Successful treatment of minocycline‐induced pigmentation with combined use of Q‐switched and pulsed dye lasers

Minocycline is a tetracycline antibiotic that can induce hyperpigmentation and scarring of the skin, nails, mucous membranes, thyroid, teeth, bones, and heart valves. Minocycline-induced cutaneous hyperpigmentation consists of three types. Type I pigmentation occurs in areas of prior inflammation such as scars, and it is not thought to be dependent on treatment dose or duration. Type II pigmentation and type III pigmentation, which occur on normal skin and sun-exposed skin, respectively, appear to be dose-related. This side effect can persist for years if not permanently despite treatment attempts, and definitive therapy does not exist. A few case reports have documented successful treatment of minocycline-induced pigmentation with Q-switched lasers and nonablative fractional photothermolysis, but the potential for combination laser therapy is not well-studied. Additionally, little is known about the efficacy of pulsed dye lasers in treating drug-induced pigmentation. Here, we report a case of successful resolution of minocycline-induced hyperpigmentation with combined Medlite Q-switched and Vbeam pulsed dye laser treatment.