Tetracyclines may pose greater hyperpigmentation risk

According to a study presented at the Society for Investigative Dermatology's recent annual meeting, doxycycline is significantly associated with the development of new hyperpigmentation in acne patients, particularly in patients with skin of color.

[Dermatologists discuss new understandings of the pathogenesis of melasma and emerging treatments inDermWorld.]

The researchers identified over one million patients diagnosed with acne, including 150,714 who were prescribed doxycycline, 43,987 prescribed minocycline, and 38,112 prescribed cephalexin for oral monotherapy. They found that patients who received doxycycline and minocycline were more likely to develop new hyperpigmentation versus those given cephalexin. Odds of new hyperpigmentation associated with doxycycline versus cephalexin were higher in Black, Hispanic, and Asian patients. Results were similar but with lower risk for minocycline versus cephalexin.

The researchers suggest that dermatologists may want to lean more toward minocycline when prescribing for patients. Also, they recommend taking a second look at topical formulations of antibiotics as well as counseling patients about sunscreen use, particularly in patients with darker skin.

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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