A Review of Systemic Minocycline Side Effects and Topical Minocycline as a Safer Alternative for Treating Acne and Rosacea

Abstract

Resistance of Cutibacterium acnes to topical antibiotics historically used to treat acne (topical erythromycin and clindamycin and, more recently, topical azithromycin and clarithromycin) has been steadily increasing and new topical antibiotics are needed. Minocycline is a semisynthetic tetracycline-derived antibiotic currently used systemically to treat a wide range of infections caused by Gram-negative and Gram-positive bacteria. In addition to its antibiotic activity, minocycline possesses anti-inflammatory properties, such as the downregulation of proinflammatory cytokine production, suppression of neutrophil chemotaxis, activation of superoxide dismutase, and inhibition of phagocytosis, among others. These characteristics make minocycline a valuable agent for treatment of dermatological diseases such as acne vulgaris and papulopustular rosacea. However, more frequent or serious adverse effects have been observed upon the systemic administration of minocycline than with other tetracyclines. Examples of serious adverse effects include hypersensitivity syndrome reaction, drug-induced lupus, idiopathic intracranial hypertension, and other autoimmune syndromes that may cause death. Here, we review adverse effects and drug–drug interactions observed with oral administration of minocycline and contrast this with topical minocycline formulations recently approved or under development for effectively treating dermatological disorders with fewer adverse effects and less drug interaction.

[Retracted] Analysis of the Effect of DPL Combined with Clarithromycin in the Therapy and Improvement of Rosacea

“…The etiology and pathogenesis of rosacea are complex and are related to Propionibacterium acnes infection, abnormal androgen secretion, strong sebum secretion, and other factors. In addition, genetic factors, neuroimmune dysfunction, etc., may also lead to rosacea [ 1 , 2 ]. The commonly used clinical treatment of rosacea is oral medicine or external medicine, which has antibacterial and anti-inflammatory effects.…”

Minocycline and the SPR741 Adjuvant Are an Efficacious Antibacterial Combination for Acinetobacter baumannii Infections

“…However, in vivo studies to date have been limited [ 31 , 58 ], and to our knowledge, this is the only study that has evaluated SPR741 with minocycline in vivo . Given the known toxicities associated with the tetracycline class, and minocycline in particular [ 59 ], the combination of minocycline with SPR741 offers an attractive approach for future clinical applications given that SPR741 was successful in a Phase 1 clinical trial [ 60 ] and because the minocycline dosage could be lowered. The data presented here are encouraging with respect to the use of SPR741 and other polymyxins in combination with minocycline and could become crucial in the fight against XDR bacteria, which has become a global problem poised to reach epidemic proportions.…”

A randomized, controlled trial of intense pulsed light in combination with minocycline hydrochloride for the treatment of inflammatory acne vulgaris

“…It also can inhibit the chemotaxis of the complement C system and neutrophils to mitigate the inflammatory response. The curative effect of minocycline is well documented, 17 but it is also associated with many adverse effects such as scleral, dermal hyperpigmentation, 18 and antibiotic resistance 19 3 …”

“…The curative effect of minocycline is well documented, 17 but it is also associated with many adverse effects such as scleral, dermal hyperpigmentation, 18 and antibiotic resistance. 19 Therefore, there is an effort to develop concomitant therapeutic strategies with minocycline to reduce the dosages of antibacterial drugs, which is recommended by our acne treatment guidelines. 3 IPL has emerged as a non-invasive modality for acne treatment with few adverse effects.…”