Minocycline induced pigmentation in the treatment of acne—a review and personal observations

We prospectively investigated 300 patients who had taken oral minocycline for the treatment of acne. The incidence of iatrogenic pigmentation was 3.7 per cent (3.2 per cent on doses of 100 mg daily and 4.9 per cent on doses of 200 mg daily). In two patients, diffuse muddy pigmentation developed; this was clearly exacerbated by sunlight, and persisted 2 and 4 years after stopping therapy. In a further two subjects, pigmentary change was demonstrated at sites distal to the acne sites. In eight patients, the pigmentation occurred around areas of acne inflammation and/or scarring. The latter two types of pigmentation usually resolve; in eight of the nine affected subjects it resolved on discontinuing therapy. The time of resolution varied from 6 to 18 months (mean 12 months).