Treating Acne With Oral Minocycline

Minocycline is a medication used to treat inflammatory acne. The medication is typically prescribed to people aged 12 years and older who have moderate to severe acne. 

Minocycline for acne has benefits, but it can take up to two months to see improvements after you start treatment. 

Minocycline is part of a group of antibiotics called tetracyclines. Doxycycline and tetracycline, two other acne treatments, also belong to this group. It's also used to treat respiratory and urinary tract infections, and some sexually transmitted infections (STIs).

This article discusses minocycline for acne, including dosages, side effects, and how quickly it works.

Minocycline Benefits

Minocycline has been used to treat acne for a long time—however, it’s rarely used alone. Minocycline for acne is almost always prescribed along with a topical acne medication. The combination usually leads to better results than just using minocycline.

Minocycline treats acne in two ways:

• It stops the growth of bacteria that cause acne breakouts
• It reduces inflammation

Minocycline will not help with blackheads and other non-inflamed blemishes. Topical retinoids are a better choice for those skin problems. Minocycline also does not help with acne scarring. 

Minocycline Dosage

Minocycline has a common starting dosage of 50 to 100 milligrams (mg), one or two times a day.

You'll slowly stop taking (taper off) minocycline treatment once your acne is under control. 

At this point, acne can often be kept in check by using topical treatments alone. 

Sometimes, oral antibiotics have to be taken long-term to keep acne from returning.

What to Expect While Taking Minocycline

Minocycline comes in a capsule, or, as the brand Solodyn, an extended-release tablet. 

If your healthcare provider prescribes the capsule, you'll take it either two or four times a day at regular intervals. Solodyn is a once-per-day treatment.

All brand-name versions of minocycline can be taken with or without food, but the generic form needs to be taken either one hour before or two hours after a meal. Regardless of the brand or formulation, you should drink a full glass of water with every dose of minocycline. 

Follow the instructions from your provider. Do not take more of the medication than has been prescribed for you. 

For the first few days that you take minocycline capsules (not extended-release tablets), start with a single daily dose—usually recommended at bedtime—and work up to the full prescribed amount. 

Side effects that you may have when you first start minocycline include:

• Dizziness
• Headaches

Most people taking minocycline at night find that these symptoms are gone by morning. Your provider or pharmacist can guide you on when to start taking additional daily doses of minocycline. 

How Quickly Does Minocycline Work?

It can take six to eight weeks for minocycline to work for acne. If you're also using a topical acne treatment, you may start seeing results from that before the minocycline is in full effect.

Since it can take two months to notice any changes, expect your provider to want you to take minocycline for at least three months to see if it’s working.

Side Effects

Common side effects of minocycline treatment include:

• Nausea and vomiting
• Diarrhea
• Dizziness

Bluish discoloration of the gums, mouth, skin, nails, tears, and urine can also happen with long-term minocycline use but it usually goes away when the medication is stopped. A bluish discoloration of the teeth is uncommon but possible and might be permanent. 

Other less common side effects of minocycline include:

• Itching of the vagina or rectum
• Tinnitus (ringing of the ears)
• Hair loss
• Dry mouth
• Swollen tongue
• Sore throat
• Inflammation in the tip of the penis
• Muscle pain
• Mood changes
• Numbness, tingling, or prickling sensations

If you have side effects that are not getting better or are making it hard to stay on your treatment, tell your provider. They might be able to adjust your dose or recommend a different treatment. 

Who Should Not Take Minocycline?

Minocycline should not be used if you’re pregnant or breastfeeding.

Children under the age of eight should use minocycline because of the risk of permanent tooth discoloration. Some experts recommend waiting until after age 10 or even age 12 to start minocycline.

Drug Interactions

Minocycline can interact with several medications. If you take any of these medications, your provider might need to change your dose or change your medication.

Drugs that can interact with minocycline include:

• Low-dose oral contraceptives (birth control pills). Minocycline may lower the effectiveness of some birth control, which could lead to breakthrough bleeding or unwanted pregnancy. You should use an additional form of birth control while you are taking minocycline.
• Anticoagulants. The dosage of these blood thinners may need to be lowered while you are taking minocycline. Examples of anticoagulants are Coumadin (warfarin), Xarelto (rivaroxaban), and Eliquis (apixaban).
• Penicillin. Minocycline may change how these antibiotics work. Combining these medications is not advised. Examples of penicillin drugs are amoxicillin, ampicillin, and oxacillin.
• Methoxyflurane. Combining this inhaled anesthetic with minocycline can lead to fatal kidney toxicity. The brand name of the drug is Penthrane.
• Other tetracyclines. Taking minocycline with other drugs in its class may also lead to severe kidney toxicity.

Absorption of minocycline can be affected by certain metals or nutrients that are used medicinally. Let your provider know if you regularly take:

• Antacids (which may contain aluminum, calcium, or magnesium)
• Calcium supplements
• Magnesium supplements
• Iron supplements

Your provider should always have a complete list of all the medications you take, including prescription, over-the-counter, and supplements.

When to See a Healthcare Provider

Minocycline can cause serious side effects, but they're less common. Call your healthcare provider or get medical attention immediately if you have:

• Blurry, double, or loss of vision
• Rash, hives, or blistering/peeling skin
• Swelling of the face, throat, tongue, lips, and eyes
• Problems breathing or swallowing
• Yellowing eyes or skin with nausea, vomiting, or confusion
• Bloody urine
• Watery or bloody stools with stomach cramps or fever (up to two months after stopping treatment)
• Joint pain or inflammation
• Swollen lymph nodes
• Unusual bleeding or bruising
• Seizures
• Chest pain or irregular heartbeat

If any of these symptoms occur, your provider will likely want you to stop taking minocycline. However, do not stop the medication without talking to a provider first.

Summary

Minocycline is used to treat acne. You will usually take it along with another kind of acne treatment. 

It can take weeks or even a couple of months to work but minocycline is very effective for inflammatory acne. It won’t help with milder forms of acne, though.

Like most medications, there are side effects and risks of minocycline and some people cannot take it. Talk to your provider about whether minocycline is an acne treatment option that you could try.