For decades we have known that one of the very best antibiotics at our disposal to treat inflammatory skin conditions, especially acne and rosacea, is minocycline. Minocycline is like all antibiotics in that it kills bacteria. However, more important than this is its anti-inflammatory effect.
Minocycline for Acne & Rosacea
Acne vulgaris and papulopustular rosacea are two clinically similar conditions that both affect the face and cause breakouts. With these types of acne, we tend to see inflamed bumps, some of them with an overlying white cap. These are called papules and pustules. Inside these bumps, there are inflammatory white blood cells that substantially contribute to the problem with their inflammatory properties, including the release of proteins that further worsen inflammation.
History of Rosacea and Acne Medication
For decades, oral antibiotics (those taken as a pill by mouth) have been the antibiotic of choice to treat acne and rosacea (the National Rosacea Society explains why here). The best dermatologists have worked to be more conservative with the use of these medications because of their other potential long-term effects on the body. Taking this into consideration, our general approach at Advanced Dermatology of the Midlands has always been to discuss plans for how to minimize exposure to oral antibiotics whenever we are prescribing them.
When treating these specific conditions with oral antibiotics, we also counsel patients on how they should reduce and attempt to stop the antibiotic in time as they improve. This helps to minimize systemic exposure and potential side effects. We also frequently use topical (applied) antibiotics instead of (or along with) oral antibiotics. This allows us to get the best effect possible for our patients with the highest level of safety. Where necessary, this combination can make it easier to stop the oral antibiotic more rapidly.
Minocycline has remained the most prescribed oral antibiotic for acne and papulopustular rosacea. Yet, up to now, we haven’t had a topical version of this medication. The exciting news is that all that has changed!
Types of Topical Minocycline for Acne
Amzeeq (4% minocycline foam)
Amzeeq entered our repertoire for treating acne about a year ago. We have seen some excellent results so far in kids ages 9 and older. This is fantastic because we are seeing more and more acne in the preteen/prepubertal age group.
Active Ingredient
The active ingredient in Amzeeq is minocycline, which belongs to a class of antibiotics called tetracyclines. In Amzeeq, minocycline is formulated as a topical foam.
How to Use:
The foam should be applied once daily to the affected areas of the skin after washing and drying the skin thoroughly. A thin layer of foam should be gently massaged into the skin until it disappears. It’s important to avoid contact with the eyes, mouth, and mucous membranes.
Side Effects
Common side effects of Amzeeq may include headache, application site pain, application site dryness, application site erythema, and contact dermatitis. Serious side effects are rare but may include hypersensitivity reactions and severe skin reactions.
Amzeeq is available by prescription only and should be used under the guidance of a healthcare professional.
Zilxi (1.5% minocycline foam)
Zilxi was more recently approved for use in rosacea. It is best in treating the type of rosacea known as papulopustular rosacea. Patients with this condition are generally adults and have scattered pimple-like areas on the face. Zilxi is already showing good promise in our practice, with many patients having excellent results.
Active Ingredient
The active ingredient in Zilxi is minocycline, which belongs to a class of antibiotics known as tetracyclines. Minocycline works by reducing inflammation and controlling the growth of bacteria associated with rosacea.
How to Use:
Zilxi should be applied once daily to the affected areas of the face. It is important to follow the instructions provided by your healthcare provider for proper application and dosage.
Side Effects
Common side effects of Zilxi may include application site reactions such as skin irritation, itching, burning, or redness. These side effects are usually mild to moderate and tend to improve with continued use. Serious side effects are rare but may include allergic reactions or worsening of the underlying skin condition.
Zilxi is available by prescription only and should be obtained through a licensed healthcare provider. It is important to use Zilxi exactly as prescribed and to follow up with your healthcare provider as directed to monitor your progress and any potential side effects.
We are very excited to have these medications available to offer to our patients as well as an entire repertoire of other great rosacea and acne treatments.
Consider scheduling a consultation for treatment of your complexion.
Long-Term Effects of Minocycline for Acne
While it’s primarily used to treat various bacterial infections, including acne, rosacea, respiratory tract infections, and urinary tract infections, its long-term use may lead to certain side effects and considerations:
- Photosensitivity
- Discoloration of Teeth and Skin
- Gastrointestinal Effects: nausea, vomiting, diarrhea, and abdominal pain.
- Vestibular Effects: dizziness, vertigo, and imbalance, especially when taken in high doses or for an extended period.
- Hepatotoxicity: elevated liver enzymes, hepatitis, or liver failure.
- Central Nervous System Effects: headaches, dizziness, or lightheadedness
It’s essential to use minocycline under the guidance of a healthcare professional, following prescribed dosages and duration of treatment. Regular monitoring for side effects and adjusting treatment as necessary can help mitigate potential long-term effects. Additionally, discussing any concerns or changes in health with a healthcare provider is crucial for managing the risks associated with minocycline.
Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists
At Advanced Dermatology the Midlands Our vision is to deliver the highest level of dermatological care, using the most advanced technology and evidence-based medicine in a personalized and compassionate environment. Contact us to schedule a consultation.
