually minor. Minocycline rarely causes significant blood or internal problems. A topical acne cream is normally used along with these pills.

Start off taking it only at bedtime for a few days until ones body gets "used to" this medication. During this time dizziness or headaches may occur. These last a few hours and are gone by the morning. After that, the medication can be taken any time and is easiest to remember at meals. Only the generic form must be taken one hour before or two hours after meals. If the side effects continue, the drug can be taken at a lower dose or stopped. One in a hundred people have an allergy to the drug which shows up as outbreaks of hives two or three weeks into the treatment, or feeling sick or unwell.

There are a few significant, but very rare side effects that develop in about 1 in 10:000 people. One is hypersensitivity lupus/hepatitis, which causes severe joint pains. The other is pseudotumor cerebri (an accumulation of fluid around the brain) that causes progressively worsening headaches and vision problems. Stop the medication if these occur. They resolve over time, but very slowly. These also occur with some other antibiotics. A form of lupus seems unique to minocycline. It appears after taking the pill for an average of 3 years. Remember that facial scarring and long lasting psychological harm are very real "side effects" of acne and are much more common than 1 in 10,000.

If acne does not improve after several months of minocycline, a dermatologist will change the acne medicine to a different one. If the acne improves, the dose needs to be lowered or minocycline will build up in the body. As this accumulates, the medication turns dark purple in the body and might show up as a discoloration. This looks like bruises that don't go away, or dark pigment in acne scars. The pigmentation will clear up as long as it is recognized and the medication is stopped, but it may take a year or more. This is one of the reasons regular exams are needed for people on minocycline. More difficult pigmentation problems occur if the maximum dose is taken for a few years. Recent research has show that the pigment problems may be avoided by taking Vitamin C 500mg twice daily.

Overall, minocycline is safer than ibuprofen or penicillin. Minocycline has been a standard treatment for severe acne for over 20 years and has been proven safe and effective with proper usage.

 

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The medical information provided in this site is for educational purposes only and is the property of the American Osteopathic College of Dermatology. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. If you have a specific question or concern about a skin lesion or disease, please consult a dermatologist. Any use, re-creation, dissemination, forwarding or copying of this information is strictly prohibited unless expressed written permission is given by the American Osteopathic College of Dermatology. 

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