Patients with acne treated with doxycycline more prone to seasonal hyperpigmentation
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Key takeaways:
- Patients that were prescribed doxycycline were affected by seasonal differences (P = .016).
- Patients taking doxycycline received more diagnoses of hyperpigmentation in the spring than the winter (P = .006).
Doxycycline was associated with an earlier onset of acne-related hyperpigmentation during seasons with high sun exposure, whereas minocycline was not, according to a study.
“Although oral tetracyclines are widely prescribed for acne given their anti-inflammatory properties, they independently increase the risk of hyperpigmentation, particularly in the setting of sun exposure,” Katherine Young, BS, MEng, of Harvard Medical School, and colleagues wrote.
To evaluate the seasonal trends associated with various oral tetracyclines, the authors performed a retrospective review of patients with acne (n = 2,830; mean age, 29.9 years; 16.6% male) seen at Mass General Brigham between 1992 and 2022.
Patients that were prescribed doxycycline (n = 546) were affected by seasonal differences (P = .016) whereas those prescribed minocycline (n = 148) were not. Patients taking doxycycline received more diagnoses of hyperpigmentation in the spring compared with the winter (P = .006), with the most diagnoses in April.
On the other hand, acne patients who never received a tetracycline (n = 2,136) still experienced seasonal diagnoses of hyperpigmentation with those diagnoses peaking in May (P < .001). Additionally, Google searches for hyperpigmentation-related terms were much higher in the spring and summer compared with the fall and winter (P < .001).
The data together suggests that sunlight exposure is a potential risk factor for hyperpigmentation as new diagnoses of hyperpigmentation frequently occurred in the spring and summer with diagnoses among doxycycline-treated patients, specifically, peaking in the early spring.
“For those taking doxycycline, early and aggressive photoprotection prior to the spring may be of benefit,” the authors said.
However, minocycline may be an alternative option for acne patients during these seasons.
“We found no significant evidence of seasonal variation among acne patients taking minocycline, which is thought to be equally effective in treating acne and less photosensitizing than doxycycline,” the authors concluded. “This may suggest a potential benefit of using minocycline over doxycycline during months with more sun exposure, as well as considering other alternatives to tetracyclines whenever possible.”
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